Email the Daum Agency

Thank you for your interest in the Daum Agency. Please provide your questions or comments about our products or services we will get back to you as soon as possible. A valid email address is needed in order to send you a copy of this inquiery and an electronic response. Please read the Important Notice shown below before sending your email.

First Name: (required) Address:
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Email Address: (required) State:
Telephone: (required) Zip Code:

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If by phone, when would you like to be contacted?
Please provide me with information on the following insurance products:
Automobile
Snowmobile
Health Insurance 		Homeowners
Boat
Business 		Umbrella
Life insurance
Long Term Care
Please contact me to discuss the following partnership opportunities:
MEEMIC Foundation Grants
Speakers Bureau
Sponsorship Programs
Comments:

Important Notice We will strive to contact you within one (1) business day upon receipt of your email.

However, we cannot guarantee the exchange of information over the Internet. Your email may be reviewed by the Company and you may be contacted to confirm that your request was fulfilled. Your sending of email is your consent for the Company to review the content of your email. Please note that we cannot ensure the confidentiality of information sent over the Internet. Communicating via email does not constitute an offer of coverage. For your protection, we require a personal conversation between you and your agent (or an authorized person in your agent's office) prior to binding new coverage or coverage changes - which means that new coverages or changes in coverage cannot take effect until this conversation occurs.

Policy conditions, terms, and eligibility can vary from state to state. MEEMIC coverages are subject to the policy terms and conditions detailed in the insurance contract issued after purchase.

MEEMIC reserves the right to declare any information or material received to be the intellectual property of MEEMIC upon receipt of the information or material in any form.

This form may not be used to report claims.