Melvin - RightWay Insurance

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Address: 111 Center Park Drive Suite 106 Knoxville, Tennessee 37922
Phone: (865) 293-7520
Email: service@RightWayInsuranceTN.com

Why Us?
Our Products
Tools
- Service Center
- Compare My Policy
Contact Us
Join Our Team
Get Quotes

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Melvin C. Jackson, III

Insurance Agent

Father / Coach / BBQ Connoisseur

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Get Insured With Melvin Today!

Step 1 of 9

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Name*
First Last
Email*
Phone*
How did you hear about us?*
- Facebook
- Google
- Referred by Realtor
- Referred by Loan Officer
- Referred by a Friend
- Other
Name of person that referred you: (We want to thank them!)
Telling us how you heard about us, helps us!

What products can we quote for you?*
You can save up to 35% by bundling.
Are you sure?*
If we quote one product, we'll still give you the solo option.

Current Address
Street Address Address Line 2 City Tennessee ZIP Code
Are you in the process of buying a home?*
New Address*
Street Address Address Line 2 City Tennessee ZIP Code
Projected Closing Date
MM slash DD slash YYYY

What is your date of birth?*
MM slash DD slash YYYY
Marital Status*
Spouse/Partner's Name*
First Last
Spouse/Partner's Date of Birth*
MM slash DD slash YYYY
Do you have any pets?*
Please list the type of pet(s) and quantity, including breed.
Do you have one of the following?*
Do you want Sinkhole Coverage?*
Check out a Tennesse Sinkhole map here: https://tnlandforms.us/heatmap/3x3heat.html
Do you want Earthquake Coverage?*
See Earthquake risk map here: https://earthquake.usgs.gov/earthquakes/byregion/tennessee-haz.php

Name of Current Auto Insurance Carrier*
What best matches your current bodily injury limits?*
(To the best of your knowledge)

Vehicle 1 - Year, Make, & Model*

Please include VIN if known
Another Vehicle?*
Vehicle 2 - Year, Make, & Model*

Please include VIN if known
Another Vehicle ?*
Vehicle 3 - Year, Make, & Model*

Please include VIN if known
Another Vehicle ?*
Vehicle 4 - Year, Make, & Model*

Please include VIN if known

Driver #1 - Full Name, Date of Birth, & Driver's License Number*
Driver #2 - Full Name, Date of Birth, & Driver's License Number
Is there another driver in the home?*
Driver #3 - Full Name, Date of Birth, & Driver's License Number*
Driver #4 - Full Name, Date of Birth, & Driver's License Number

Height
Weight
Date of Birth
MM slash DD slash YYYY
Tobacco Use
Amount of Coverage Desired
- $50,000
- $100,000
- $250,000
- $500,000
- $750,000
- $1,000,000
If you have existing medical conditions, please list below:

Would you like a video explaining the proposal we found for you?*
- Yes
- No
This is a very helpful option we offer to make sure you understand your policy coverage.
Have any files to attach?
Drop files here or

Max. file size: 98 MB, Max. files: 4.
Some people attach files of their current policy, declaration page, screenshots, etc.

Address: 111 Center Park Drive Suite 106 Knoxville, Tennessee 37922
Phone: (865) 293-7520
Email: service@RightWayInsuranceTN.com

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