Become an Agent

Join the Lighthouse Excalibur family

Lighthouse Excalibur partners with top agencies in Louisiana to serve our policyholders. We have designed a geographically diverse strategy that allows our agents some exclusivity in their respective territory while giving us a balanced spread of risk. Please complete all fields below and a member of our Sales Team will contact you to review our voluntary program details.

(Submission of the below form does not guarantee an appointment with Lighthouse Excalibur Insurance Company.)

Submission Form:

Agency Name *

DBA, if applicable

Agency Pricipal’s Name *

Agency Principal’s Phone Number *

Principal’s Email Address *

Key Contact’s First Name *

Key Contact’s Last Name *

Key Contact’s Phone Number

Key Contact’s Email Address

Street Address *

Address 2

City *

State *

Postal Code

County/Parish

Writing State *

Please select the state your agency will be writing in. If different than these options, please explain in the additional information section below.

Agency Phone Number *

Agency Fax Number

Agency Website

Please indicate what type of organization your agency is. *

Agency Premium Volume ($) *

What percentage (%) of your book of business is Personal Lines? *

Please enter a number from 0 to 100.

What percentage (%) of your book of business is Commercial Lines? *

Please enter a number from 0 to 100.

Does your agency pursue small commercial business? *

Yes:

No:

Does your agency utilize BOP and Commercial Property for these risks where the TIV is $5M or less? *

Yes:

No:

How much of this type business does your agency write? *

Length of time your agency has been in business. *

Number of Homeowners policies written per month. *

Number of Flood policies written per month. *

Who are your top five (5) Personal Lines Carriers? *

What is your Personal Lines Pure Loss Ratio? (%) *

Do you use a competitive rater? *

Have you previously been appointed or worked for an agency that was appointed with Lighthouse Property Insurance Corporation? *

Yes:

No:

Why do you believe an appointment with Lighthouse Property Insurance Corporation would be mutually beneficial? *

Is there any additional information you would like to include in your application?

How did you hear about us? *

* required