California Consumer Privacy

The CCPA (California Consumer Protection Act) provides consumers (California residents) with specific rights regarding their personal information. For more information on your CCPA rights and choices, please visit our Enterprise Privacy Statement. You may use this webform to submit your requests as permitted by CCPA. Information you provide in connection with your request will not be used for marketing purposes.

*Mandatory field

I am submitting this request: *

For myself

On behalf of someone else

Submitting a request on behalf of someone else will require legal proof that you have the authorization to represent them for this request. Please call our Consumer Request Line directly so a representative can assist you with completing this request. Dial 1-855-327-6548 Monday to Friday from 8 a.m. to 5 p.m. Pacific time.

Request Type *

Access my Data

Do not sell my data (Opt-Out)

Receive My Data Categories

Opt In

Delete My Data

Consumer Information

First name *

Last name *

Address line 1 *

Address line 2

City *

Zip code *

Phone *

Date of Birth *

Policy Number(s)

Claim Number(s)

Quote Number

CCPA Request Form

Request Type *

Consumer Information

Acknowledgment

Acknowledgment