1 Your Bike 2 About You 3 Review Policy4 Purchase Policy This will be quick and simple.Just tell us a little about your bike and yourself first. 1How much would you like to insure your bike for? Bike Value*2Tell us about your bikeBike Type*Select bike typeRoad BikeElectric BikeMountain BikeBMXBike BrandBike ModelBike Year3Did you buy your bike brand new?Did you buy your bike brand new?*YesNo4Did you buy your bike this year?Did you buy your bike this year?*YesNoWhen did you buy it?Purchase year (manual input)Purchase year (сurrent year)Actual purchase year5How much did you pay for it?Bike purchase price*6What’s your primary reason for cycling?Reason for cycling*Please select ...CasualCommuterCompetitiveFitness7Do you belong to any of these bike associations?Bike association*Please select ...NoneIMBAUSA CyclingUSA TriathlonOther8What additional coverage would you like to add to your quote?CASUAL OR FITNESS* No additional coverage for me. I only want basic bike coverage Bicycle Liability CoverageUp to $25,000 in coverage Medical Payment Coverage Up to $1,000 in coverage Vehicle Contact Protection Up to $10,000 in coverage Worldwide Physical Damage Full-value coverage Roadside assistance LiabilityBicycle Liability Coverage / CASUAL OR FITNESSMedicalMedical Payment Coverage / CASUAL OR FITNESSVehicleVehicle Contact Protection / CASUAL OR FITNESSWorldwideWorldwide Physical Damage / CASUAL OR FITNESSRoadsideRoadside assistance / CASUAL OR FITNESSCOMMUTER* No additional coverage for me. I only want basic bike coverage Bicycle Liability Coverage Up to $25,000 in coverage Medical Payment Coverage Up to $1,000 in coverage Vehicle Contact Protection Up to $10,000 in coverage Worldwide Physical Damage Full-value coverage Roadside assistance LiabilityBicycle Liability Coverage / COMMUTERMedicalMedical Payment Coverage / COMMUTERVehicleVehicle Contact Protection / COMMUTERWorldwideWorldwide Physical Damage / COMMUTERRoadsideRoadside assistance / COMMUTERCOMPETITIVE No additional coverage for me. I only want basic bike coverage Bicycle Liability Coverage Up to $25,000 in coverage Medical Payment Coverage Up to $1,000 in coverage Vehicle Contact Protection Up to $10,000 in coverage Worldwide Physical Damage Full-value coverage Roadside assistance LiabilityBicycle Liability Coverage / COMPETITIVEMedicalMedical Payment Coverage / COMPETITIVEVehicleVehicle Contact Protection / COMPETITIVEWorldwideWorldwide Physical Damage / COMPETITIVERoadsideRoadside assistance / COMPETITIVE9Choose your deductible:Deductible / bike purchase price <=$1,333.00 / competitive*$500Deductible / bike purchase price <=$1,333.00 / competitive*$500Deductible / bike purchase price <=$1,333.00 / competitive*$500Deductible*$500$300$200Selected Deductible Factorselected DEDUCTIBLEDON'T DELETE JS added to this field idselected ADDITIONAL COVERAGESDON'T DELETE JS added to this field idADDITIONAL COVERAGES TOTALDON'T DELETE JS added to this field id This will be quick and simple.Your seconds away from a quote and choosing a policy.1Let’s get some info about you Don’t worry, we hate spam just as much as you do Contact Name* First Name * Last Name * Email* Phone Number*By requesting a quote you agree to our terms & privacy policyprivacy-policy checkbox* By requesting a quote, you agree to the Simple Bike Insurance Privacy Policy ** My Simple Bike Insurance QuoteMy Bicycle Bicycle & lock value: Bike Type: Brand: Model: Is your bike new: Bike purchase year: Bike purchase price: Reason for cycling: My Contact Information First Name: Last Name: Email: Phone: Policy Details Bike repair or replacement at full-value* Spare part, cycling accessory, and apparel cost reimbursement* Temporary bicycle rental cost reimbursement* Transit protection to and from locations within the United States and Canada Bicycle liability coverage Medical payment coverage Deductible: *In case of damage, theft, crash, vandalism, or collision with other cyclists Basic Bike Insurance Policy Additional Coverages: TOTAL: /Year (/Month) Price questions? Contact us We just need a little more information. Fill out the form below to purchase and activate your policy. Are you an operator for this bike? Are you an operator for this bike?*YesNoWho is the operator of this bike? Operator Name* First Name Last Name Do you need to add additional operators? You may add up to three. additional operators Yes Add operator 1Add operator 2Add operator 3Who is the primary operator? Primary OperatorSelect primary operator ... Primary Operator’s Date of Birth Date of Birth* Date Format: MM slash DD slash YYYY Primary Operator’s Mailing Address Where do you live?*United StatesCanadaPrimary Operator’s Mailing Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Primary Operator’s Mailing Address* Street Address Address Line 2 City Province AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Postal Code Is the bike at the same location as the mailing address above? Is the bike at the same location as the mailing address above?*YesNoWhat’s the primary location of the bike? What’s the primary location of the bike?* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code What’s the primary location of the bike?* Street Address Address Line 2 City Province AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Postal Code Primary Operator’s Phone Number Phone NumberPrimary Operator’s marital status? Marital statusSingleMarriedCivil UnionDomestic PartnershipPrimary Operator’s gender identity? GenderMaleFemaleOtherIs the Primary Operator a homeowner? Is the Primary Operator a homeowner?YesNoIs the Primary Operator a triathlete? Is the Primary Operator a triathlete?YesNoIs the Primary Operator a professional cyclist? Is the Primary Operator a professional cyclist?YesNoEnter the bike’s serial number (also known as a frame ID): *serial number (can be letters, numbers, or both)Where’s my serial number? Bicycle serial numberBasic Insurance per YEAR /purchase price LESS $1333Basic Insurance per YEAR /purchase price MORE $1333TOTAL per YEARTOTAL per MONTHTOTAL per MONTH (no fee)Simple Bike Insurance (annual subscription) Price: $0.00 Simple Bike Insurance (monthly subscription) Price: $0.00 Purchase My Policy:Payment*/Month/YearPayment Method*Credit CardEmailThis field is for validation purposes and should be left unchanged.
