Personal property
enrollment form
Enroll online at www.haylor.com/pp OR complete the
application below.
Coverage
Amount
With a
$50 Deductible
With a
$100 Deductible
Your annual premium is:
Your annual premium is:
$2,000
 $70
 $65
$4,000
 $95
 $90
$6,000
 $145
 $140
$8,000
 $190
 $185
$10,000
 $225
 $220
$12,000
 $250
 $245
$20,000
 $295
 $290
You value your
personal property.
Now learn how
you can protect it.
ZIP code at permanent address ___ ___ ___ ___ ___
College ID # _______________________________________________________________________
Name ______________________________________________________________________________
First Name
Last Name
Home address ____________________________________________________________________
City ____________________________________ State _____ ZIP___________
Primary phone # __________________________________________________________________
Parent email _______________________________________________________________________
Signature of student or parent/guardian if under 18 years of age
______________________________________________________________________________________
Premium amount (from above) $ _________________
 My check payable to Haylor, Freyer & Coon is enclosed.
 I’m paying by credit card:  Visa  MasterCard  Discover
Card # ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___
Expiration Date ___ ___ /___ ___
Haylor, Freyer & Coon, Inc.
Attention: Collegiate Division
P.O. Box 4743
Syracuse, NY 13221-4743
Student email _____________________________________________________________________
Worldwide coverage for
your laptop, smartphone,
bike, camera, clothing
& other stuff
Name on account _______________________________________________
Signature _______________________________________________________
Cardholder’s mailing address:
Street ___________________________________________________________
Enroll at:
City ____________________________________ State _____ ZIP___________
www.haylor.com/pp
Eligibility and terms
Plan covers
Covered losses
n Cell phone
n Computer
n Books
n Clothes
n TV/Monitor
n Musical instrument
n Electronics
n Bicycle
n And more
n Theft
n Vandalism or
malicious mischief
n Fire, lightning, smoke
n Collision or overturn
of transporting
conveyance
n Explosion/Windstorm
n Accidental damage
Price of coverage:
As little as
$65 annually
Covering your personal
belongings is more than dollars
and cents. With HF&C personal
property coverage, we’ll
insure all you value.
Why you should enroll
n Low deductible (what you’ll pay before coverage
kicks in)
n Simple claims process
n Peace of mind for students and parents
n Coverage that’s active whether on or off campus,
a worldwide benefit
n All registered students (both undergraduate and
graduate), faculty and staff are eligible.
n This coverage is being offered as a resource to you
on behalf of your college/university, which
encourages your participation.
n Coverage begins on Aug. 15, 2015, and ends
Aug. 15, 2016. If you enroll after Sept. 5, 2015,
coverage will become effective 5 days from the
date the form is received or processed online at
www.studentinsuranceprograms.com/pp.
n A certificate of coverage will be provided to you
upon enrollment.
Peace of mind: Priceless
How to enroll
Online: www.haylor.com/pp
By mail: Complete the form in this brochure and
return it to: Haylor, Freyer & Coon, Inc.
Attention: Collegiate Division
P.O. Box 4743
Syracuse, NY 13221-4743
Policy limitations/exclusions
Coverage for theft losses pertaining only to jewelry,
precious metals and stones, is limited to $2,000 per
loss, with a maximum payout equaling $4,000 for such
items during the period of coverage.
A $100 deductible applies to all mobile/electronic
devices for accidental damage, regardless of which
coverage limit/deductible you select.
Your policy does not cover the following:
n Financial documents, stock, cash, intellectual
property, transportation or other tickets, bouillon,
manuscripts or mechanical drawings
n Unexplained disappearance
n Automobiles, motorized vehicles of any kind,
including vehicle equipment or accessories
n Theft from a vehicle, unless there are visible signs
of forced entry
Please review the certificate of coverage for
complete policy details.
Accepted forms of payment
Or check made payable to
Haylor, Freyer & Coon, Inc.
Connect with us
By phone: 866-535-0456
By email: [email protected]
https://www.facebook.com/hfcinc
Service of this plan
Coverage is provided by Harleysville Insurance, long
recognized among U.S. companies for its superior
financial strength and exceptional customer service.
Enrollment, administration and claim processing are
handled by Haylor, Freyer & Coon Insurance Agency.
As your insurance representative and at your direction, is it our
role to procure insurance proposals on your behalf, to place
coverage per your instructions and provide policy service during
the policy term. Insurance companies pay us a sales commission
on policies we place with them. The amount we are paid may
vary among the insurers we represent. We may receive
additional compensation through a contract provision with an
insurance company that is contingent on our overall profitability
and/or premium volume with the carrier. At your request, we will
provide information on the actual compensation we expect to
receive from the sale of insurance policy(s) to you, or what we
would have expected to be paid had you selected any alternate
quotations that we might have presented to you.
Z-1236 04/15