Dwelling and Homeowners

Additional Location Supplemental Application
(Complete in addition to Dwelling Fire Application)

PDF icon Additional Location Supp (9/12)

Dwelling Application - Illinois, Indiana and Ohio
- Roush Dwelling Program (DP-1, Market Value)
Please click the Roush Rater button on the main menu.

Dwelling Fire Application

PDF icon Dwelling Fire App (2/13)

Homeowner Application

PDF icon Homeowner App (2/12)

In Home Business Supplemental Questionnaire
(Complete in addition to Homeowner Application)

PDF icon In Home Business Supp (6/11)

Mobile Home Application

PDF icon Mobile Home App (11/16)

Protection Class Questionnaire
(Complete for PC 8B, 9 & 10 in addition to Homeowner Application)

PDF icon Protection Class Quest (4/14)

Residential Builder's Risk Supplemental Application
(Complete in addition to Dwelling Fire Application)

PDF icon Residential Builder's Risk Supp (6/07) R

Supplemental Heating Questionnaire
(Required if any form of supplemental heating)

PDF icon Supplemental Heating Quest (12/02)

About Us

Roush Insurance Services, Inc. is a wholesale general insurance agency that has been in business since 1990. We offer licensed insurance agents access to the excess and specialty market for risks domiciled in Indiana, Illinois and Ohio.

Industry Links

Our memberships in WSIA, PIA of IN, IIA of IN and IIA of IL enable us to stay abreast of industry developments and better serve your insurance needs.

Contact Us

Roush Insurance Services, Inc.
18077 River Road, Suite 107
Noblesville, IN 46062-8311
Toll Free: (800) 752-8402
Phone: (317) 776-6880
Fax: (317) 776-6891
Submissions: quote@roushins.com
Claims: claim@roushins.com
Accounting: accounting@roushins.com
Information: info@roushins.com