Agent Appointment Request | Conifer Insurance

Effective March 20th, 2019, Conifer has suspended cancellation of policies due to non-payment of premium for clients who indicate financial impact by the recent COVID-19 outbreak and are experiencing trouble making a payment. Additionally, late pay fees have been waived at this time.

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Become a Conifer Agent


The Conifer Holdings family of companies offers innovative niche market products through a network of independent agents and brokers.

If you are interested in becoming an agency partner, please complete our agency appointment form. From there, you can expect to have a member of our team evaluate and reach out with further information on a potential appointment.

[ACTIVE] Appointment Application - Shortened Version
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Agency Information

if applicable
Agency Physical Address *
Agency Physical Address
City
State
Zip/Postal

Program Interest

Please Select the Program(s) of Interest
MGA Partner Program(s) of Interest
by selecting any of these programs, your information will be provided to the appropriate MGA partner to assist further.