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ID Theft
Why do I need Identity Theft Insurance? Am I really at risk? Yes. More than 15 million people become victims of identity theft every year, and over 200 million identities were breached in 2007. An identity is stolen every two seconds in the United States - it's been the fastest growing crime in the U.S. for the past four years. But with Advance Insurance, you can protect yourself and your family's identity so you don't become a statistic. By providing us with your personal information, we will be able to verify your identity and register you as a member. All of the information you provide will be transferred to us through a private, secure connection.
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