Get an insurance quote or talk to a broker1-800-489-7889

Home Insurance

Name:
Address:
City:
Province:
Postal Code (X1Y 2Z3):
Phone Number (123-456-7890):
Email:
Do you own your own home, own a condo unit or rent:	HomeownerCondo OwnerRenter
Estimated replacement value of dwelling: (homeowner only):
Estimated replacement value of personal property:
Policy deductible preferred:	$1,000 $2,500
Liability amount requested:	$2,000,000
How many years have you consistently had a property policy in force:
Number of claims in the past 10 years:
How many years since last claim (if within 10 years):
Do you smoke:
Do you have a monitored alarm? (fire & burglary):
Do you have a mortgage/secured line of credit on the property:
What is your occupation:
How many years since last time you moved:
What is your date of birth? (or of oldest named insured person):	Date and time
Was your prior policy canceled for non payment:
Was your policy lapsed for any other reason by the insurance company:
What is the amount of jewelry required to be scheduled:
Which insurance company has your current auto insurance:
When does your current coverage expire?:	Date and timeNow