•
Car Insurance
•
Home Insurance
Home Insurance
Name:
Email Address:
Address:
City:
Province:
Postal Code:
Phone Number:
Do you own your own home,
own a condo unit or rent?
Homeowner
Condo Owner
Renter
Are you currently insured?
Yes
No
Name of previous insurance company:
Estimated replacement value
of dwelling (homeowner only)
Estimated replacement value of
personal property (condo & renters only)
Policy deductible preferred:
$200
$300
$500
$1000
Liability amount requested:
$500 000
$1 million
$2 million
Have you had any personal property claimed in the past three years?
Yes
No
Disclaimer
