Home & Auto Contest - Maria

Let's Get You a Personal Insurance Quote!  

 

What type of insurance are you interested in? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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  • ACE
  • APCC
  • CIAA
  • CKA
  • CMBA
  • CNAREA
  • CPRS
  • CSPDM
  • DDA
  • MPI
  • NACCB
  • VRA
Are you a member of one of the associations listed above? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Are you looking for insurance outside of Ontario? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Before We Dive In

 

Please confirm that NONE of the drivers listed on this application:

  • Have been involved in two (2) or more at-fault accidents in the last six (6) years;
  • Have received a license suspension in the last six (6) years;
  • Have had their auto policy cancelled by an insurer in the last three (3) years.
I confirm that all of the statements listed above are true: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Getting to Know You

 Help us get to know you so that we can tailor a plan to cover your needs at the best possible price.

 

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MM/DD/YYYY

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Are you part of an association or group? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Please write N/A if not applicable.

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Is this the address that you want to insure? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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What is the adress you want to insure?
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Square footage.

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Including the basement.

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Mark as N/A if not applicable.

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The cost to replace your assets according to their current worth (your best estimate).

Do you run a home-based business? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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i.e. daycare.

Is any part of your home rented? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Do you have a basement? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Is your basement finished? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Do you have a swimming pool? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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My pool is: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Do you use woodburning auxillary heating? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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i.e. wood burning fireplace or a wood stove?

Let's Get You Some Property Discounts

The questions in this section are designed to get you the best coverage at the best price. 

Please describe the most recent renovations (made by you or a predecessor).

 

Roof

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To the best of your knowledge.

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Plumbing

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To the best of your knowledge.

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Heat

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To the best of your knowledge.

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Hot Water Heater

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To the best of your knowledge.

Is the hot water heater tankless? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Electrical

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To the best of your knowledge.

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The main electrical service delivered to your house. Most homes have an electrical service of between 100 to 200 amps.

More Property Discounts

 Opportunities for even more discounts, because we really want to get you the best price!

 

Do any occupants of your household smoke? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Do you have any of the following (check all that apply): {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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To the best of your knowledge.

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Would you agree to a credit check to reduce your premiums? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Please note: This will have no impact on your credit score.

 

Tell Us About Your Vehicle

 Let's get you the best insurance for your car. Which vehicle(s) you are looking to insure?

 

Vehicle Details

Vehicle {binding ItemNumber}

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16 or 17 digits. If you aren't sure right now, you can always provide it to us later.

Ownership Type: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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MM/YYYY

Vehicle condition at point of Purchase, Lease or Finance: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Total kilometres driven in a year.

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Kilometres on your daily commute to work.

Do you use winter tires? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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To and from client meetings, etc.

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About the Driver(s)

Tell us about the primary driver of the vehicle and any secondary/occasional driver(s).

 

Driver

Driver {binding ItemNumber}

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License type.

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MM/DD/YYYY

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Write N/A if not applicable.

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Write N/A if not applicable.

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Please delete any vehicles that are not driven by this driver.

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A Little More About the Driver(s)

 

Have any of the drivers been licensed for less than three years in Canada? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Was a classroom driver's course taken? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Is there a receipt of driver course training? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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You may be asked to provide proof.

Have any of the drivers been involved in a accident/claim/loss in the past 10 years through either the ownership or operation of any vehicle listed/specified in this application? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Please note, it does not matter whether the accident was the fault of the driver or not. We need to know all accidents before proceeding.

Please provide dates and details of all accidents, claims or losses to the best of your knowledge:

Accidents, claims, losses

Accident, Claim or Loss {binding ItemNumber}

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MM/DD/YYYY

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Have any of the drivers received a traffic ticket in the last three years (excluding parking tickets)? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Please provide ticket dates and details to the best of your knowledge:

Ticket Dates

Ticket {binding ItemNumber}

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MM/DD/YYYY

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MM/DD/YYYY

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Tell Us About Your Property Insurance History

 

Do you currently have a property insurance policy? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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MM/DD

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Have you had claims in the past 5 years? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Include month and year.

Has an insurer cancelled your property insurance in the last five years? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Last Property Questions

 

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Do you have a mortgage? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Do you own any of the following? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Check all that apply.

About Your Auto Insurance History

 

Do you currently have an auto insurance policy? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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MM/DD

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Please consider any auto insurance you may have had in the past, put 0 if you have never had auto insurance.

Pick a Limit for Your Auto Insurance

An insurance coverage limit determines the maximum amount of money an insurance company will pay for a covered claim.

I want a limit of: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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The maximum amount that the insurance company will pay.

PRO TIP:

Selecting $2M in coverage will only cause a slight bump in your premium (usually around 5%), but the benefits far outweigh the costs.

 

Pick Deductibles for Your Auto Insurance

The amount that you will have to pay out-of-pocket when you submit a claim. 

I want a Collision Deductible of: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Collision coverage protects your car if it's damaged in a collision with another vehicle or object and you are found to have been at fault.

Note: Opting out leaves you with no physical damage coverage on your vehicle in the event you are in an at fault loss (including single vehicle accidents), hit and run losses, theft of car, vandalism, fire, hitting animals that run out into the road and windshield losses. The only physical damage coverage is from a not-at-fault loss where the at fault loss driver has adequate insurance.

I want a Comprehensive Deductible of: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Comprehensive coverage covers your vehicle if it's stolen or damaged in an event that is not a collision.

Note: Opting out leaves you with no physical damage coverage on your vehicle in the event you are in an at fault loss (including single vehicle accidents), hit and run losses, theft of car, vandalism, fire, hitting animals that run out into the road and windshield losses. The only physical damage coverage included is from a not-at-fault loss where the at fault loss driver has adequate insurance.

Accident Benefits

 

Did you know that your auto insurance policy also provides you with access to additional benefits, like medical care, income replacement, and more? Okay, maybe you did.

But did you know that you can also secure additional coverage at a minimal cost? 

Click here to learn more about the enhanced accident benefits that are available to you (please note this page opens in a new tab).

Do you want a representative to contact you about increasing any of your Standard Accident Benefits? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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We Need Your Consent

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If the Client requires additional detail for any of the below listed reasons, the Client may contact the Broker Privacy Officer:

  • Review personal information maintained by the Broker pertaining to the Client’s application; 
  • Review personal information maintained by the Broker pertaining to the Client’s policy or policies;
  • Obtain copies of the Broker’s privacy policies or standards; or,
  • Make other enquiries or express concerns.

Broker Privacy Officer: Email Melissa Bajwa or call (647) 693 7627

Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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To sign: click and hold your mouse button in the box, then draw your signature. For mobile, use your finger to draw the signature in the box. Press the 'x" to clear.

Home & Auto Contest - Maria

Home & Auto Contest - Maria

Let's Get You a Personal Insurance Quote!  

 

What type of insurance are you interested in? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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  • ACE
  • APCC
  • CIAA
  • CKA
  • CMBA
  • CNAREA
  • CPRS
  • CSPDM
  • DDA
  • MPI
  • NACCB
  • VRA
Are you a member of one of the associations listed above? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Are you looking for insurance outside of Ontario? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Before We Dive In

 

Please confirm that NONE of the drivers listed on this application:

  • Have been involved in two (2) or more at-fault accidents in the last six (6) years;
  • Have received a license suspension in the last six (6) years;
  • Have had their auto policy cancelled by an insurer in the last three (3) years.
I confirm that all of the statements listed above are true: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Getting to Know You

 Help us get to know you so that we can tailor a plan to cover your needs at the best possible price.

 

Your First Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Your Last Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Date of Birth {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Phone Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Email Address: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Are you part of an association or group? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Which association or group do you belong to? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Which association do you belong to? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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What is your association member ID number? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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City {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Province / Territory {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Postal Code {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Is this the address that you want to insure? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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What is the adress you want to insure?
Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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City {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Province / Territory {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Postal Code {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Type of Property: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Year Built: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Total Living Area: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Number of Storeys: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Number of Separate Units: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Ownership type: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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What is the replacement value of your belongings? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Do you run a home-based business? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Please describe your business: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Is any part of your home rented? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Who rents it? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Approximate monthly rent: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Do you have a basement? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Is your basement finished? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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What percentage of your basement is finished? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Do you have a swimming pool? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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My pool is: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Do you use woodburning auxillary heating? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

Let's Get You Some Property Discounts

The questions in this section are designed to get you the best coverage at the best price. 

Please describe the most recent renovations (made by you or a predecessor).

 

Roof

Year Updated: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Material Type: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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What material is your roof? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

 

Plumbing

Year Updated: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Material Type: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Please explain: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Heat

Year Updated: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Material Type: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Please explain: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Hot Water Heater

Year Updated: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Is the hot water heater tankless? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

 

Electrical

Year Updated: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Material Type: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Please explain: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Please indicate your amp service (if you don't know, please leave blank): {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

More Property Discounts

 Opportunities for even more discounts, because we really want to get you the best price!

 

Do any occupants of your household smoke? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Do you have any of the following (check all that apply): {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
What year was your sump pump installed? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Do you have a centrally monitored third party burglar alarm system? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Please explain: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
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Would you agree to a credit check to reduce your premiums? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

 

Tell Us About Your Vehicle

 Let's get you the best insurance for your car. Which vehicle(s) you are looking to insure?

 

Vehicle Details

Vehicle {binding ItemNumber}

Vehicle Year: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Vehicle Make: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Vehicle Model: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
V.I.N. Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Ownership Type: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Vehicle Purchase Date: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Vehicle condition at point of Purchase, Lease or Finance: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Approximate total kilometres driven annually: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Kilometres in daily commute, one way: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Do you use winter tires? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Percent of kilometres for business use (excluding your commute) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
{ binding firstError.message }

About the Driver(s)

Tell us about the primary driver of the vehicle and any secondary/occasional driver(s).

 

Driver

Driver {binding ItemNumber}

First Name: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Last Name: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
License: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Date of Birth: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Year G1 Obtained: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Year G2 Obtained: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Year G Obtained: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Driver Designation: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Driver's License Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Which vehicle(s) do they drive? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

A Little More About the Driver(s)

 

Have any of the drivers been licensed for less than three years in Canada? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Was a classroom driver's course taken? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Is there a receipt of driver course training? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Have any of the drivers been involved in a accident/claim/loss in the past 10 years through either the ownership or operation of any vehicle listed/specified in this application? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Please provide dates and details of all accidents, claims or losses to the best of your knowledge:

Accidents, claims, losses

Accident, Claim or Loss {binding ItemNumber}

Driver's Name: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Accident, Claim or Loss Date: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
What happened? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
Have any of the drivers received a traffic ticket in the last three years (excluding parking tickets)? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Please provide ticket dates and details to the best of your knowledge:

Ticket Dates

Ticket {binding ItemNumber}

Driver's Name: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Date Pulled Over: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Date Ticket Paid: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
What happened? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

Tell Us About Your Property Insurance History

 

Do you currently have a property insurance policy? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Name of your current insurance company: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Expiry day and month: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
How long have you been with your current insurer or broker? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
How many years have you continuously (no gaps) had property insurance? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Have you had claims in the past 5 years? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
What happened? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }
Has an insurer cancelled your property insurance in the last five years? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
What happened? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

Last Property Questions

 

How long have you lived at the address you want to insure? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Previous Street Address: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Previous City: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Previous Province / State: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Previous Postal / Zip Code: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Previous Country: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Do you have a mortgage? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Who is your mortgage provider? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Do you own any of the following? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

About Your Auto Insurance History

 

Do you currently have an auto insurance policy? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Name of your current insurer: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Expiry Date: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
How long have you been with your current insurer or broker? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
How many years (total) have you had auto insurance? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

Pick a Limit for Your Auto Insurance

An insurance coverage limit determines the maximum amount of money an insurance company will pay for a covered claim.

I want a limit of: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
PRO TIP:

Selecting $2M in coverage will only cause a slight bump in your premium (usually around 5%), but the benefits far outweigh the costs.

 

Pick Deductibles for Your Auto Insurance

The amount that you will have to pay out-of-pocket when you submit a claim. 

I want a Collision Deductible of: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

Note: Opting out leaves you with no physical damage coverage on your vehicle in the event you are in an at fault loss (including single vehicle accidents), hit and run losses, theft of car, vandalism, fire, hitting animals that run out into the road and windshield losses. The only physical damage coverage is from a not-at-fault loss where the at fault loss driver has adequate insurance.

I want a Comprehensive Deductible of: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

Note: Opting out leaves you with no physical damage coverage on your vehicle in the event you are in an at fault loss (including single vehicle accidents), hit and run losses, theft of car, vandalism, fire, hitting animals that run out into the road and windshield losses. The only physical damage coverage included is from a not-at-fault loss where the at fault loss driver has adequate insurance.

Accident Benefits

 

Did you know that your auto insurance policy also provides you with access to additional benefits, like medical care, income replacement, and more? Okay, maybe you did.

But did you know that you can also secure additional coverage at a minimal cost? 

Click here to learn more about the enhanced accident benefits that are available to you (please note this page opens in a new tab).

Do you want a representative to contact you about increasing any of your Standard Accident Benefits? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

 

We Need Your Consent

If the Client wishes to restrict the general nature of this consent to any specific area, please indicate in the space below: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

If the Client requires additional detail for any of the below listed reasons, the Client may contact the Broker Privacy Officer:

  • Review personal information maintained by the Broker pertaining to the Client’s application; 
  • Review personal information maintained by the Broker pertaining to the Client’s policy or policies;
  • Obtain copies of the Broker’s privacy policies or standards; or,
  • Make other enquiries or express concerns.

Broker Privacy Officer: Email Melissa Bajwa or call (647) 693 7627

Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Please sign {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }