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JE DÉSIRE ÊTRE
CONTACTÉ PAR Courtier et/ou assureur

CONTACTER

SOUMISSION
INSTANTANÉE Système intelligent en assurance

DÉBUTER

Vehicle Insurance

"*" indicates required fields

Step 1 of 3

33%
Name*
Important! Your submissions will be returned to you at this address.
Address*
YYYY dash MM dash DD
Spouse's name

Vehicle 1

(Toyota, Honda, etc...)
(Exact model, eg Civic LX, SI, two doors, four doors, coupe or hatchback, etc ...)

Véhicule 2

(Toyota, Honda, etc...)
(Exact model, eg Civic LX, SI, two doors, four doors, coupe or hatchback, etc ...)

Vehicle 3

(Toyota, Honda, etc...)
(Exact model, eg Civic LX, SI, two doors, four doors, coupe or hatchback, etc ...)

Driver information

This does not include temporary permits, only learners’ permits and permanent licenses.
By entering your driver's license number, the submissions you receive will be much more accurate.
MM slash DD slash YYYY
To be more precise, indicate the date of the incident, the amount claimed, and the percentage of responsibilities. Example: 0%, 50%, 100%.
Indicate the reasons for the infractions and the number of points lost.
YYYY dash MM dash DD
One-way
To visit clients or business meetings.

You are now on the last step of the form. You will probably find some questions that seem out of context; however, all questions can affect your premium and give you very good discounts on your quote.

Example: intensive markings, anti-starter, smart key, tracking system

What kind of bonus would you like to receive with this submission?

Contact preference
Combined with
Terms and conditions of use*
Date

Home Insurance

"*" indicates required fields

Step 1 of 6

16%
Name*
Important! Your submissions will be returned to you at this address.
Address*
Combined with
YYYY dash MM dash DD
Spouse's name*
YYYY dash MM dash DD
YYYY dash MM dash DD
Hidden

Home Insurance - Owner & Chalet

YYYY dash MM dash DD
Hidden

Home Insurance - Tenant

Hidden

Home Insurance - Co-owner

YYYY dash MM dash DD

Vehicle Insurance

Vehicle 1

(Toyota, Honda, etc...)
(Exact model, eg Civic LX, SI, two doors, four doors, coupe or hatchback, etc ...)

Vehicle 2

(Toyota, Honda, etc...)
(Exact model, eg Civic LX, SI, two doors, four doors, coupe or hatchback, etc ...)

Vehicle 3

(Toyota, Honda, etc...)
(Exact model, eg Civic LX, SI, two doors, four doors, coupe or hatchback, etc ...)

Driver information

By entering your driver's license number, the submissions you receive will be much more accurate.
YYYY dash MM dash DD
To be more precise, indicate the date of the incident, the amount claimed, and the percentage of responsibilities. Example: 0%, 50%, 100%.
Indicate the reasons for the infractions and the number of points lost.
YYYY dash MM dash DD
One-way
To visit clients or business meetings.
Example: intensive markings, anti-starter, smart key, tracking system

What kind of bonus would you like to receive with this submission?

Additional information

You are now on the last step of the form. You will probably find some questions that seem out of context; however, all questions can affect your premium and give you very good discounts on your quote.
$5000 increments
Contact preference
Par le même formulaire, aimeriez-vous recevoir une soumission d'assurance vie, invalidité ou hypothécaire?
Terms and conditions of use*
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