The Standard - We Know Insurance
Quote Request Serving Your Community for Over 40 Years

Online Quotes

Auto Insurance

The Standard Insurance Brokers Ltd. Is a leading insurance broker in Northwestern Ontario. We believe in personalized service therefore through this website the Standard Insurance Brokers Ltd offers the first steps to take in order to receive a quote for all of your insurance needs. By filling out the online quote forms our brokers can comparison shop for your insurance on your schedule without the sales pressure. Receive quotes tailored to your specific needs and securely without hassel. You’ll receive quotes from some of Canada’s leading carriers including: Intact, Wawanesa, Economical and more.

Once completed we will have a broker contact you at a time that is convenient for you.
General Information
Name:
Address:
City:
Province:
Postal Code:
Phone Number:
*Required Email Address:
   
Underwriting Information  
Have you ever had insurance cancelled for non payment?   
Have you been previously insured?   
How many years have you been continuously insured?
Name of previous insurance company:
Expiry of previous insurance:
Do you own your own home?   
What is the expiry date of that policy?
 
Driver(s) Information #1 #2 #3
Name of Driver:
Date of Birth:
Years licensed in Canada:
License class:
Date Licenced (G):
Date Licenced (G2):
Date Licenced (G1):
Sex:
Young Drivers Training:
Convictions in past 6 years
(including suspensions):
ALL accidents (including not at fault) and/or Claims in past 10 years:
Have there been claims in the past?   
Claims Information  
#1:
Type of Claim:
Date: (mm/yyyy)
Driver Involved: 
#2:
Type of Claim:
Date: (mm/yyyy)
Driver Involved: 
#3:
Type of Claim:
Date: (mm/yyyy)
Driver Involved: 
 
Vehicle Information Vehicle #1 Vehicle #2
Vehicle #3
Remove Vehicle
Add Vehicle
Vehicle make:
Year:
Model:
Serial Number:
Purchase Price:
       
Vehicle Use Vehicle #1 Vehicle #2
Vehicle #3
Who is primary driver:
Use:
KM driven one way to work:
Kilometres driven per year:
 
Coverage Required Vehicle #1 Vehicle #2
Vehicle #3
Liability Limit:
All Perils deductible:
Collision deductible:
Specified Perils deductible:
Comprehensive deductible:
Unrepaired Damage? Yes Yes
Yes
Lien holder/Lessor? Yes Yes
Yes
 
Comments:  
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