Auto Insurance

Any quotation for Auto Insurance is based on the information you provide with your Request for Quotation (RFQ) below. Should you accept a quotation, the information you provide in your RFQ will be verified. In the event that the information is incomplete or inaccurate, the Insurer reserves the right to revise the premium accordingly or withdraw coverage, if coverage has been bound. If the Insurer is required to withdraw coverage under these circumstances, you may encounter difficulty in obtaining coverage in the future. 

Prior to binding coverage, you may be requested to provide the following documentation:

  • Current Driver Abstract – 3 Year Statement of Driving Record for each driver. Driver Abstracts are available from a Ministry of Transportation - Driver and Vehicle Licensing Office or ServiceOntario Kiosk near you or online at www.mto.gov.on.ca  for a nominal cost.
  • Loss experience letter(s) from the prior insurer(s) covering the past 6 years, with no coverage breaks.
  • Client Consent Form (available from our office) authorizing Waddell Insurance to act as your exclusive Broker and to release personal information for the purpose of securing requested insurance products and services.

 Please proceed to input your Request For Quotation.
Name:
  Email Address:
  Address:
  City:
  Province:
  Postal Code:
  Phone Number:
  Age of principal driver:
  Marital status of principal driver:
  Class of license & earliest license date:
  Driver's license number:
  No. of years continuously insured:
  Existing / prior insurance Co. name
  Policy #
  Gender of additional drivers
under 25 years of age:
  Do driver(s) under 25 years of age
have driver training certification? 		 
Yes     No
 
  Any at fault accidents in past 6 years?  
Yes     No
 
  If yes, provide dates and full details:
  Any driving convictions in past 3 years?  
Yes     No
 
  If yes, provide dates and full details:
  Any claims of any type in the
last 6 years?
Yes     No
  If yes, provide dates and full details:
  Do you use your vehicle for business?  
Yes     No
 
  Do you use your vehicle to commute
to and from work? 		 
Yes     No
  No. of Km's to work - one way:
  No. of Km's per annum:
  Year, make and model of vehicle:
  Liability limit requested:
  Coverage Preferred:
  Deductible:
  Additional vehicles to be quoted?  
Yes     No
 
  Has any company ever cancelled or
refused insurance of this description?
Yes     No
  If yes, provide dates and full details:
  For additional drivers or vehicles,
provide full details as above at
Additional Comments below. 		 
  Additional comments:

   

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