Client Services

Add a driver to your policy

Please answer a few questions so we can find your policy information....

Contact Info:
Your name:
Your address:
Your E-mail address:
An inaccurate e-mail address means that you WILL NOT receive confirmation that we have received your policy change request and may delay or abort your change request completely.
Your policy number:
The name of your insurer:

Effective date:
This driver will be added with effect from the date you send us this E-mail unless specifically requested otherwise in the Additional Information section below.
Day
 Month
 Year

Basic driver information:
What is the name of the new driver?
Driver's licence number:
Date of Birth:
Day
 Month
 Year
Gender: Male
Female
Marital Status : Married
Single
Which car does this person drive most often? The only car on the policy or
Year
 Make
 Model
This person is being declared as:

Driver's previous experience:
Has this driver passed a Driver Training course within the last 3 years and is the Certificate available? Yes
No
If yes, please fax the certificate to us at (416) 322-0424 . Make certain your policy number is on the document
What is the date this driver was first licenced in Canada at the G2 level or full licence level?
Complete accuracy is only important if you have been licensed less than 6 years.
Day
 Month
 Year
If this person has been insured at any time during the past 6 years by a Canadian insurer, please tell us:
Previous Insurer:
Previous Insurance Policy Number:
Has this person's driver's licence been suspended or cancelled in the last 6 years? Yes
No
If yes, give details in the Additional Information section
Has any insurance company cancelled car insurance for this person in the last 3 years? Yes
No
If yes, give details in the Additional Information section
During the last 3 years, has any car insurance policy issued to this driver been cancelled or has any claim been denied for material misrepresentation? Yes
No
If yes, give details in the Additional Information section
Has this driver been found by a court to have committed a fraud connected with car insurance? Yes
No
If yes, give details in the Additional Information section
Has this driver had any traffic tickets (violations) in the LAST 36 MONTHS (3 years)? Yes
No
If yes, tell us how many
Has this driver had any claims or accidents in the last 6 years where he/she was deemed to be wholely or partially at fault? Yes
No

If yes, what were the dates?
Accident
1
2		 Month

 Year

Additional Information
Please tell us any additional information that you feel is important or ask us any questions about insurance on this car

User Validation


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