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Location
- Calgary
Testimonial
Insurance
Blog
Partners
About Us

Hi. How can I help you?

Personal Insurance Commercial Insurance

First Name

Last Name

Email

Phone Number

What type of Personal Insurance?

Auto Property

Street Address

City

Province

Postal Code

Country

How many vehicles?

1 vehicle 2 vehicles 3 vehicles 4 vehicles

First vehicle

Vehicle info

Year

Make

Model

Is your vehicle Financed or Lease?

yes no

Please tell us when this policy will start?

Winter Tires?

yes no

Where does this vehicle park?

Private garage Private driveway Underground parking Parking lot Carport Indoor storage Street parking other

Primary use of vehicle

Personal Business Both Personal and Business

Coverage Options

One way Two Way

Second vehicle

Vehicle info

Year

Make

Model

Is your vehicle Financed or Lease?

yes no

Winter Tires?

yes no

Where does this vehicle park?

Private garage Private driveway Underground parking Parking lot Carport Indoor storage Street parking other

Primary use of vehicle

Personal Business Both Personal and Business

Coverage Options

One way Two Way

Third vehicle

Vehicle info

Year

Make

Model

Is your vehicle Financed or Lease?

yes no

Winter Tires?

yes no

Where does this vehicle park?

Private garage Private driveway Underground parking Parking lot Carport Indoor storage Street parking other

Primary use of vehicle

Personal Business Both Personal and Business

Coverage Options

One way Two Way

Fourth vehicle

Vehicle info

Year

Make

Model

Is your vehicle Financed or Lease?

yes no

Winter Tires?

yes no

Where does this vehicle park?

Private garage Private driveway Underground parking Parking lot Carport Indoor storage Street parking other

Primary use of vehicle

Personal Business Both Personal and Business

Coverage Options

One way Two Way

How many drivers?

1 driver 2 drivers 3 drivers 4 drivers

1st Driver

Driver's info

First name

Last name

Birthday

Email

Phone Number

Driver License number

Please select all that applies

Insurance cancellation in last 3 years License suspension in last 6 years At fault claims in last 5 years Violation tickets in last 3 years no claims and violations

Second Driver

Driver's info

First name

Last name

Birthday

Email

Phone Number

Driver License number

Please select all that applies

Insurance cancellation in last 3 years License suspension in last 6 years At fault claims in last 5 years Violation tickets in last 3 years no claims and violations

Third Driver

Driver's info

First name

Last name

Birthday

Email

Phone Number

Driver License number

Please select all that applies

Insurance cancellation in last 3 years License suspension in last 6 years At fault claims in last 5 years Violation tickets in last 3 years no claims and violations

Fourth Driver

Driver's info

First name

Last name

Birthday

Email

Phone Number

Driver License number

Please select all that applies

Insurance cancellation in last 3 years License suspension in last 6 years At fault claims in last 5 years Violation tickets in last 3 years no claims and violations

For a discount of up to 30%, please indicate whether you would install an app on your phone that scores your driving habits.

Yes No

For the better quotes, would you like us to include a 10-15% discount for multiple policies (e.g. home, tenant, or condo insurance) with the same company?

Yes No

Type of Property

Home Insurance Condo/townhouse Insurance Landlord/Tenant Insurance

Street Address

City

Province

Postal Code

Country

Please tell us when this policy will start?

Eldest Occupant

First name

Last Name

Birthdate

Occupation

Accountant Nurse Actuary Optometrist Chemist Orthodontist Chiropractor Pharmacist Computer Science Physicist Dentist Student Engineer Teacher Geologist Retired other

Other Occupation

Do you have a mortgage?

Yes No

Who resides in the residence?

You You and your family Your family and another family Your family and two another families It's rented out / commercial purposes

How many bathrooms?

1 1.5 2 2.5 3 3.5 4 4.5 5+

How many bedrooms?

1 2 3 4 5 5+

When did you move in?

Do you have a current policy?

Yes No

Have you ever had home Insurance?

Yes No

How long have you had insurance without gaps?

0 year 1 year 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years 10+

How long have you been with your current Insurance comapny?

0 year 1 year 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years 10+

Do you have a current policy?

Yes No

Claims In the last 5 years?

Yes No

Claims In the last 5 years?

Yes No

Do you pay monthly for monitored security system?

Yes No

Are the occupants non-smokers?

Yes No

Property Upgrades

Heating

Year updated

Plumbing

Year updated

Hot water tank

Year updated

Roof

Year updated

Furnace

Year updated

Do you own or rent?

Own - Landlord Rent - Tenant

When did you move in?

When did you purchase this property?

Do you have a mortgage?

Yes No

What are you charging for rent?

Property Manager Information

Property Manager name

Address

City

Postal Code

Phone Number

What is the SQFT?

How many bathrooms?

1 1.5 2 2.5 3 3.5 4 4.5 5+

How many bedrooms?

1 2 3 4 5 5+

How long have you had insurance without gaps?

0 year 1 year 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years 10+

How long have you been with your current Insurance comapny?

0 year 1 year 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years 10+

Claims In the last 5 years?

Yes No

Contents to protect

min 30k 35k 40k 45k 50k 55k 60k 70k 80k 90k 100k 100k+

Commercial Auto Form

Owner's information

Owner's name

Owner's email

Owner's phone number

Business info

Nature of the business

Usual operating radius

Maximum radius

Days operation out of Alberta

Value of attached machinery

Will drivers be making deliveries

Insurance Information

Tansporting dangerous good

Yes No

Is there a CGL currently in force

Yes No

Has there been a commercial claim in the last 5 years

Yes No

Insurance lapse in the last 6 years

Yes No

Rented or Leased to others

Yes No

Drivers' Information

Do all drivers have 3 years of experience driving these types of vehicles?

Yes No

How many drivers?

1 driver 2 drivers 3 drivers 4 drivers

First driver

First name

Last name

Birthdate

Driver License number

Please select all that applies

Insurance cancellation in last 3 years License suspension in last 6 years At fault claims in last 5 years Violation tickets in last 3 years none of above

Second driver

First name

Last name

Birthdate

Driver License number

Please select all that applies

Insurance cancellation in last 3 years License suspension in last 6 years At fault claims in last 5 years Violation tickets in last 3 years none of above

Third driver

First name

Last name

Birthdate

Driver License number

Please select all that applies

Insurance cancellation in last 3 years License suspension in last 6 years At fault claims in last 5 years Violation tickets in last 3 years none of above

fourth drivers

First name

Last name

Birthdate

Driver License number

Please select all that applies

Insurance cancellation in last 3 years License suspension in last 6 years At fault claims in last 5 years Violation tickets in last 3 years none of above

Vehicle Information

1 vehicle 2 vehicles 3 vehicles 4 vehicles

First vehicle

Year

Make

Model

VIN

% Business use

First Lien holder

Financed

Yes No

Leased

Yes No

Do you require full coverage

Yes No

Second vehicle

Year

Make

Model

VIN

% Business use

Second Lien holder

Financed

Yes No

Leased

Yes No

Do you require full coverage

Yes No

Third vehicle

Year

Make

Model

VIN

% Business use

Third Lien holder

Financed

Yes No

Leased

Yes No

Do you require full coverage

Yes No

Fourth vehicle

Year

Make

Model

VIN

% Business use

Fourth Lien holder

Financed

Yes No

Leased

Yes No

Do you require full coverage

Yes No

Any special requests? Something that we should know to get a more accurate quote?

Getting insurance can be complicated, and involve a wide range of factors. Getting the right insurance policy can help protect your investments, and save you thousands of dollars. At InsureLine, we understand the complexities of finding the right insurance coverage. We are passionate about ‘Simplifying Insurance’, and saving customers money.

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First vehicle

Second vehicle

Third vehicle

Fourth vehicle

1st Driver

Second Driver

Third Driver

Fourth Driver

Eldest Occupant

Property Upgrades

Commercial Auto Form

Owner's information

Company information

Business info

Insurance Information

Drivers' Information

First driver

Second driver

Third driver

fourth drivers

First vehicle

First Lien holder

Second vehicle

Second Lien holder

Third vehicle

Third Lien holder

Fourth vehicle

Fourth Lien holder

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