Full Legal Names of people on title
Applicant(s) Date(s) of Birth
Current address & date you moved in
Address of property to be insured including postal code
Primary Residence, Rental, Secondary, Vacation or other
Do you have any type of habitational policy in place at your current home? E.g. Home, Tenant, Condo.
If so: How many years have you had continuous insurance?
Name of the Insurance Company, Policy Number, and the Expiry Date.
What date would you like the policy/quote to start?
Do you consent to the insurance companies running a soft credit score check? Some insurers do offer a discount for this - the amount of discount varies based on results
How many years have you lived at this address?
Age of the home?
Style of home? Bungalow, bi-level, 2 stories? What is the Square footage?
Is basement finished? Square footage of basement?
Type of roof material? Year last updated?
Type of plumbing material? (Copper, plastic, etc.) Year plumbing was last updated? Year the hot water tank was last replaced?
Type of electrical wiring? (Aluminum, copper, etc.) Year electrical was last updated? Breaker panel service? (100 amp, 125 amp, 200 amp, etc.)
Construction (Wood-Frame, Stucco, Vinyl Siding etc)
Primary heat source? e.g. Natural gas, electric and when is the last time it was updated?
Any wood burning heat source?
Is there a sump pump? Alarmed? Back up battery or generator?
Is there a backflow valve?
Is there a garage? Attached or detached? How many cars does it hold?
Coverages and Underwriting
Number of mortgages or loans on the property?
Is there a fire hydrant within 300 metres? Is there a firehall within 8 km?
Do you conduct any business from the home? Please describe. Do you have a separate business insurance or CGL policy?
Is there a suite or rental unit in the home? Will there be any unrelated individuals living in the home?
Are any of the occupant’s smokers?
Is there a sprinkler system installed in your location?
Do you have a Burglar Alarm? Is it Monitored or Local?
Have you had any claims or losses in the last 5 years, insured or uninsured? (If yes, please outline)
Have you ever been cancelled, declined, or non- renewed home insurance? (If yes, please outline)