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Lakeview Insurance Auto Quote

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If you are coming from out of province, please have on hand minimum 9 years insurance claims history from your prior Insurance companies and a minimum 3-year driver’s abstract (Required to issue a policy of Insurance)

Personal Information

Full Name(Required)

Date of Birth(Required)

MM slash DD slash YYYY

Address(Required)

City(Required)

Postal Code

Prior address if moved within the last 3 years

Occupation for discount:

Phone Number(Required)

Email(Required)

Marital Status

Single

Married

Divorced

Widowed

Do you consent for a soft credit check for discounted rates? This has no impact on your credit score.

Yes

No

Driving Record

Driver’s License Number(Required)

Class

When were you first licensed to drive?

CLASS 5 / 5GDL

Driver’s Training?

Yes

No

Completion Date

MM slash DD slash YYYY

Convictions or suspensions in 3 years

Yes

No

Approximate dates & classification

Accidents in 6 Years

Yes

No

Approximate Dates & fault

Insurance History

Have you been cancelled by any Insurance company within the last 3 years?

Yes

No

Reason

How long have you had continuous insurance with no gaps in coverage of more than 2 years?

Most recent Company

Length of time insured

Vehicle Details

Vehicle 1(Required)

Driver(Required)

Year

Make

Model

VIN

Purchase date & Price

Condition

New

Used

If financed or leased

Winter tires?

Yes

No

Coverage

Liability

Collision

Comprehensive

How long is your commute to school or work one way?

How many annual KM’s

Is the Vehicle used for business Use?

Yes

No

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We’re dedicated to helping each of our clients enjoy life to the fullest by guiding them toward high-quality, well-chosen insurance products.

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