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Automobile Insurance Availability form

Before you complete the form, make sure you have all the information requested on hand.

You must provide:

  • The name of five insurers or brokers you contacted and who refused to insure you (mandatory).
  • Information regarding your last insurance policy (name of the insurer or broker, policy No., expiry date and a copy or photo of the insurance policy), where applicable.
  • Information regarding any the other insurance you have: home, auto or business (name of insurer or broker, and policy No.), where applicable.

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