Contact us 

1-877-443-0101

 

 

      Your Best Life Insurance Quote

   
Applicant 1  
   
Name
Gender Male      Female
Date of Birth   dd/mmm/yyyy
Smoker?

Yes    No

E-mail
City
Province      
Phone Number
   
Applicant 2
   
Name
Gender   Male      Female
Date of Birth dd/mmm/yyyy
Smoker?  Yes  No
   
 Coverage Options  
   
Plan Type
Coverage Type
Coverage Amount $         (min. $10,000)
Premium Frequency
   
   

 

 

        Additional Information, Notes and Questions

(if you have more applicants, please put their gender, date of birth and smoker status here)

Please contact me to follow up with my quotes:   by phone        by E-mail  

 

Please confirm your E-mail *  

 

 

Your quotes will be e-mailed you during one business day.

If you have questions or need assistance, please call

at 416-493-0101 (toll free 1-877-443-0101)

 

Revised: March 27, 2017