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Why we ask this

Tell us about your vehicle:

Tell us about your driving habits

The information you provide will help us determine your insurance needs
If you’re unsure of the exact number, give it your best guess
1,000km 50,000km +100,000km

If you use your vehicle to commute to work/school/other, more…
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If you use your vehicle to commute to work/school/other, tell us how far you drive one way

 0km10km20km30km40km50km60km70km

If you use your vehicle to conduct business, tell us more…
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If you use your vehicle to conduct business, tell us how many kilometers you drive per year

0    1,000km2,000km3,000km4,000km

If you’re unsure of the exact number, give it your best guess
 110203040506070

Years insured with your current provider

If you’re unsure of the exact number, give it your best guess

What class of licence do you hold?

Not sure? Find out more about G, G2 and G1
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G: May drive any car, van or small truck or combination of vehicle and towed vehicle up to 11,000 kg provided the towed vehicle is not over 4,600 kg

G2: Graduate Licence – Level 2
May drive Class G vehicles without accompanying driver but are subject to certain conditions

G1: Graduated Licence – Level 1
May drive Class G vehicles when accompanied by a fully licenced driver with at least 4 years of driving experience

Have you completed a Driver's Training Course in the last 3 years?

What class of licence do you hold?

Not sure? Find out more about 5, and 7
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5: Rules for 5 license
May drive some other thing

7: Rules for 7 license
May drive something

Have you completed a Driver's Training Course in the last 3 years?


Type of marking device

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Type of anti-theft device

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Type of tracking device

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Is vehicle leased?


How many years have you been insured as a principal operator?

If you’re unsure of the exact number, give it your best guess

Do you have other Co-operators insurance products?

Bundling your insurance products may qualify you for additional discounts.

Any minor traffic tickets?

Examples of minor violations may include more…
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Examples of minor traffic violations may include moderate speeding, running red lights or stop signs, failure to obey traffic signs, and tailgating.


Any other driving convictions?

Examples of other driving offenses include more…
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Examples of other driving offenses include excessive speeding, speeding in a school zone, passing a school bus, and driving without insurance.


Number of auto claims made in the past 10 years?

If you are unable to recall the exact number, give it your best guess

Claim 1:
Type of claim

If you are unable to recall the exact number, give it your best guess
 0 1 2 3 4 5 6 7 8 910

Claim 2:
Type of claim

If you are unable to recall the exact number, give it your best guess
 0 1 2 3 4 5 6 7 8 910

Has your driver's licence been suspended in the last 3 years?


Occupation


Are you retired


Marital status

Optional Additional Coverage What's this?

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Increased Death and Funeral

This option doubles the basic death benefit amounts to your spouse and dependants and increases the amount to cover funeral expenses if you were to die in an accident.

Loss of use

This is an optional coverage which covers the cost of a rental vehicle, taxi or public transportation up to the limit stated while your vehicle is being repaired (provided the damage or loss is caused by a peril for which you are insured).

Removing depreciation for new vehicles

If your brand-new car is still within the first 24 months of the original delivery date, this optional coverage ensures you will receive the full value of what you paid for the car without depreciation if it is written off.

Accident Forgiveness

With this coverage, if you have been licensed and accident free for six consecutive years, your first at-fault collision will not affect your claims-free rating.

Coverage for rented or borrowed vehicles

Extend your auto insurance to vehicles in your care that you don’t own, including those you rent, borrow, or lease. All drivers listed on your policy are also covered. You do not need to carry collision, all perils or comprehensive coverage to purchase this option.

Complement

Additional protection provided:
i) Deductible deletion in case of hit-an-run (maximum $500);
ii) Deductible deletion in the event of total loss (maximum $500);
iii) Drive other automobile endorsement;
iv) Leasing expenses reimbursement (maximum of $1 500 per event) - Broad Form
v) Coverage of $75 000 in Civil Liability for damage to non-owned automobiles endorsement;
vi) Accident benefits endorsement (Insured Capital: $15 000, Medical Expenses: $2 000).

Loss of use

This is an optional coverage which covers the cost of a rental vehicle, taxi or public transportation up to the limit stated while your vehicle is being repaired (provided the damage or loss is caused by a peril for which you are insured).

Removing depreciation for new vehicles

If your brand-new car is still within the first 24 months of the original delivery date, this optional coverage ensures you will receive the full value of what you paid for the car without depreciation if it is written off.

Accident Forgiveness

With this coverage, if you have been licensed and accident free for six consecutive years, your first at-fault collision will not affect your claims-free rating.

Coverage for rented or borrowed vehicles

Extend your auto insurance to vehicles in your care that you don’t own, including those you rent, borrow, or lease. All drivers listed on your policy are also covered. You do not need to carry collision, all perils or comprehensive coverage to purchase this option.

Loss of use

This is an optional coverage which covers the cost of a rental vehicle, taxi or public transportation up to the limit stated while your vehicle is being repaired (provided the damage or loss is caused by a peril for which you are insured).

Removing depreciation for new vehicles

If your brand-new car is still within the first 24 months of the original delivery date, this optional coverage ensures you will receive the full value of what you paid for the car without depreciation if it is written off.

Accident Forgiveness

With this coverage, if you have been licensed and accident free for six consecutive years, your first at-fault collision will not affect your claims-free rating.



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