Tools and Resources

Your best insurance is an Insurance Broker

Policy Change Forms - Change Vehicle Use

For your added protection, changes made to your policy do not become effective until we contact you to verify the change and effective date. This is to protect your existing coverage, should additional information or coverage be required to make the change you have asked.

About You

Name(s) of insured(s):

1^st insured:

2^nd insured:

How can we reach you?

E-mail address:

Daytime telephone #:

Home telephone #:

Fax #:

Vehicle Information

Vehicle make:

Year:

Model:

Use of vehicle:

Comments (details if use is other):

Is this vehicle used out of the province more than 30 days/year?

Yes

Is this vehicle used for commercial or delivery purposes?

Yes

Kilometres traveled per year:

How many kilometers one-way for daily commute?

If this vehicle is used for work-related travel, how many kilometers/year (not including travel to and from the workplace)?

Effective Date

When will this change be effective? (dd/mm/yyyy)

About Your Insurance
(Specify the policy to which this change applies)

Company:

Policy #:

Will this change in use result in changes in use of any other vehicles owned?

If so, please indicate what will change:

Name of your broker: