Fast-Track Home Questionnaire

1Applicants

2Policy Info

3Additional Info

4Required Documents

Congratulations! Based on the information you submitted, our insurance products appear to be a good fit for you.
Bundled Auto Insurance Quote

Estimated time to complete: 5 minutes

How everything works:
1) You fill out this form.
2) A local broker will carefully work on your quote, and get in touch with you for additional information if needed.
3) Review coverage options with your broker by phone or appointment, and start your policy!
Fast-Track Home Questionnaire

Estimated time to complete: 10 minutes

How everything works:
This form is designed to help us gather the extra details needed to prepare your home insurance application. It covers important questions about your property details, along with a list of documents we’ll need. Filling out this form helps your broker fast-track your quote through the application process.

You may save and continue this form at any time.
Who is the broker working on this quote?*
Insurance Carrier*
How many applicants are there?*
The applicants are the individuals with signing authority on the insurance policy as well as ownership of the properties, and are financially responsible for the insurance policy. There may be a single applicant for an insurance policy containing multiple drivers and vehicle.
Applicant Info
Name of Applicant 1*
First Last
Occupation and Place of Employment for Applicant 1
Some occupations or employers may be eligible for additional discounts.
Email Address for Applicant 1*

This email will be used to electronically sign your application later.
Paperless Document Delivery*
Wawanesa is paperless only
Email Address for Paperless Document Delivery*
Name of Applicant 2*
First Last
Occupation and Place of Employment for Applicant 2
Some occupations or employers may be eligible for additional discounts.
Email Address for Applicant 2*

This email will be used to electronically sign your application later.
Name of Applicant 3*
First Last
Occupation and Place of Employment for Applicant 3
Some occupations or employers may be eligible for additional discounts.
Email Address for Applicant 3*

This email will be used to electronically sign your application later.
Name of Applicant 4*
First Last
Occupation and Place of Employment for Applicant 4
Some occupations or employers may be eligible for additional discounts.
Email Address for Applicant 4*

This email will be used to electronically sign your application later.
Does any applicant for insurance currently owe any money on another Alberta Property Policy?*
Example: Previous NSF from a monthly payment plan that led to the cancellation of a home insurance policy and an outstanding balance.

Policy Setup
What date would you like your policy to start?*
DD slash MM slash YYYY
Do you currently reside in the home?*
What is your move in date?*
DD slash MM slash YYYY

Important: If the home will not be occupied within 24 hours of possession you must notify us immediately as additional vacancy coverage may be required to maintain proper insurance protection. It is strongly recommended that the main water supply be shut off and all water lines/reservoirs be drained until the home is occupied. Failure to complete the above while the home is vacant or unoccupied may result in denied claims.
What payment plan would you like for this application?*
Note: monthly payment plans are subject to eligibility requirements.
What is the Payment method for this application?*
What is the Monthly Payment method for this application?*
What is the Monthly Payment method for this application?*
Upload a copy of your Direct Deposit or Void Cheque form.*
Accepted file types: jpg, jpeg, gif, png, pdf, tif, Max. file size: 15 MB.

If you have a scanned copy of your Direct Deposit Form or Void Cheque you can upload it here.
Upload a copy of your Direct Deposit or Void Cheque form.*
Accepted file types: jpg, jpeg, gif, png, pdf, tif, Max. file size: 15 MB.

If you have a scanned copy of your Direct Deposit Form or Void Cheque you can upload it here.
Preferred Monthly Withdrawal Date*
Select a day between 1 - 27
Do you have any Property Insurance History? (Tenants, Condo, Home)
Note: Previous policy details are required prior to Application to credit insurance history and to qualify for claims free discounts.
Please provide the company name, policy number, and renewal date of your last property insurance policy*
Required for claims free discount – if you do not have prior insurance, write “First Time”. Otherwise, please input carrier details: ABC Insurance - #1234567 - DD/MM/YYYY
Do you have a mortgage on the home?
Note: Mortgagee details are required prior to the Application.
What is the name and mailing address of your mortgage company (if applicable)*
Example: ABC Bank - 12345 12 ST Edmonton, AB A1B 2C3

Eligibility and Underwriting Questions
Note: Complete and accurate information is crucial. Incorrect or missing information may affect your eligibility for coverage, result in policy cancellation, or result in claim denial.
Plumbing: Does the home have any Cast Iron, Lead, Poly-B, or Galvanized Steel plumbing?*
PEX Plumbing: If there is PEX plumbing in the home, is any of it manufactured by: Uponor, Zurn PEX, or IPEX Inc.?*
Electrical Wiring: Is there any wiring in the home that is not copper? If yes, specify the type (e.g. aluminum, knob-and-tube).*
What type of Electrical Wiring do you have?*
Breaker Panel: Is the main breaker panel rated below 100 amps? If yes, specify its amperage.*
What is the amperage of your breaker panel?*
Do you own or rent any other properties besides the one listed in your quote?*
Do you have any roomers, boarders, tenants, or any kind of long-term or short-term rental (e.g., Airbnb) of any kind?*
Please provide details*
Is there any daycare operation in the home?*
Do you have any of the following?
- Trampoline
- Garden Tractor
- Golf Cart
- Saddle or Draft Animals (E.g. Horses)
- Unlicensed Recreational Vehicles
- None of the above
Select all that apply
Do you have any Watercrafts?*
Please provide details about you water craft (Paddleboard, Kayak, Boat, etc.)*
Is there any renewable energy installation on the premises (e.g., solar panels)?*
Do you have any full-time residence employees (e.g., maids or chefs)?*
Is there any business operation run from the home?*
Is there any existing or unrepaired damage to the home, or anything you’re aware of that might give rise to a claim*
How many dogs are in the household?*
Please provide the breed of each dog
Are there any cannabis plants grown on premises?*
Carrier Specific
If your home is 35 Years or older; Please upload photos of the front and back of the home
Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, tif, Max. file size: 50 MB, Max. files: 5.
A wide shot with roof visible.
Do you prefer Paper or Paperless copies of your documents*

Bundled Auto Insurance Quote

Applicant Info

Policy Setup

Eligibility and Underwriting Questions

Carrier Specific

Required Documents