Home insurance claim

For fast and efficient processing, fill out this form and we will contact you as soon as possible to follow-up on your file.

First name

Last name

Policy number?

Telephone (day) e.g.: 418-888-8888

Ext.

Telephone (evening) (optional) e.g.: 418 888-8888

Ext.

Cellphone (optional) e.g.: 418-888-8888

Address where incident occurred

Postal code

Province

Ville

Autre ville

Rue

Autre rue

Street number

Apartment (optional)

Date Format : YYYY-MM-DD

Time Format : hh:mm

Type of Incident

Detailed description of the incident, facts, witnesses (names and addresses) and other relevant information

Detailed description of the damaged property

Actions already performed (e.g., cleaning, salvage, placarding, etc.)

You have pictures, a police report, an accident report or any other relevant factor? Please attach the documents (optional).

Documents accepted: gif, jpg, png, bmp, pdf and doc.

Size maximum 5MB per file and size for all files should not exceed 15 MB.

File 1

One file only.
5 MB limit.
Allowed types: gif jpg png bmp pdf doc docx.

File 2

One file only.
5 MB limit.
Allowed types: gif jpg png bmp pdf doc docx.

File 3

One file only.
5 MB limit.
Allowed types: gif jpg png bmp pdf doc docx.