REQUEST A QUOTE -

Which quote are you applying for?

Visitor insurance (International visitors to Canada)

Student insurance (International Students to Canada)

Super visa insurance

First Name

Last Name

Date of Birth (YYYY-MM-DD)

Are there additional applicants?

Enter each of their Date of Birth below

Date of birth of applicant 2 (YYYY-MM-DD)

Date of birth of applicant 3 (YYYY-MM-DD)

Country of residence (Country of origin)

Destination province (Where the applicant will spend the majority of the time)

Is the applicant covered by a Canadian government health insurance?

Yes

Arrival date in Canada or (date the applicant is leaving their country) (YYYY-MM-DD)

Coverage Start date (YYYY-MM-DD)

Coverage End date (YYYY-MM-DD)

Deductible

Coverage amounts

*For Super visa, the minimum coverage amount is $100,000.

Coming to study?

Yes

If yes, please provide Education Start Date (YYYY-MM-DD)

If yes, please provide Education End Date (YYYY-MM-DD)

Do you need pre-existing conditions coverage? (For visitors)

Yes

Contact name (Who we should send the quote to)

First Name

Last Name

Phone Number

Anything else we should know about?

IMPORTANT ELIGIBILITY INFORMATION

PLEASE READ:

By submitting your information, you're giving us permission to collect, use, and disclose personal information required for purposes of considering an application for an insurance quote.The Canadian Saver is authorized to collect, use, keep and disclose personal information and provide such personal information to third parties, as required, including insurance companies. If you wish to review personal information pertaining to your application or policy maintained by The Canadian Saver, obtain copies of The Canadian Saver’s privacy policies or standards, or make other enquiries or express concerns, you may do so by contacting The Canadian Saver.