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📞 (825) 402-4115

Auto Insurance Quote

Complete the questionnaire below for an accurate, personalized proposal - takes about 5 minutes.

Client

Insurance

Vehicle

Coverage

Review

Client Information

Full Name *

Date of Birth *

Gender *

Male Female

Marital Status *

Married Single Other

Driver's License # *

Occupation

Phone Number *

Email *

Primary Address *

City

Province

Postal Code

Years at Address

Add a Co-Insured (spouse, partner, etc.)

Co-Insured Information

Details about the second person on the policy.

Full Name *

Date of Birth *

Gender

Male Female

Relationship

Driver's License # *

Phone

Address (if different)

Auto Insurance Questionnaire

Auto Policy Information

Details about your current auto insurance policy.

Renewal Date of Current Policy *

Current Insurance Provider

Years with Current Provider

Years of Continuous Insurance

Driver Information

Your driving experience and history.

Date First Licensed *

Driver's Training Completed

Yes No

Tickets in the Past 3 Years *

Yes No

Please provide details

License suspended in past 6 years? *

Yes No

Please provide details

Claims in past 6 years? *

Yes No

Please provide details

Any additional drivers? *

Yes No

Vehicle Information

Coverage Selection

Liability Coverage *

$1,000,000 $2,000,000

Collision Coverage *

Yes No

Comprehensive Coverage *

Yes No

Credit Check Authorization

Insurers may use credit information to determine pricing. This is a “soft inquiry” that won’t affect your credit score.

I authorize PROTEX Insurance to complete a credit check for insurance purposes only Better rates are often available to customers who consent to credit checks

Review Your Application

✓

Thank you!

Your application has been received. A PROTEX Insurance representative will contact you shortly to discuss your quote.

Call us: (825) 402-4115

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Get a free, no-obligation auto insurance quote from PROTEX Insurance today. Our licensed Alberta brokers compare top carriers to find you the best coverage.

Call (825) 402-4115

Suite 401, 3420 Allan Drive SW, Edmonton, Alberta T6W 3G9 • Mon–Fri 08:00am–04:30pm | Weekends: CLOSED