Make A Claim
Contact Us

Contact Us
Make A Claim

Home
About Us
Insurance Services
Contact Us
GET AN ESTIMATE

Home
About Us
Insurance Services
Contact Us
GET AN ESTIMATE

service@stanleyelliot.ca

Drop us a line

1-800-442-9714

Make a call

Home
About Us
Insurance Services
Contact Us
GET AN ESTIMATE

Home
About Us
Insurance Services
Contact Us
GET AN ESTIMATE

Get An Estimate test

There are enough bumps in the roads of New Brunswick and the road of life; your auto insurance shouldn’t be one of those bumps.

Let us know what type of Insurance you’re looking for:

Thanks for asking us to provide you with a premium estimate on your insurance needs! This form will allow you to request a quote for our Business, Auto or Property Insurance, or any combination there-of. The more accurate information you can provide the better service we can offer you. To get started, please tell us a little bit about yourself:

First Name:

Last Name:

Address:

Address Line 2:

City:

Postal Code:

Province:

Email:

Phone Number:

Cell Phone Number

Preferred Start Date of Policy:

Preferred Method of Contact:

Type of estimate requested:
Please let us know what type of coverage you'd like a quote for. You can select more than one type and the form fields below will change based on your selections.

Auto Coverage Business Coverage Farm Coverage Home Coverage

Name

First Last

Address

Street Address Address Line 2 City Province Postal Code

Phone

(###) ###-####

Cell Phone

(###) ###-####

Preferred Start Date of Policy

Preferred Method of Contact

Best time of day to call?

Type of Estimate Requested

Please let us know what type of coverage you'd like a quote for. You can select more than one type and the form fields below will change based on your selections.

Auto Coverage

Business Coverage

Farm Coverage

Number of Drivers

If more than four drivers, please contact us directly.

One

Two

Three

Four

Driver One

Driver One Name

First Last

Driver One Date of Birth

Month

Day

Year

How many years licensed (in Canada)?

How many years with continuous auto insurance?

License Class

How many convictions/driving violations/tickets has Driver One had during the past 3 years?

How many at-fault accidents has Driver One been involved in during the last 6 years?

Has Driver One's auto insurance ever been cancelled for any reason during the past 6 years?

Has Driver One's drivers license been suspended during the past 6 years?

Driver Two

Driver Two Name

First Last

Driver Two Date of Birth

Month

Day

Year

How many years licensed (in Canada)?

How many years with continuous auto insurance?

License Class

How many convictions/driving violations/tickets has Driver Two had during the past 3 years?

How many at-fault accidents has Driver Two been involved in during the last 6 years?

Has Driver Two's auto insurance ever been cancelled for any reason during the past 6 years?

Has Driver Two's drivers license been suspended during the past 6 years?

Driver Three

Driver Three Name

First Last

Driver Three Date of Birth

MM slash DD slash YYYY

How many years licensed (in Canada)?

How many years with continuous auto insurance?

License Class

How many convictions/driving violations/tickets has Driver Three had during the past 3 years?

How many at-fault accidents has Driver Three been involved in during the last 6 years?

Has Driver Three's auto insurance ever been cancelled for any reason during the past 6 years?

Has Driver Three's drivers license been suspended during the past 6 years?

Driver Four

Driver Four Name

First Last

Driver Four Date of Birth

MM slash DD slash YYYY

How many years licensed (in Canada)?

How many years with continuous auto insurance?

License Class

How many convictions/driving violations/tickets has Driver Three had during the past 3 years?

How many at-fault accidents has Driver Three been involved in during the last 6 years?

Has Driver Three's auto insurance ever been cancelled for any reason during the past 6 years?

Has Driver Three's drivers license been suspended during the past 6 years?

Business Coverage Details

Please provide a little info about your business.

Please describe your business:

How many years have you carried business insurance?

Current Liability Limit

Gross Annual Revenue

How many business insurance claims have you made during the past 5 years?

Have you ever been cancelled or refused business insurance?

Farm Coverage Details

Please tell us a little bit about your farm.

Type of Farm

Please describe your farming operation:

How many years have you been farming?

How many farm insurance claims have you had in the past 5 years?

Have you ever been cancelled or refused farm insurance?

Home Coverage Details

Please tell us a little bit about your home/property.

Type of Home Policy

Year Built

How many square feet approximately?

Style of Home

How many claims have you had in the past 5 years?

Have you ever been cancelled or refused home insurance?

Untitled

First Choice

Second Choice

Third Choice

Untitled

First Choice

Second Choice

Third Choice

Have any Question? Call Us

(800) 442-9714

Quick Links

About Us
Insurance Services
Stanley Elliot on Facebook
Sitemap
Contact Us

Services

Business Insurance
Auto Insurance
Property Insurance
Make A Claim
Make A Payment

Head Office

229 Metcalf Street
Saint John, N.B. E2K 1K7
service@stanleyelliot.ca
(506) 658-1986
1-800-442-9714

Facebook Linkedin Instagram Youtube

Facebook Linkedin Youtube