Home ins form

Melville Agencies (1974) Ltd

Please select "home insurance quote" or "property claim," then complete the required information below to help with the process.

Make your selection
Please provide me with a home insurance quote
I want to report a property claim
Name(s) of insured (as appears on title)
First Name
Last Name
Date of Birth:
MM
/
DD
/
YYYY
Additional name(s) of insured (as appears on title)
First Name
Last Name
Date of Birth:
MM
/
DD
/
YYYY
Name of occupant if different than insured
First Name
Last Name
Relation to owner
Credit Scoring Consent (soft check matching name and date of birth, for possible discount)
Yes
No
MAILING ADDRESS
Street Address
Address Line 2
City
Province / State / Region
Postal Code / Zip
Country
CIVIC ADDRESS
Street Address
Address Line 2
City
Province / State / Region
Postal Code / Zip
Country
Phone
Previous insurance/claims history in last five years and $ amount (please include policy number)
Possession Date (for new home purchase only)
MM
/
DD
/
YYYY
Mortgage Company (full name/address)
Lawyer's Name (for new home purchase only)
Year Built
Square Footage
Style of House/construction type
Garage
Yes
No
If garage, indicate attached/detached and number of cars
Basement
Finished
Unfinished
Partial
If partially finished, please indicate percent finished.
Exterior wall coverings
Roofing (including age)
Updates - plumbing/heating/electrical (year of updates)
Heating type (natural gas, wood, heating oil, etc.)
Flooring types and percentage of each
Any fireplace(s) and/or woodstove (list number and fuel used for fireplace)
Sump pump (type/battery or generator back-up)
Backflow valve (flapper or gate)
Total # of bathrooms (list each full or half)
Deck (material)/Sunroom/Porch and square footage
Additional features - AC/central vac/hot tub/etc.
Is any portion of the house used for business? If yes, please explain.
Any other information you want to provide
REPORT YOUR CLAIM
If your claim involves your auto, please report your claim by visiting www.sgi.sk.ca (use the online services auto eClaim tab) or by calling 1-800-667-1480 (available 8 am to 5 pm) or 1-800-647-6448 (available after 5 pm and weekends).

If this is an emergency or you need immediate assistance, please call 9-1-1.
Policy Number*
Date of Loss*
MM
/
DD
/
YYYY
Your Name*
First Name
Last Name
Insured's Name*
First Name
Last Name
Contact Name*
First Name
Last Name
Contact E-mail*
Contact Phone*
LOCATION OF LOSS*
Street Address*
Address Line 2
City*
Province / State / Region*
Postal Code / Zip
Country*
DETAILS OF LOSS*
Police File # (if applicable)