Get a Quote – PWI Insurance

Get a quote today! It’s as easy as 1, 2, 3!

Please provide the requested information below and we’ll be happy to prepare a quote to suit your specific needs.

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Get a Quote

Employer*
Address*
Street Address City Province Postal Code
Phone
Contact Person
Fax
Email*
Do you currently have a group insurance plan?
Please check the benefits you would like us to include in your quote:
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- Employee Life Insurance
- Accidental Death & Dismemberment
- Extended Health Care
- Dependent Life Insurance
- Short Term Disability
- Long Term Disability
- Dental
We also specialize in:
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- RRSPs
- Optional Life Insurance
- Individual Health Insurance
- Individual Dental Insurance
- Individual Travel Insurance

Employee Information

FULL-TIME EMPLOYEE’S NAME OR CODE	OCCUPATION	SEX	DEPENDENT CHILDREN?	DATE OF BIRTH	MARITAL STATUS*	ANNUAL EARNINGS
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