Quick quote life insurance in QuebecHomeQuick quote life insurance in QuebecSoumission assurance vie (#49)Step 1Step 2Step 3Step 4Step 5How much life insurance is required?- Select -$50,000$100,000$200,000$300,000$400,000$500,000$600,000$700,000$800,000$900,000$1,000,000$2,000,000$3,000,000$4,000,000$5,000,000$10,000,000OtherPreviousNextFirst NameSurnameBackground (we have solutions) Do you have a criminal record? Have you ever been cancelled for "non-payment"?What do you want to insure?PreviousNextAddressAddress Line 1TownProvinceZip codePhone/mobileEmailPreviousNextCurrent or previous insurerAre you a smoker?- Select -SmokingNon-smokingYour date of birthYour occupationPreviousNextThe information collected in this section allows us, among other things, to pre-qualify for your insurance needs and potentially provide you with an insurance quote. The information provided is stored in order to meet legislative and regulatory requirements. In addition, by filling out the form, you consent to our use, communication or sharing internally and externally (in particular with partner firms and/or insurers) and that we retain this information. I agreeI would like to subscribe to the Assur360 newsletter for its contests, promotions and information YesAdditional InformationPreviousSoumettre la demande Last updated: May 1, 2026
