Welcome to Holman Insurance Brokers on-line Travel Insurance quick quote page. Please ensure you complete the form as accurately as possible in order to ensure the best possible estimate. If you would rather speak to one of our sales representatives, please call us at (905) 886-5630 or 1-800-567-1279.

Completion of this form is for informational purposes only, and is just an estimate.
This WILL NOT result in a new policy, or change to an existing policy.

* Required Fields

Contact Information
First Name*
Last Name*
Address*
Phone*
City*
Phone 2
Province*
E-Mail*
Postal Code*
Contact Method
Phone Email
Insurance Information
Are you presently insured? If yes, what company?* (enter "none" if answer is no)
Policy Number* (enter "none" if you do not have a policy number)
Expiry Date
What is your current annual premium?
$
Why are you looking for a new insurer or broker?
Coverage Information
Date of Departure
Date of Return
Departure City
Destination City
Situation of Travel
Beneficiary
Method of Travel
Specify if Other
Please list all people to be insured:
Name Date of Birth Occupation Relation to Applicant
Currently Insured
Yes No
Insurance Company
Current Policy Number
Expiry Date
What is your current annual premium?
$
Why are you looking for a new insurer or broker?
Additional Comments



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Thank you for trusting Holman Insurance Brokers Ltd. for your insurance needs, one of our representatives will contact you soon with your quote!
Travel Quote