RV Insurance - Application for Motorhomes

Application - Motorhome

Premium Calculation Insurance becomes effective on completion of full application, and acceptance of risk by broker.

General Details
Motorhome Type:
Amount of Insurance Required*:
Explorer RV Club Membership #:
Explorer RV Club Membership Expiry Date:
KOA Membership #:
KOA Membership Expiry Date:
GOOD SAM Membership #:
GOOD SAM Membership Expiry Date:

* Recently, a motorhome owner did not include taxes in the amount of insurance required. Unfortunately, the RV was stolen and the owner was underinsured by 15% or almost $20,000 - a bitter pill to swallow. Don't let this happen to you!

Optional Coverages
		Reduce Comprehensive Coverage deductible to $100.00. This will add $50 to your premium.
		Claims Protection. This will add $25 to your premium.
		Emergency Road Service This will add $85 to your premium.

Wayfarer Insurance Brokers Ltd.
328 Mill Street, Unit 6, PO Box 160
Beaverton, Ontario, L0K 1A0
Tel: 1-800-461-0318 Fax: (705) 426-4064

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