POLICY CHANGE REQUEST – SS INSURANCE

Policyholder Information

Full Name (required) Policy Number (required) Phone Number (required) Email Address (required)

Requested Change(s)

Type of Change (select all that apply):

Change of AddressChange of VehicleAdd/Remove DriverUpdate CoverageAuto policy park modeCancel PolicyOther (please specify below) Effective Date of Change (required) Please describe the requested change(s) in detail (required)

📎 Supporting Documents (if required)

Upload Documents (e.g. license, proof of address, registration, etc.)

Authorization

By submitting this form, you authorize us to process the requested changes to your insurance policy. Additional verification may be required.

I confirm that the information provided is accurate and I am authorized to make changes to this policy.

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Contact Info

Head Office

2550 Meadowvale Blvd. Unit 2, Mississauga ON L5N 8C2

For inquiries, email us at tech@ssinsurance.ca

Office Timing

Monday -10:00 AM – 6:00 PM

Tuesday -10:00 AM – 6:00 PM

Wednesday-10:00 AM – 6:00 PM

Thursday-10:00 AM – 6:00 PM

Friday- 10:00 AM – 6:00 PM

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