Fillable CGI Consumer Autoplus Request Form

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CGI Consumer Autoplus Request Form

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The CGI Consumer Autoplus Request Form form is 1 page long and contains:

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  • 5 check-boxes
  • 10 other fields

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File type: PDF

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Revised August 2019
CGI Consumer Autoplus™ Request Form
(CGI USE)
Proof of Residence
To Process your request confirmation of mailing address is required. To confirm your mailing address; a clear scanned
copy of the front of your current provincial driver’s license showing your mailing address is required. If you do not have a
current provincial driver’s license, provide a copy of a current utility statement showing your mailing address and your
name.
Required Information:
* Denotes Required Information
*Last Name:
*First Name:
*Driver’s License Number:
Current Insurance Company and Policy #:
*Day Time Phone Number:
Email Address:
*Signature: (original signature required)
*Date:
*Reason for your request – select the reason for your request
Proof of insurance for insurance quote:
Name of insurance company or broker:
Confirm policy and/or claims Information:
Proof of insurance for employment:
Other – (please indicate):
*
Confirm copy of PROOF OF "CURRENT RESIDENCE "is included with your request
Send your request by one of the options below:
Scan and email: insurance.helpdesk@cgi.com
Fax: 1-514-415-3989
Mail: CGI Technical Assistance Centre
5800 St-Denis, 7th floor
Montreal, PQ, H2S 3L5
By signing this request you agree:
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You are requesting your own personal information.
The AutoPlus™ report will only be mailed to the address supplied in your Proof or Residence
CGI will mail a copy of your personal report via regular mail within 10 business days of receiving your request.
A Consumer AutoPlus™ Report provides your individual automobile policy and claims history as submitted by the Canadian
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Property and Casualty (P&C) industry. CGI Autoplus Reports are not available for the following provinces as they do not
provide CGI with historical data; Quebec, British Columbia, Manitoba, and Saskatchewan.
CGI will provide one report within a 12 month period at no cost.
CGI stores and reports data and is not authorized to make changes to this data.
If you do not agree with the information on your Autoplus™ Report please contact the Complaint Officer/
Ombudsperson, of the insurer, that provided the data. A list of these individuals can be found on the Financial Services
Commission of Ontario website http://www.fsco.gov.on.ca/english/insurance/resolvecomplaint-insurance.asp and select
“Company Consumer Complaint Officers”.
You have read, understand and agree to the guidelines as described.
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CGI Consumer Autoplus Request Form

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Completed 1 February 2021

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