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Partner Application Page

Insured Person(s)

Policy holder

To insure more people, please contact us for a personal quote.

Select your plans

Premium

The cost of your insurance is:

Normally: 
You Pay:

This is the cost of your insurance for the first 3 months. Then, monthly payment of $ starting on the 4th month.

Details

Once your application is submitted, you will be linked to a secure payment website.
Certificates will then be sent to your email address within 12 hours.

Policy holder

Further information

Declarations

Questions

Questions

Company you work for

You can pay 'PART' or 'ALL' of your insurance by referring your friends to CCM, and at the same time, they can also save money on the price of their insurance!

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