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* 1. Enter the name of your group (e.g. the company, association or organisation you belong to that may make you eligible to benefit from Intact Insurance's Group Home and Automobile Insurance Program

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* 2. Please enter your contact information:

By completing the above form, you authorize Intact Insurance to contact you by phone, email, or other means, using the contact information you provided on the form, in order to offer you an insurance quote or to give you information about Intact Insurance products and services. You may withdraw your consent at any time by mail addressed to 2450 Girouard Street West, Saint-Hyacinthe QC  J2S 3B3.

*Contest begins January 1, 2020 and ends December 31, 2020. The draw will be held on January 20, 2021. The prize consists of one (1) cheque in the amount of CAN $1000. Certain conditions, limitations and exclusions apply. The contest is open to residents of the Province of Quebec who are employees or retired employees of an eligible group. The winner will be required to correctly answer a mathematical skill-testing question. For full contest rules, write to: Intact Compagnie d'assurance, 2450 Girouard Ouest, Saint-Hyacinthe, QC J2S 3B3.© 2019, Intact Insurance Company. All rights reserved.