Broker Application Webform

Broker Application Webform

Registration Type

Register As (Required)

New User Account (Existing Brokers)

Brokerage / Branch Details

Branch Address

User Details

New Brokerage Application

Brokerage Details

Head Office Details

Head Office Address

List of Branches

Branch Details

Maximum file size: 32MB

Accepted file types: xlsx, xls

Contracts, MGA's & Wholesalers

List all contracts with insurance companies

Insurance Company

List all MGA’s & Wholesalers you do business with

Points of Contact

Commercial Lines

Personal Lines

Overall Contract Relationship

Electronic Data Transmission Contacts


Product Training

Canada’s Anti-Spam Law (CASL) requires consent for our electronic messages.

 I consent to Taycon Risk sending emails to my Brokerage.

Platform User Logins

DRUM is our self-serve platform where you can quote & issue your documents in real time.

For all brokerage accounts, we require you to provide a *General email address. This email address will be sent a copy of all policy activity (for all users). This serves as an excellent audit trail for brokerage management. (Consider –

Each individual user’s login will be their company email. Every user can view all brokerage transactions. The platform records activity by individual user.

When a user enters a policy transaction, the individual user will receive the document in their company email and the brokerage will also receive an email in the *General email address provided below for the Brokerage.

Required for general policy deliverance

User Accounts

Maximum file size: 32MB

Accepted file types: xlsx, xls

Errors & Omission Coverage

Has there been any E&O claims in the past 5 years?

Licencing - List Current Licences

Has the Brokerage had any license(s) suspended, terminated or been fined?
Has the Brokerage or any licensed individual representing the Brokerage been reprimanded by a Regulator in the past 5 years?


Need Some Help? Or Prefer a Download

Should you have any questions, please contact us.
If you prefer pen to paper, download our fillable Broker Application Form and spreadsheet.

Broker Application Form