Representative’s Resource Library
Forms
Administration
Claims
Underwriting
Administration
- Needs Analysis - ULI (PDF - 177 Kb)
- Authorization to Collect Personal Information (PDF - 303 Kb)
- Change of Occupation (PDF - 84 Kb)
- Declaration of Health (Life, S.P. and U.L.I.) (PDF - 102 Kb)
- Declaration of Health - Short Form (PDF - 87 Kb)
- Declaration of Insured (Acci-Jet) (PDF - 132 Kb)
- Legal Change Request (PDF - 147 Kb)
- Overhead Expense Insurance (PDF - 160 Kb)
- Overhead Expense Insurance for Farm Enterprise (PDF - 189 Kb)
- Overhead Expense Insurance for Truck Owners (PDF - 158 Kb)
- Pre-Authorized Debit Agreement (PDF - 309 Kb)
- Reinstatement Form (Acci-Jet) (PDF - 81 Kb)
- Reinstatement Form (Excel Hospitalization) (PDF - 81 Kb)
- Reinstatement Form (Excel Life) (PDF - 81 Kb)
- Reinstatement Form (Cancer Guard) (PDF - 80 Kb)
- Reinstatement Form (Access Life 1) (PDF - 479 Kb)
- Reinstatement Form (Access Life 2) (PDF - 478 Kb)
- Income Sharing (PDF - 206 Kb)
- Cancellation Request (PDF - 405 Kb)
- Modification Form (PDF - 484 Kb)
Declarations of Understanding
- Declaration Arabic (PDF - 241 Kb)
- Declaration Filipino (PDF – 108 Kb)
- Declaration German (PDF - 112 Kb)
- Declaration Greek (PDF - 108 Kb)
- Delcaration Haitian Creole (PDF - 303 Kb)
- Declaration Hindi (PDF - 280 Kb)
- Declaration Italian (PDF – 110 Kb)
- Declaration Japanese (PDF – 345 Kb)
- Declaration Korean (PDF - 373 Kb)
- Declaration Mandarin - Simplified (PDF – 305 Kb)
- Declaration Mandarin - Traditional (PDF – 176 Kb)
- Declaration Persian (PDF - 155 kb)
- Declaration Polish (PDF – 109 Kb)
- Declaration Portuguese (PDF – 108 Kb)
- Declaration Punjabi (PDF – 384 Kb)
- Declaration Russian (PDF – 111 Kb)
- Declaration Sinhalese (PDF - 178 Kb)
- Declaration Spanish (PDF – 107 Kb)
- Declaration Tamil (PDF - 134 Kb)
- Declaration Thaï (PDF – 154 Kb)
- Declaration Turkish (PDF - 110 Kb)
- Declaration Vietnamese (PDF – 181 Kb)
Claims
Life Insurance & Hospitalization
- Acci7 (PDF - 210 Kb)
- Individual Insurance Proof of Death - Life (PDF - 119 Kb)
Overhead Expenses Insurance & ULI
- Business Overhead Claim Form (PDF - 85 Kb)
- Universal Loan Insurance Claim Form (PDF - 83 Kb)
- Universal Loan Insurance Claim Form - Rent (PDF - 85 Kb)
Statements of Attending Physician
- Attending Physician's Statement - Acci-Jet (Accident & Soft Tissue Injury) (PDF - 167 Kb)
- Attending Physician's Statement - Cancer and CI (PDF - 93 Kb)
- Attending Physician's Statement - Hospitalization (PDF - 87 Kb)
- Attending Physician's Statement - Illness (Superior Program, Acci-Jet & ULI) (PDF - 220 Kb)
- Attending Physician's Statement - Pregnancy (PDF - 90 Kb)
- Attending Physician's Statement - Psychological Illness (Superior Program, Acci-Jet & ULI) (PDF - 309 Kb)
Statements of Claimant or Employer
- Statement of Claimant - Cancer (PDF - 228 Kb)
- Statement of Claimant - Standard (PDF - 160 Kb)
- Statement of Claimant - ULI (PDF - 159 Kb)
- Statement of Employer (PDF - 114 Kb)
Other
- Accident & Health Claim Form (PDF - 67 Kb)
- Authorization to Collect Personal Information (PDF - 303 Kb)
- Authroization - RAMQ (PDF - 82 Kb)
- Claim Procedure (PDF - 387 Kb)
- Return of Premium (PDF - 148 Kb)
- Trip Cancellation (PDF - 467 Kb)
- Travel Insurance - Hospital & Medical Expenses (PDF - 106 Kb)
MRA groups
- Accidental dismemberment and loss of signs (PDF – 214 Kb)
- Authorization (PDF – 104 Kb)
- Authorization for disclosure of information (PDF – 72 Kb)
- Death authorization (PDF – 319 Kb)
- Dependent's life insurance benefit claim and proof of death (PDF – 104 Kb)
- Life insurance benefit claim and proof of death (PDF – 108 Kb)
- Long-term disability insurance claim or request for waiver of premiums (PDF – 146 Kb)
- Overhead Expenses Claim Form (PDF – 55 Kb)
- Overhead Expenses Claim Form - Eligible Vehicule Expenses (PDF – 55 Kb)
- Statement to be made by employer or by Insured if self-employed (PDF – 96 Kb)
- Statement to be made by Employer or by Insured if self-employed (Resident, other than Province of Quebec) (PDF – 100Kb)
- Statement to be made by attending physician (PDF – 161 Kb)
- Statement of Attending Physician - Psychological Illnesses (PDF – 193 Kb)
- Statement of income and job description ($1,000 and -) (PDF – 96 Kb)
- Statement of income and job description ($1,000 and +) (PDF – 98 Kb)
Underwriting
- Authorization (PDF - 536 Kb)
- Aviation or Aerial Sports (PDF - 536 Kb)
- Back (PDF - 502 Kb)
- Bowel Disorders (PDF - 499 Kb)
- Cardiovascular Disorders (PDF - 468 Kb)
- Climbing or Mountaineering (PDF - 524 Kb)
- Diabetes (PDF - 497 Kb)
- Digestive Disorders (PDF - 499 Kb)
- Driving Record (PDF - 585 Kb)
- Drug Use (PDF - 515 Kb)
- Epilepsy (PDF - 534 Kb)
- Joints (PDF - 508 Kb)
- Motor Sports (PDF - 497 Kb)
- Nervous Disorders (PDF - 499 Kb)
- Occupationnal Class Enhancement (PDF - 486 Kb)
- Out of Country Travel or Stays (PDF - 521 Kb)
- Pulmonary Disorders (PDF - 468 Kb)
- Rider (PDF - 560 Kb)
- Tobacco Use (PDF - 87 Kb)
- Trucker - Driver - Transport Driver (PDF - 192 Kb)
- Underwater Diving (PDF - 525 Kb)
- Change from Smoker to Non-Smoker Rate - Access Life (PDF - 473 Kb)
- Urinary Disorders (PDF - 503 Kb)
- Change from Smoker to Non-Smoker Rate - Cancer 1 (PDF - 468 Kb)
- Change from Smoker to Non-Smoker Rate - Cancer 2 (PDF - 469 Kb)