Preparing for your insurance application

Personally-owned insurance

Information below is required from each person being insured under a policy, unless otherwise stated

1. Your driver’s licence

2. Your Social Insurance Number

3. (If you are a US resident or citizen) Your Taxpayer Identification Number

4. Your employer’s address and postal code

5. (For life insurance) Who you want as your:

   • Primary beneficiaries

   • Contingent beneficiaries (receive the death benefit if no primary beneficiaries are living)

   • Trustee for any primary or contingent beneficiaries currently under age 18

6. Your financial information (for each person to be insured and for the policyowner if the policy is to be owned by another party):

   • Total assets (e.g. your principal residence, other properties, car, savings and investments)

   • Total liabilities (e.g. mortgage, any other loans)

   • Net worth = total assets - total liabilities

   • Annual earned income (e.g. from employment)

   • Annual unearned income (e.g. from investments)

7. Details of any life, critical illness, disability or long-term care insurance you currently have, or were declined for, decided to cancel, or had policy issue postponed:

   • Insurer

   • Face amount

   • Year issued or submitted (if issue is still pending)

   • If an application was denied or policy cancelled or postponed, why?

8. The date (if applicable, as near as you can remember, month and year are fine) of the last time you used marijuana, tobacco, hash, nicotine products or nicotine substitutes

9. Details (if applicable) of any trips you’ve taken outside North America in the past 12 months or plan to take in the next 12 months (length of time away and purpose of trips, dates of departure and return if possible)

10. Details (if applicable, dates and types of violation) of any moving violations (e.g. speeding, running a stop sign or red light) in the last 3 years, and any licence suspensions, DUIs or reckless driving convictions in the past 10 years.

11. Name of your family doctor and any specialists you’ve consulted and, for each:

• 1. Their practice’s address

  2. Their phone number

  3. Date of last consultation, reason for consultation, treatment or medication prescribed, and results

12. Your height, weight, and amount (if any) of weight change in the last year and why

13. Details of any medical conditions you currently have, what medications you take for them, dates of diagnoses

14. Details of any hospitalizations in the past 5 yrs

15. Family health history of parents brothers and sisters (disease or disorder, if any, any of them suffered from, age at onset, age if living or age at death and cause of death)

16. A blank cheque for pre-authorized debits (if paying monthly)

Corporately-owned insurance

Same as the personal requirements, plus:

1. Corporation’s legal name (and trade name, if applicable), business number, and address

2. The corporation’s financial information:

   • Total assets (e.g. equipment, retained earnings)

   • Total liabilities (e.g. mortgage, any other loans)

   • Net worth = total assets - total liabilities

   • Annual earned income (e.g. from active business)

   • Annual unearned income (e.g. passive investment income)

   • Fair market value of business

   • Net profit after taxes for the last two years

3. Your percentage ownership of the business

4. Details of business insurance on other members of business and how amount of insurance was determined

5. For cash value life insurance:

   • Copy of articles of incorporation

   • Copy of organization chart, if available

   • Names and addresses of all persons or entities who own 25% or more of the shares of the corporation