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*Effective date: |
(DD/MM/YYYY) |
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*Expiry date: |
(DD/MM/YYYY) |
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*Arrival date in Canada: |
(DD/MM/YYYY) |
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*Beneficiary name: |
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*Sum insured: |
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The applicant can add a deductible to receive a discount on their premium: |
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The applicant(s) confirms that they know of no reason for which they may seek medical attention.
The applicant(s) confirms that currently no circumstance is known for which a claim may be made.
The applicant(s) understands that if this policy is purchased within 60 days of their arrival in Canada, there is no coverage for Sickness occurring or arising during the first 48 hours from the effective date of this policy.
The applicant(s) understands that if this policy is purchased more than 60 days after their arrival in Canada, there is no coverage for Sickness occurring or arising during the first 7 days from the effective date of this policy. |
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| Please select the number of people to be covered by this policy: |
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