Other forms

Insurance on an account, loan, line of credit or credit card

Important: Before you begin

  • Print, fill out and sign the form.
  • Gather original supporting documents.
  • Send everything to the address indicated on the form.

Forms – Loan Insurance


Claim for Loan Insurance – Insured’s Statement (B2E) (PDF 908 KB) Opens in a new tab.

Submit a claim for Loan Insurance.


Claim for Loan Insurance – Physician’s Statement – Original request * cancer only (D301E) (PDF 760 KB) Opens in a new tab.

This form must be completed by the attending physician.

Forms – Loan Insurance – Versatile Line of Credit


Claim for Loan Insurance – Versatile Line of Credit – Insured’s Statement (B2E) (PDF 908 KB) Opens in a new tab.

Submit a claim for Loan Insurance – Versatile Line of Credit.


Claim for Loan Insurance – Versatile Line of Credit – Physician’s Statement – Original request * cancer only (D301E) (PDF 760 KB) Opens in a new tab.

This form must be completed by the attending physician.

Forms – Savings-Life Insurance


Claim for Savings-Life Insurance – Insured’s Statement (B2E) (PDF 908 KB) Opens in a new tab.

Submit a claim for Savings-Life Insurance.


Claim for Savings-Life Insurance – Physician’s Statement – Original request * cancer only (D301E) (PDF 760 KB) Opens in a new tab.

This form must be completed by the attending physician.

Forms – Insurance included with cash advances by equal installments and RRSP financing – Business


Claim for Insurance included with Cash Advances by Equal Installments and RRSP Financing – Business – Insured’s Statement (B2E) (PDF 908 KB) Opens in a new tab.

Submit a claim for insurance included with cash advances by equal installments and RRSP financing for a business.


Claim for Insurance included with Cash Advances by Equal Installments and RRSP Financing – Business – Physician’s Statement – Original request (D3E) (PDF 764 KB) Opens in a new tab.

This form must be completed by the attending physician.

Forms – Credit Balance Insurance – Individuals


Claim for Credit Balance Insurance – Individuals – Insured’s Statement (B2E) (PDF 908 KB) Opens in a new tab.

Submit a claim for Credit Balance Insurance for an individual.


Claim for Credit Balance Insurance – Individuals – Physician’s Statement – Original request (D3E) (PDF 764 KB) Opens in a new tab.

This form must be completed by the attending physician.

Forms – Credit Balance Insurance – Business


Claim for Credit Balance Insurance – Business – Insured’s Statement (B2E) (PDF 908 KB) Opens in a new tab.

Submit a claim for Credit Balance Insurance for a business.


Claim for Credit Balance Insurance – Business – Physician’s Statement – Original request (D3E) (PDF 764 KB) Opens in a new tab.

This form must be completed by the attending physician.