Canada Protection Plan Critical Illness Insurance Application
This file contains the application form for Critical Illness Insurance provided by Canada Protection Plan. It includes a checklist to ensure priority service and avoid delays. The application details different plans, optional benefits, and issue ages.
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How do I fill this out?
To fill out this form, start by completing all applicable questions clearly and legibly. Make sure to provide all necessary documents and initial any corrections. Ensure the initial premium payment details are included as specified.

How to fill out the Canada Protection Plan Critical Illness Insurance Application?
1
Complete all applicable questions legibly.
2
Provide necessary documents and initial corrections.
3
Ensure initial premium payment details are included.
4
Attach a void cheque for monthly payments by Pre-Authorized Debit.
5
Verify all advisor information and submit the application.
Who needs the Canada Protection Plan Critical Illness Insurance Application?
1
Individuals seeking Critical Illness Insurance coverage to protect against major illnesses.
2
Advisors needing a comprehensive application form to offer to clients.
3
Clients who require assistance in paying for potential medical expenses from covered illnesses.
4
Policyholders looking to add optional benefits such as Accidental Death Benefit.
5
Individuals requiring a detailed checklist to ensure their application is complete and accurate.
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1
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2
Use the PDF editor to complete all applicable sections.
3
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5
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What are the instructions for submitting this form?
Submit the completed form with necessary documents via email to info@canadaprotectionplan.com, fax to 1-866-440-9881, or mail to Canada Protection Plan, 250 Ferrand Dr. Suite 1100, Toronto, ON M3C 3G8. Ensure all applicable questions are completed, and payment details are included. For online submissions, visit Canada Protection Plan's official website and follow the submission directions provided. Always double-check the provided information to avoid delays or issues in processing.
What are the important dates for this form in 2024 and 2025?
There are no specific dates listed for the form in 2024 and 2025. Ensure to check Canada Protection Plan updates for any changes.

What is the purpose of this form?
The purpose of this form is to provide individuals with a means to apply for Critical Illness Insurance through Canada Protection Plan. This insurance offers protection against major illnesses, helping clients manage potential medical expenses. The form includes detailed instructions, checklists, and options for different plans and benefits, ensuring applicants have a clear and structured application process.

Tell me about this form and its components and fields line-by-line.

- 1. Applicant Information: Contains personal details of the applicant including name, address, and contact information.
- 2. Coverage Details: Specify the type of coverage and plan being applied for, including any optional benefits.
- 3. Payment Information: Details regarding initial premium payment, including options for cheque or credit card payments.
- 4. Advisor Information: Section for the advisor's details, ensuring they have a valid insurance license and E&O on file.
- 5. Signature Section: Includes space for the signatures of the applicant and advisor, along with initialing any corrections made.
What happens if I fail to submit this form?
Failure to submit this form accurately and on time can result in delays or denial of insurance coverage.
- Delayed Processing: Incorrect or incomplete forms can lead to extended processing times.
- Denial of Coverage: Failing to provide accurate information may result in the application being denied.
- Missing Benefits: Not selecting optional benefits or providing necessary payment details can lead to loss of potential benefits.
How do I know when to use this form?

- 1. Initial Application: When first applying for critical illness insurance coverage.
- 2. Policy Updates: To update information or add optional benefits to an existing policy.
- 3. Premium Payment Changes: To change the method or frequency of premium payments.
Frequently Asked Questions
How do I complete this application form?
Complete all applicable sections legibly, attach necessary documents, and ensure accurate payment information.
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Use our electronic signature feature to add your signature directly to the document.
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You can share the PDF via email or by generating a shareable link.
What should I do if I make a mistake on the form?
Cross out the error, initial the correction, and ensure all parties sign the updated section.
How do I handle premium payments?
Include initial premium payment details as specified in the form, such as providing a void cheque for monthly PAD payments.
What optional benefits are available?
The form includes options for Accidental Death Benefit and Return of Premium on Death.
Who needs to sign the application?
Both the applicant and advisor must sign the form, each ensuring all information is accurate.
What documentation is required?
Attach any disclosed forms, void cheques for monthly payments, and necessary advisor information.
How do I ensure priority service?
Complete all applicable questions, attach necessary documents, and provide accurate payment details to avoid delays.
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