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Canadian Alumni Association

Canadian Insurance & Investment Advisors Alumni association

 

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Group Insurance Quote

Insurance Proposition
 
Full Name:
Province:
Postal Code:
Name at Birth
Address:
E-Mail (REQUIRED):
E-Mail again for accuracy:
Phone:
Fax (optional):

Sex (M/F): Smoker or
Non-smoker?
:
 
 
 
Please list each person adding information on your spouse and children in charge:

Information on your Spouse (if applicable)




Second Dependent




 

Third Dependent




  

Fourth Dependent




  

Fifth Dependent




 
  

Benificiary Name: Benificiary Type(Revocable/Irrevocable):
Relation to Benificiary:

Thank you for filling out this form COMPLETELY!


Click Button Below When Done

Coverage takes effect on lst of the month following receipt of your application form.

Coverage for your dependents

If you choose couple, single parent or family coverage your spouse and your children will be automatically covered by insurance medication. If you choose guaranteed medical expenses (option 3 or 4), your dependents will be covered by life insurance , drug insurance and medical insurance costs.


By spouse we mean your spouse under a marriage or any other formal union recognized by law or the person of the opposite sex or same sex with whom you are living together for at least twelve months and is publicly represented as your spouse. No minimum period of cohabitation is required if a child is born of your union.


By dependent child, we mean your child or that of your spouse, with the exclusion of a child taken into foster homes or who is neither married nor related by another type of formal union recognized by law and is under the age of 21 years (or under 26 if he/she is a full-time student you fully support). No age limit applies if the child is disabled due to physical or mental disability. However, this must have occurred before the age of 18 years and when the child met the definition of a dependent child.

Cessation of coverage


The coverage will end at the first of dates below:
on the date of termination
on the date you cease to be a member in good standing
at the time of fault as to payment of premiums
on the date on which is received a written notice or the date specified in the notice
at the time you reach the age of termination for each of the guarantees.

Management and program administration

MédicAssurance inc. administers the insurance program of the Register of Osteopaths of Quebec and is available to answer your questions about insurance and provide you with the necessary forms. Insurers of the program areLa Survivance, Mutual Life Insurance, Industrial Alliance Pacific and ACE INA Life Insurance.
This document provides an overview of the main features of the insurance program but does not show all the features. The contract established by the insurers to the intention of the Register of Osteopaths of Quebec, describes, in full the terms, conditions, exclusions and restrictions that governth policy.


Why do you need insurance?


The Register of Osteopaths of Quebec recognizes the importance of ensuring the financial security of loved ones and your peace of mind. A comprehensive insurance program can give you a solid foundation for the protection so that you might support and maintain your lifestyle if you are unable to work because of an accident or disease. That is why the ROQ Medic has allied with Assurance inc., La Survivance, Mutual Life Insurance, Industrial Alliance Pacific and ACE INA Life Insurance to offer a quality assurance program that combines flexibility for individual coverage with the financial benefits provided by group insurance. As a member of the ROQ, you can benefit from the guarantees offered here at an affordable price.

 

Life insurance


A strong element of financial planning
Whether you are just starting your career, married and established a plan for your retirement, protect the financial well-being of your family and loved ones in the event of your death through life insurance.

The death or accidental dismemberment insurance

Additional protection
The death or accidental dismemberment insurance helps to provide additional protection in case of death or serious injury resulting from an accident. This is a complete economical solution that will meet your needs for health care.

The medical expense insurance, prescription drug insurance and dental insurance


The medical expense insurance, prescription drug insurance and dental insurance provided by the program cover a range of cost medically necessary, which are not covered by the health insurance plan in your province. They can help you solve the problems that you might encounter when purchasing prescription drugs,for medical assistance in an emergency when traveling outside your province, or to receive dental care.

Critical Illness Insurance

Because it is important to enjoy a good protection
Thanks to technological advances in the medical field, the chances of surviving a serious illness are better than ever. The effects that the diagnosis of serious illnesscan can have on the physical and emotional development are difficult to bear, but what about the financial consequences?The loss of your employment income and the cost of medical treatments which are not covered by provincial health insurance or a private plan can compromise your security and financial independence. Insurance against Critical Illness is designed to contribute to your peace of mind so you can devote to what matters most - your recovery

Long-term wage inurance

Preserve your ability to earn income
Your ability to earn is the one of your most important assets. If you are unable to work due to accident or illness, the long-term wage insurance can contribute to your financial security and that of your family by providing a monthly income.

 

 



www.JustinCaseInsurance.com
Daniel La Tour: Financial Security Advisor - Canadian Insurance Advisor & Broker