Protecta Critical Illness insurance


To order quantities of printed forms, please contact your sales office. Sales offices can complete Request for Forms (PC BIL 3340) and fax it to us toll-free at 1 877 536-4666.


Name
Loan Repayment Form 1581
Claim Note Form 2004
Client Identification Supplementary Information
(effective June 23, 2008)		 PC 6330
Life Insurance and Critical Illness Insurance -
Express Application Form		 5072
Life Insurance and Critical Illness Insurance -
Express Application fillable Form

Fillable application Instructions - Life Insurance and Critical Illness Insurance - Express Application 		5072 –
Fillable

5072 –
Instructions
Life Insurance and Critical Illness Insurance -
Comprehensive Application Form		 5071
Pre-approved Protecta CI offer for adults – acceptance forms PC 6066
Pre-approved Protecta CI Child offer – acceptance forms PC 6067
Your guide to underwriting with Standard Life 5664
Protecta Adult Plans Insurability Checklist PC 5016
Protecta Child Plans Insurability Checklist PC 5017
Fax order form for Underwriting Requirements PC BIL 3186
Underwriting Requirements -
Protecta, Perspecta, Term 10/20		 PC 4439
Declaration of Insurability 2761
Declaration of Continued Insurability PC 6065
Pre-Authorized Debit (PAD) Agreement PC 2010-Fillable
Gradual Inheritance Concept (Flyer and application form) PC 6544-fillable

Supplementary Questionnaires (as required)

Name
Nervous condition questionnaire BIL 5829
Mountaineering questionnaire PC BIL 5830
Activities of daily living (ADL’s) PC BIL 5832
Alcohol Usage PC BIL 2149
Asthma XPS BIL 541
Diabetes PC BIL 260
Drug Usage PC BIL 2148
Confidential Financial Questionnaire PC 2863
Hazardous & Aviation Activities 659
Loss of Consciousness PC BIL 2150
Foreign Residence/Travel 3965

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