Coverage is available from a minimum of $50,000 to a maximum of $5,000,000 in units of $50,000.

A telephone interview will be required in order to assess your application. Manulife has selected a national support organization to conduct this interview. A carefully screened and trained interviewer will ask you a series of questions about your medical history, your doctor's name, and any medications taken. The interview will take approximately 30 minutes and be kept in strictest confidence. The information you provide will be used solely for insurance purposes and will be sent to Manulife promptly upon completion.

Indicate the amount of coverage you are applying for at this time, excluding existing Doctors of BC coverage if any.

*For more information about the riders,visit the Doctors of BC website at www.doctorsofbc.ca/insurance.

Beneficiary Designation 

This designation supercedes any previous beneficiary designation and will apply to the entire amount of your Doctors of BC Life insurance coverage.

I hereby designate the individual named as beneficiary on this application to receive any death benefit payable with respect to the coverage applied for. If all the
primary beneficiaries are no longer alive, any death benefit payable will become payable to the secondary beneficiary.

If no beneficiary is designated, benefits will be payable to the Estate.

If you designate a beneficiary who is a minor when benefits become payable, benefits will be paid into court or to the Public Trustee, unless a trustee is appointed. By appointing a trustee below, you agree that if the beneficiary is a minor on the date that benefits become payable, the benefits will be paid to the trustee to hold in trust for the minor until the minor comes of age.

A primary beneficiary is a designated individual(s) who are first in line to receive the proceeds of the life insurance policy. A secondary beneficiary is the individual(s) who would receive the proceeds if something happened to the primary beneficiary.

If your appointed beneficiary is under the age of 19 you must name a trustee. A trustee is ther person who manages a minor’s inheritance under a trust.

Coverage is available from a minimum of $50,000 to a maximum of $5,000,000 in units of $50,000.

A telephone interview will be required in order to assess your application. Manulife has selected a national support organization to conduct this interview. A carefully screened and trained interviewer will ask you a series of questions about your medical history, your doctor's name, and any medications taken. The interview will take approximately 30 minutes and be kept in strictest confidence. The information you provide will be used solely for insurance purposes and will be sent to Manulife promptly upon completion.

Indicate the amount of coverage you are applying for at this time, excluding existing Doctors of BC coverage if any. 

*For more information about the riders,visit the Doctors of BC website at www.doctorsofbc.ca/insurance.

Beneficiary Designation 

This designation supercedes any previous beneficiary designation and will apply to the entire amount of your Doctors of BC Life insurance coverage.

I hereby designate the individual named as beneficiary on this application to receive any death benefit payable with respect to the coverage applied for. If all the
primary beneficiaries are no longer alive, any death benefit payable will become payable to the secondary beneficiary.

If no beneficiary is designated, benefits will be payable to the Estate.

If you designate a beneficiary who is a minor when benefits become payable, benefits will be paid into court or to the Public Trustee, unless a trustee is appointed. By appointing a trustee below, you agree that if the beneficiary is a minor on the date that benefits become payable, the benefits will be paid to the trustee to hold in trust for the minor until the minor comes of age.

A primary beneficiary is a designated individual(s) who are first in line to receive the proceeds of the life insurance policy. A secondary beneficiary is the individual(s) who would receive the proceeds if something happened to the primary beneficiary.

If your appointed beneficiary is under the age of 19 you must name a trustee. A trustee is ther person who manages a minor’s inheritance under a trust.

Coverage is available from a minimum of $50,000 to a maximum of $500,000 in units of $10,000.

Coverage is available from a minimum of $50,000 to a maximum of $500,000 in units of $10,000.

Coverage is available in units of $100. You can apply for a minimum of $500 to a combined monthly maximum of $30,000, depending on the elimination period you select.

You can select up to a maximum of $11,000 under the 14 day elimination period or $30,000 under the other elimination period options. If you select the $11,000 maximum under the 14 day elimination period option, you may select an additional amount up to the $30,000 overall maximum under longer elimination periods.

The elimination period is the time period between when an illness/injury has occurred and the commencement of the benefit payment.

The shorter the elimination period, the higher the premium.

*For more information about the riders,visit the Doctors of BC website at www.doctorsofbc.ca/insurance.

You can apply for coverage in increments of $100 to a maximum of $25,000 per month from all sources (excluding the Physicians’ Disability Insurance) with an elimination period of 28 days, 60 days, 90 days or 120 days. 

The elimination period is the time period between when an illness/injury has occurred and the commencement of the benefit payment. The shorter the elimination period, the higher the premium.

Total benefit applied for cannot exceed $25,000.

*For more information about the riders,visit the Doctors of BC website at www.doctorsofbc.ca/insurance.

The provincial government provides funding for this benefit. The premium paid on your behalf is a taxable benefit to you.

Complete this section if you are a member applying for Disability Income insurance or Professional Expense Insurance

You indicated you are an employee. The vast majority of employees are covered by employment insurance. To be sure, you can check your most recent paystub and look for EI deductions in your year-to-date column.

If this helps you confirm your EI status, please re-answer the EI question above as 'yes' before continuing. Otherwise, you may leave it as 'unsure'.

You indicated you are self-employed. Self-employed people are generally not eligible for employment insurance if they own more than 40% of the voting shares of a private corporation or they are sole proprietors running their own business.

However, there is a special voluntary EI benefits program for self-employed people that you can voluntarily opt-in. This was introduced by the government of Canada in 2010. In order to opt-in you must have completed an application via your My Canada Service Account and have been approved.

If this helps you confirm your EI status, please re-answer the EI question above as 'No' before continuing. Otherwise, you may leave it as 'unsure'.

If you are applying for Disability insurance, financial documents are required to confirm your income (unless you are in residency or have commenced your initial medical practice in Canada in the last two years).

If you are applying for Professional Expense Insurance that exceeds a total of $10,000 per month, financial documents are required to confirm your expenses.

Note: If you intend to replace coverage, do not cancel your existing coverage until you receive your new insurance certificate. A replacement form or declaration may be required, and we may not be able to issue an insurance certificate where replacement is indicated.

Please press Submit - our insurance team will follow-up with you directly by DocuSign to obtain the required signatures.