March 10, 2025: We are experiencing issues with this e-application form. If you experience challenges submitting this form, please use the alternate DocuSign beneficiary Designation form.

Alternatively you may access a paper version of this form you can email to insurance@doctors of BC here.

General Information

In this application, we, us and our refer to The Manufacturers Life Insurance Company (Manulife). You and your refer to the person who is the Doctors of BC member.

By completing this form, you are asking us to change the information you previously provided. Any previous beneficiary designation or trustee appointment is revoked.

This designation supersedes any previous beneficiary designation and will be applied to all lines of life insurance on the life of the insured named above?

A beneficiary is the person or organization that will receive your policy’s death benefit. A revocable beneficiary is someone you choose that can be changed at any time without their permission. An irrevocable beneficiary cannot be changed without the written permission of the irrevocable beneficiary.

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.

If naming a corporation as beneficiary: write the name of the corporation in the "Last Name" field. Enter one space for the first name and leave the initial blank. Relationship to insured can be professional corporation, employer, holding company. Percentage should be 100%

If you designate more than one beneficiary, you must indicate the percentage of the claim to be paid to each beneficiary (the total percentage for all beneficiaries combined cannot be more than 100%).

You may want to designate a "contingent beneficiary" - an alternate beneficiary who you want to receive the death benefit in the event the beneficiaries you designated as primary beneficiaries are not living at the time of your death.

If naming a corporation as primary beneficiary: a contingent beneficiary is not required.

Complete this section only if a beneficiary named on this form is a minor. If so, 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.

Please complete the DocuSign request below. Once signed your form will be automatically submitted to Doctors of BC insurance.  

Underwritten by The Manufacturers Life Insurance Company (Manulife)

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