Broker - Life Insurance and Living Benefits
Your Advisor Centre
See all our information and sales concepts related to our life insurance, health and disability insurance (living benefits) products.
- Marketing documents
- Forms
- Guides
General Information
- K036 Health Insurance (PDF - 1 page)
- K1001E Life Insurance Summary (PDF - 1 page)
- T085 Family of Products (PDF - 6 pages)
Term Life Insurance
- K1001E Life Insurance Summary (PDF - 1 page)
- See all our concepts
Permanent Life Insurance
- K002 100% Pure Protection, leaflet (PDF - 6 pages)
- K014 Affirmative, leaflet (PDF - 8 pages)
- K079 Simplified Advantage, leaflet (PDF - 8 pages)
- K081 100% Pure Evolvement, leaflet (PDF - 6 pages)
Critical Illness Insurance
- K004 Extended Second Chance, leaflet (PDF - 8 pages)
- K012 Second Chance Children, leaflet (PDF - 8 pages)
- K032 Simplified Second Chance, leaflet (PDF - 8 pages)
Concepts
- K040 Credit Protection Insurance, leaflet (PDF - 6 pages)
- K042 Credit Protection Insurance, worksheet (PDF - 4 pages)
- K050 Mortgage Credit Insurance, table (PDF - 4 pages)
- K054 Disability Income Benefit Rider, table (PDF - 4 pages)
- K058 Rent Insurance, leaflet (PDF - 2 pages)
- K060 The Family Plan, leaflet (PDF - 6 pages)
- K099 Support Payment Insurance, leaflet (PDF - 2 pages)
- T089 Integrated Life Insurance, worksheet (PDF - 1 page)
Administration
- Authorization for the Disclosure of a Driving Record by the SAAQ (PDF - 1 page)
- Authorization to Disclose Medical Information (PDF - 1 page)
- Authorization to Disclose Medical Results (PDF - 1 page)
- Charitable Donation of Life Insurance Policy (PDF - 2 pages)
- Collateral Assignment (Outside Quebec) (PDF - 1 page)
- Contract Change (PDF - 1 page)
- Designation of Subrogated Policyholder (PDF - 1 page)
- Designation of Two Subrogated Policyholders (PDF - 1 page)
- IND001E Life Saver - Annual Premium Adjustment (PDF - 2 pages)
- IND002E Life Saver - Additional Contribution (PDF - 2 pages)
- IND003E Life Saver - Investment Instructions (PDF - 2 pages)
- IND034E Verification of an Entity's Identity (PDF - 5 pages)
- IND040E Verification of Tax Classification (FATCA AND CRS) - Individual (PDF - 1 page)
- IND041E Verification of Tax Classification (FATCA AND CRS) - Entity (PDF - 3 page)
- IND051E Declarations for Designation or Change of Irrevocable Beneficiary in Nova Scotia (PDF - 1 page)
- IND058E Authorization to Disclose Information to the Advisor or to the General Agent (PDF - 1 page)
- IND069E Change of Beneficiary - Critical Illness (PDF - 2 pages)
- IND075E Identification of Politically Exposed Persons and Heads Of International Organizations (PDF - 2 pages)
- IND078E Change of Beneficiary - Life Insurance (PDF - 2 page)
- IND080E Resolution of the Board of Directors (PDF - 1 page)
- IND100E Extra Premium Review - Exclusion Review (PDF - 1 page)
- IND102E Changing of Premium Payment Method (PDF - 1 page)
- IND103E Preauthorized Debit (PAD) Agreement (PDF - 1 page)
- IND104E Retrocession (PDF 1- page)
- IND106E Reinstatement (PDF - 1 page)
- IND107E Preferred Rate (PDF - 1 page)
- IND108E Cancellation - Surrender (PDF - 2 pages)
- IND117E Hypothecation of Rights under an Insurance Contract (Quebec) (PDF - 1 page)
- IND121E Verification of an Individual's Identity (PDF - 1 page)
- IND139E Designation or Change of Contingent Beneficiary (PDF - 1 page)
- IND147E Declaration of Name (PDF - 1 page)
- IND153E Confirmation of Insurable Risk (PDF - 1 page)
- IND177E Medical Authorization (PDF - 1 page)
- Opinion Request (PDF - 1 page)
- Policy Assignment (PDF - 1 page)
- Transfer of Coverage (PDF - 1 page)
Questionnaires
- IND012E Musculoskeletal Disorders Questionnaire (PDF - 3 pages)
- IND013E Back or Neck Disorders Questionnaire (PDF - 3 pages)
- IND014E Respiratory Disorders Questionnaire (PDF - 2 pages)
- IND015E Diabetes Questionnaire (PDF - 3 pages)
- IND016E Disabilitiy Income Benefit Questionnaire (PDF - 2 pages)
- IND017E Psychological Disorders Questionnaire (PDF - 2 pages)
- IND018E Intestinal Disorders Questionnaire (PDF - 2 pages)
- IND020E Driving Record Questionnaire (PDF - 2 page)
- IND021E Drug or Opiate Use Questionnaire (PDF - 2 pages)
- IND022E Criminal Record Questionnaire (PDF - 1 page)
- IND023E Indoor and Outdoor Climbing Questionnaire (PDF - 2 pages)
- IND024E Aviation Questionnaire (PDF - 2 pages)
- IND025E Racing Questionnaire (PDF - 1 page)
- IND026E Hang Gliding Questionnaire (PDF - 1 page)
- IND027E Sky Diving Questionnaire (PDF - 1 page)
- IND028E Scuba Diving Questionnaire (PDF - 1 page)
- IND029E Hazardous Sports Questionnaire (PDF - 1 page)
- IND030E Financial Questionnaire (PDF - 1 page)
- IND031E Alcohol Use Questionnaire (PDF - 1 page)
- IND032E Travel and Residence Abroad Questionnaire (PDF - 2 pages)
- IND043E Declaration of Insurability (PDF - 8 pages)
- IND045E Children's Life Insurance Rider - Questionnaire (PDF - 4 pages)
- IND046E Children's Critical Illness Rider - Questionnaire (PDF - 9 pages)
- IND134E Epilepsy Questionnaire (PDF - 2 pages)
Applications
- T032 Simplified Advantage Application (PDF - 8 pages)
- T056 Affirmative Application (PDF - 8 pages)
- T079 Simplified Second Chance Application (PDF - 8 pages)
- T073 Life Insurance and Critical Illness Application (PDF - 32 pages)
Claims
- Accidental Fracture Claim (PDF - 1 page)
- Children's Critical Illness - Claimant's Statement (PDF - 2 pages)
- Children's Critical Illness - Physician's Declaration (PDF - 1 page)
- Critical Illness - Claimant's Statement (PDF - 2 pages)
- Critical Illness - Physician's Statement - Alzheimer (PDF - 2 pages)
- Critical Illness - Physician's Statement - Cancer (PDF - 2 pages)
- Critical Illness - Physician's Statement - Coma (PDF - 2 pages)
- Critical Illness - Physician's Statement - Coronary Artery Bypass Surgery (PDF - 2 pages)
- Critical Illness - Physicians's Statement - Heart attack (PDF - 2 pages)
- Critical Illness - Physician's Statement - Kidney Failure (PDF - 2 pages)
- Critical Illness - Physician's Statement - Multiple Sclerosis (PDF - 2 pages)
- Critical Illness - Physician's Statement - Parkinson (PDF - 2 pages)
- Critical Illness - Physician's Statement - Stroke (PDF - 2 pages)
- Death - Claimant's Statement (PDF - 1 page)
- Death - Physician's Declaration (PDF - 1 page)
- Foreign Death - Claimant's Questionnaire (PDF - 2 pages)
- IND009E Disability Income Benefit - Payment Instructions (PDF - 2 pages)
- Long Term Care - Claimant's Statement (PDF - 2 pages)
- Long Term Care - Physician's Declaration (PDF - 2 pages)
- M311-A Disability Income Benefit - Physician's Declaration (PDF - 2 pages)
- M313-A Disability Income Benefit - Insured's Declaration (PDF - 1 page)
- M315-A Medical Authorization (PDF - 1 page)
- Required Documents and Consent - Transaction Fees - Service Fees (PDF 45 pages)
- Simplified Advantage Calculator (XLSX)
- IND133 Underwriting Requirements (PDF - 2 pages)
Contact our team
Brokerage Channel - Ontario and
Western Canada
7150 Derrycrest Drive
Mississauga Ontario L5W 0E5
Tel.: 1 855 795-2318 ext 55091
sales.support@lacapitale.com
Life Insurance & Living Benefits
Income Protection, Pillar Series
Jason Allen
Sales Director
Ontario & Western Canada
Toll free: 1 855 407-6509
Tel.: 905 795-2300 ext 55358
jason.allen@lacapitale.com
Isabelle Gauvreau
Sales Director
Quebec & Atlantic
Income Protection, Pillar Series
Toll free: 1 855 252-1578
Tel.: 418 573-8153
isabelle.gauvreau@lacapitale.com
Claudia Pilon
Sales Director
Quebec & Atlantic
Income Protection, Pillar Series
Toll free: 1 855 431-7945
Tel.: 514 226-6556
claudia.pilon@lacapitale.com
Savings & Investments
Jennifer Santos
Sales Director
Ontario & Western Canada
Toll free: 1 800 605-5536
Tel.: 416 819-4451
jennifer.santos@lacapitale.com
Andrew Gardiner
Sales Director
Ontario & Western Canada
Toll free: 1 833 570-8342
Tel.: 416 570-8342
andrew.gardiner@lacapitale.com
Simon Kirouac
Sales Director
Quebec & Atlantic
Toll free: 1 855 878-7197
Tel.: 514 809-5743
simon.kirouac@lacapitale.com
Martin-Charles Ranallo
Sales Director
Quebec & Atlantic
Toll free: 1 844 764-3767
Tel.: 514 214-4476
martin-charles.ranallo
@lacapitale.com
Broker’s support
Joe Gallo
Sales Coordinator
Ontario & Western Canada
Toll free: 1 800 268-2835
Tel.: 905 795-2300 ext 55091
joe.gallo@lacapitale.com
Simon Kirouac
Associate Director of Sales
Quebec & Atlantic
Toll free: 1 866 867-9296
Tel.: 418 528-2177
simon.kirouac@lacapitale.com
Support Line
Tel.: 1 888 392-2583