🔒 Your information is secure. Read our privacy policy.
Personal Info
Let's start with the basics.
Enter your first name.
Enter your last name.
Enter your full date of birth.
Enter a valid email address.
Enter a valid 10-digit phone number.
Mailing Address
Where should we send correspondence?
Enter your street address.
Enter your city.
Select a province.
Enter a valid postal code (A1A 1A1).
Residency Details
A few more questions about you.
Do you live in Canada?
Please answer this question.
We may not be able to help right now PolicyFind currently places coverage for Canadian residents. If you're relocating to Canada soon or think this doesn't apply to you, give us a call at 1-888-212-4212 and we'll point you in the right direction.
Are you a Canadian citizen?
Please answer this question.
Select your status.
Enter your country of birth.
Employment & Finances
Tell us about your current employment status.
Are you currently employed?
Please answer this question.
Self-employed? Enter your business name.
Enter your employer's name.
Enter your job title.
Helps us match you to insurers with the right coverage limits.
Helps ensure the coverage amount you're applying for is appropriate.
Choose an approximate range.
Do you currently hold any individual life or living benefits insurance? (Not employer-provided group coverage)
Choose a type.
Enter the coverage amount.
Enter the insurance company.
Enter a valid 4-digit year.
Medical History
Please answer the following health questions.
Your health information is kept strictly confidential and is used only for underwriting purposes.
Enter your height.
Enter your weight.
1. Tobacco / Nicotine Use
Have you used any tobacco or nicotine products (including vaping) in the past 12 months?
Have you used any tobacco or nicotine products (including vaping) in the past 12 months?
2. Major Medical Conditions
Have you ever been diagnosed with, treated for, or advised to seek treatment for any serious medical condition?
Have you ever been diagnosed with, treated for, or advised to seek treatment for any serious medical condition?
3. Ongoing Treatment or Medication
Are you currently taking prescription medication or receiving ongoing medical treatment?
Are you currently taking prescription medication or receiving ongoing medical treatment?
4. Hospitalization or Surgeries
Have you been hospitalized, had surgery, or been advised to have surgery in the past 5 years?
Have you been hospitalized, had surgery, or been advised to have surgery in the past 5 years?
5. Work & Lifestyle Risk
Are you currently off work, on disability, or limited in your ability to work due to health reasons?
Are you currently off work, on disability, or limited in your ability to work due to health reasons?
6. Family History
To your knowledge, did either of your biological parents pass away or develop heart disease, stroke, cancer, or diabetes before age 60?
To your knowledge, did either of your biological parents pass away or develop heart disease, stroke, cancer, or diabetes before age 60?
7. Prior Insurance History
Have you ever been declined, postponed, rated, or offered non-standard terms on a life or living benefits insurance application?
Have you ever been declined, postponed, rated, or offered non-standard terms on a life or living benefits insurance application?
Lifestyle & Risk Factors
A few more questions to help us match you to the right insurer.
Please choose one.
2. Alcohol or Drug Treatment
Have you ever been advised to reduce, or received treatment for, alcohol or drug use?
Have you ever been advised to reduce, or received treatment for, alcohol or drug use?
3. Mental Health
Have you ever been diagnosed with or treated for depression, anxiety, or another mental health condition?
Have you ever been diagnosed with or treated for depression, anxiety, or another mental health condition?
4. Pending Tests or Investigations
Are you currently awaiting any medical test results, or scheduled for a procedure not yet completed?
Are you currently awaiting any medical test results, or scheduled for a procedure not yet completed?
5. Abnormal Diagnostic Results
In the past 2 years, has any diagnostic test come back abnormal or required follow-up?
In the past 2 years, has any diagnostic test come back abnormal or required follow-up?
6. Hazardous Activities
Do you participate in aviation (other than as a passenger), scuba diving, skydiving, or motor racing?
Do you participate in aviation (other than as a passenger), scuba diving, skydiving, or motor racing?
7. Driving Record
In the past 3 years, has your licence been suspended or revoked, or have you been charged with impaired driving?
In the past 3 years, has your licence been suspended or revoked, or have you been charged with impaired driving?
Family Doctor
Your physician information.
Do you have a family doctor?
Please answer this question.
That's okay — not everyone has a family doctor. If needed, the insurer may arrange a paramedical exam at no cost to you as part of underwriting.
Beneficiary Designation
Who should receive the payout? You can change this anytime. Shares must add up to 100%.
Total allocated: 0%
ID Verification
Please upload a government-issued ID.
Upload a photo or file or drag and drop
PNG, JPG, or PDF up to 20MB
Remove
Please upload a government-issued ID.
🔒 Sent securely to your advisor and used only to verify your identity.
Premium Payment
Set up your payment method.
Nothing is charged today. This is a submission, not the final insurance application. Your first payment only comes out after:
- you review and sign the formal application with the insurer (e.g. RBC, Canada Life), and
- the insurer approves it.
Please confirm you've read this to continue.
Payment frequency
A clear photo of a cheque with “VOID” written across it works.
Upload a photo or file or drag and drop
PNG, JPG, or PDF up to 20MB
Remove
Please upload a void cheque so we can set up your payment.
🔒 Sent over an encrypted connection. No funds are withdrawn until your policy is approved.
Review & Submit
Please review your answers, then read and agree to the following.
Applicant Declaration I hereby declare that the information I have provided in this form is true, complete, and accurate to the best of my knowledge and belief. I understand that providing false, misleading, or incomplete information may result in delays, denial of services, cancellation of benefits, or other legal or administrative consequences.
Information Use Consent I acknowledge and consent to the collection, use, and disclosure of my personal, medical, and payment information for the purposes described in this form and in accordance with applicable Canadian privacy laws. Click here to read our Privacy Policy.