We are happy to welcome you to medical school and offer you some OPTIONAL and NO-COST benefits during medical school. There is no obligation to register and you may cancel at any time without penalty.
Your medical student membership is provided complimentary when you join either or both Doctors of BC and CMA. Membership will give you access to special benefits provided by each organization and will cover you for all consecutive years you are enrolled as a medical student. You may cancel at any time.
I hereby apply for membership for either or both Doctors of BC and the CMA By applying for each membership you agree to abide by the By-laws, Rules and Regulations of Doctors of BC and/or the By-laws, Rules and Regulations of the CMA.
Insurance Coverage Included
Life and Disability insurance will be provided to you for all four years of medical school without charge (September 1, 2021 to June 30, 2025). You must apply to receive this coverage by completing this form.
For full coverage details, see Student Brochure
Disability Income Benefits
Monthly tax free income if you are unable to attend medical school, train or work due to accident or illness:
COLA: increases your monthly disability benefit each year that you remain disabled, up to age 65, by the lesser of the change in the Consumer Price Index or 3%.
GIB: allows you to increase your insurance coverage as your needs increase, without having to provide proof of good health.
Life Insurance Benefits
$100,000 tax free payout if you die to your loved ones to help repay debt, support family, or to pay for funeral expenses.
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 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.
Authorization and Declaration
I (the Member) hereby apply for insurance to The Manufacturers Life Insurance Company (Manulife). I declare that the statements contained in this application, are true and complete and, together with any other forms signed by me in connection with this application, form the basis for any coverage issued hereunder. I understand that any material misrepresentation including misstatement of smoker status shall render the insurance voidable at the instance of the insurer, and that suicide within two years of the effective date is a risk not covered. I understand that there are exclusions and limitations on the coverage applied for.
Relative to the insurance applied for, I, the undersigned person to be insured, hereby authorize any licensed physician, medical practitioner, hospital, pharmacy, clinic or other medically related facility, insurance company,the group policy administrator, the insurance plan sponsor, any investigative and security agency, any agent, broker or market intermediary, any government agency or other organization or person that has any records or knowledge of me or my health to provide to Manulife or its reinsurers any such information for the purpose of this application and contract and any subsequent claim. I authorize Manulife to consult its existing files for this purpose. I authorize Manulife to hold a personal file about myself and my insurance coverage. I authorize Manulife, the plan administrator, and their authorized staff, agents, representatives, advisors and service providers to use and exchange information needed for underwriting, financial management, administration and adjudication of claims under this insurance coverage with any person or organization who has relevant information about me including institutions, investigative agencies, insurers, and reinsurers. A photocopy or faxed copy of this authorization shall be as valid as the original.
I hereby designate the individual(s) named as beneficiary to receive the proceeds in accordance with any certificate issued hereunder. I acknowledge my receipt of and agreement with the Notice on Privacy and Confidentiality and Notice of Exchange on Information.
I will receive a certificate specifying the coverage provided and the main certificate provisions.
Personal Information Statement
In this Statement, “you” and “your” refer to the policyowner or holder of rights under the contract, the insured providing consent. “We”, “us”, “our,” and “the Company” refer to The Manufacturers Life Insurance Company and our affiliated companies and subsidiaries.
Updates to this Statement and further information about our privacy practices are posted to www.manulife.ca.
We collect, use, verify, and disclose your personal information for identified purposes, and only with your consent, or as permitted or required by law. By selecting submit or by signing the application, you give your consent for us to collect, use, and disclose your personal information, as set out in this Personal Information Statement. Any alterations to the consent must be agreed to in writing by the Company.
What personal information do we collect?
Depending on the product you have applied for, we collect specific personal information about you, such as:
We use fair and lawful means to collect your personal information.
Where do we collect your personal information from?
What do we use your personal information for?
We will use your personal information to:
Who do we disclose your information to?
The above mentioned people, organizations, and service providers are both within Canada and jurisdictions outside Canada, and would therefore be subject to the laws of those jurisdictions.
Where personal information is provided to our service providers, we require them to protect the information in a manner that is consistent with our privacy policies and practices.
The personal information you provided in this application:
How long do we keep your information?
The longer of:
Underwritten by The Manufacturers Life Insurance Company (Manulife).
Manulife, Manulife & Stylized M Design, and Stylized M Design are trademarks of The Manufacturers Life Insurance Company and are used by it, and by its affiliates under license.
Manulife, P.O. Box 670, Stn Waterloo, ON N2J 4B8 (Product to confirm). Accessible formats and communication supports are available upon request. Visit www.manulife.ca/accessibility for more information.