Visitor Visa Insurance Form

Coverage is NOT AVAILABLE to any individual who:

• has been diagnosed with a terminal illness; or
• has been diagnosed with or received treatment for pancreatic cancer, liver cancer, or any type of cancer that has metastasized (migrated to another organ from its original site); or
• has been prescribed or used home oxygen in the last 12 months; or
• has been diagnosed with or received treatment for congestive heart failure; or
• has had a major organ transplant (heart, kidney, liver, lung); or
• has received kidney dialysis treatment in the last 12 months.

To be eligible for coverage you must, as of the effective date:

• be at least 15 days old, and
• be in good health at the time you purchase your policy and on the effective date, and know of no reason why you would seek medical attention during the period of coverage.
• not be insured or eligible for benefits under a Canadian Government Health Insurance Plan (GHIP).
   

Waiting Period:

• Age 0 to 85
  • If the insurance was purchased prior to your arrival date in Canada, the “waiting period” does not apply or,
  • If this insurance is purchased any time after your arrival in Canada, then in respect of any sickness you will only be entitled to receive benefits for the cost of eligible medical expenses incurred after the first 48 hours from the effective date of the policy.

• Age 86 and over
  • If the insurance was purchased prior to the arrival date in Canada, the “waiting period” does not apply.
  • If the insurance is purchased after your arrival date in Canada, then in respect of any sickness you will only be entitled to receive benefits for the cost of eligible medical expenses incurred after fifteen (15) days from the effective date of this policy.

• The waiting period may be waived if:
  • This policy is purchased on or prior to the expiry date of an existing Destination: Canada policy.
  • If you have insurance with another insurer during the first part of your trip in Canada, and you are purchasing this insurance after your arrival in Canada and there will be no gap in coverage. You must provide satisfactory proof that you have other coverage in force and receive written approval from the Insurer.

Please communicate the following declaration to the applicant(s):

You declare that the information given is accurate. If you were unsure about the medical information needed for a question you have checked with your doctor.

You also understand that if your health changes before Your Start Date you must contact your broker to update your eligibility.