Do they have or have they ever had- (Person-1)
Do they have or have they ever had- (Person-2)
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 understand that if you have provided incorrect information Old Republic Insurance Company of Canada will void the policy and cancel all coverage.
You also understand that if your health changes before Your Start Date you must contact your broker to update your eligibility.
To be eligible for coverage, on the effective date, you must:
If you purchase this coverage after your arrival in Canada there is no coverage for any sickness that began, or for which you experienced symptoms, during:
even if related expenses are incurred after the Waiting Period.
The waiting period may be waived if this policy is purchased on or prior to the expiry date of an existing Secure Travel RIMI Visitors to Canada Travel Insurance policy already issued by the insurer, to take effect on the day following such expiry date provided no increase in the sum insured option is applied for. The existing policy must be in effect on the date of purchase and there must be no gap in coverage.
Coverage is NOT AVAILABLE to any individual who:
To be eligible for coverage you must, as of the effective date:
There is no coverage for medical expenses resulting from COVID-19 and related conditions while on a Side-Trip outside of Canada if a Government of Canada Level 3 (avoid non-essential travel) or Level 4 (avoid all travel) travel advisory related to Covid-19 is in effect for you or for the destination on the day they leave Canada.
Please monitor travel.gc.ca for travel advisory updates from the Government of Canada.
You are not eligible for coverage under this policy if:
• you are traveling against the advice of a physician;• you have been diagnosed with a terminal illness with less than two (2) years to live;• you have been diagnosed with or received treatment within the last two (2) years for pancreatic, lung, brain, or liver cancer; or any type of cancer that has spread from one part or organ of the body to another (metastatic cancer);• you have had or are waiting for an organ or bone marrow transplant (excluding corneal transplant);• you have a kidney condition requiring dialysis;• you have used home oxygen during the 12 months prior to the date of application;• you reside in a nursing home, other long term care facility or rehabilitation centre; and/or• You are age 86 or older (unless buying the Basic Plan)
You have answered Yes to one of the Eligibility Questions; and to proceed further,
Submit the form and give me a call at-