Individual insurance and investment brokers

Document Centre

Term Life insurance

  • Family fixed term insurance, it's our business | Editable Admat
  • Loan Insurance solution | Editable Admat

  • Beneva eSignature Policy
  • Authorization for the Disclosure of a Driving Record by the SAAQ
  • Claim – Accidental Fracture
  • Authorization to Disclose Medical Information
  • Charitable Donation of Life Insurance Policy
  • Collateral Assignment – Outside Quebec
  • Claim – Death – Physician's Declaration
  • Designation of Subrogated Policyholder
  • Designation of Two Subrogated Policyholders
  • Claimant’s Questionnaire – Foreign Death
  • Claim – Disability Income Benefit – Payment Instructions | IND009E
  • Questionnaire – Musculoskeletal Disorders | IND012E
  • Questionnaire – Back or Neck Disorders | IND013E
  • Questionnaire – Respiratory Disorders | IND014E
  • Questionnaire – Diabetes | IND015E
  • Questionnaire – Disabilitiy Income Benefit | IND016E
  • Questionnaire – Psychological Disorders | IND017E
  • Questionnaire – Intestinal Disorders | IND018E
  • Questionnaire – Driving Record | IND020E
  • Questionnaire – Drug or Opiate Use | IND021E
  • Questionnaire – Criminal Record | IND022E
  • Questionnaire – Indoor and Outdoor Climbing | IND023E
  • Questionnaire – Aviation | IND024E
  • Questionnaire – Racing | IND025E
  • Questionnaire – Hang Gliding | IND026E
  • Questionnaire – Sky Diving | IND027E
  • Questionnaire – Scuba Diving | IND028E
  • Questionnaire – Hazardous Sports | IND029E
  • Questionnaire – Financial | IND030E
  • Questionnaire – Alcohol Use | IND031E
  • Questionnaire – Travel and Residence Abroad | IND032E
  • Verification of an Entity's Identity | IND034E
  • Verification of Tax Classification (FATCA AND CRS) – Individual | IND040E
  • Verification of Tax Classification (EATCA AND CRS) – Entity | IND041E
  • Questionnaire – Declaration of Insurability | IND043E
  • Questionnaire – Children's Life Insurance Rider | IND045E
  • Questionnaire – Children's Critical Illness Rider | IND046E
  • Declarations for Designation or Change of Irrevocable Beneficiary in Nova Scotia | IND051E
  • Authorization to Disclose Information to the Advisor or to the General Agent | IND058E
  • Identification of politically exposed persons | IND075E
  • Change of Beneficiary – Life Insurance | IND078E
  • Resolution of the Board of Directors | IND080E
  • Extra Premium Review – Exclusion Review | IND100E
  • Changing of Premium Payment Method | IND102E
  • Preauthorized Debit (PAD) Agreement | IND103E
  • Release from assignment | IND104E
  • Reinstatement | IND106E
  • Cancellation – Surrender | IND108E
  • Hypothecation of Rights under an Insurance Contract – Quebec | IND117E
  • Verification of an Individual's Identity | IND121E
  • Questionnaire – Epilepsy | IND134E
  • Designation or Change of Contingent Beneficiary | IND139E
  • Declaration of Name | IND147E
  • Confirmation of Insurable Risk | IND153E
  • Medical Authorization | IND177E
  • Contract Change | IND206E
  • Claim – Total Loss of Autonomy – Long Term Care – Insured's Statement | IND224E
  • Claim – Total Loss of Autonomy – Attending Physician's Statement | IND227E
  • Claim – Total disability – Insured's Statement | IND228E
  • Claim – Hospitalization due to COVID-19 | IND232E
  • Request for change to a non-smoker rate | IND241E
  • Policy Assignment | IND242E
  • Claim – Death – Claimant’s Statement | IND244E
  • Claim – Disability Income Benefit – Physician's Declaration | M311 A
  • Opinion Request
  • Application – Life Insurance and Critical Illness | T073
  • Application – Simplified Second Chance | T079
  • Transfer of Coverage
  • Claim – Claimant's Preliminary Report | Z178

  • Required Documents and Consent Transaction Fees – Service Fees
  • Underwriting Requirements | IND133
  • Immigration and foreign residency guidelines | IND212

  • Loan Insurance Solution – Brochure | K040
  • Loan Insurance Solution – Worksheet | K042
  • Loan Insurance Solution – Table | K050
  • Disability Income Benefit Rider – Table | K054
  • Succession advantage | K055
  • Rent Insurance Solution – Brochure | K058
  • Children's Insurance Solution – Brochure | K060
  • Support Payment Insurance Solution – Brochure | K099
  • Life Insurance Summary | K1001E
  • Summary Fixed Term Life Exchange | K3007
  • Family of Products | T085
  • Comparison table Pure and Enhanced series | T1004E

Permanent life insurance

  • Loan Insurance solution | Editable Admat
  • You're looking for permanent coverage? | Editable Admat

  • Beneva eSignature Policy
  • Authorization for the Disclosure of a Driving Record by the SAAQ
  • Claim – Accidental Fracture
  • Authorization to Disclose Medical Information
  • Charitable Donation of Life Insurance Policy
  • Collateral Assignment – Outside Quebec
  • Claim – Death – Physician's Declaration
  • Designation of Subrogated Policyholder
  • Designation of Two Subrogated Policyholders
  • Claimant’s Questionnaire – Foreign Death
  • Life Saver – Annual Premium Adjustment | IND001E
  • Life Saver – Additional Contribution| IND002E
  • Life Saver – Investment Instructions | IND003E
  • Claim – Disability Income Benefit – Payment Instructions | IND009E
  • Questionnaire – Musculoskeletal Disorders | IND012E
  • Questionnaire – Back or Neck Disorders | IND013E
  • Questionnaire – Respiratory Disorders | IND014E
  • Questionnaire – Diabetes | IND015E
  • Questionnaire – Disabilitiy Income Benefit | IND016E
  • Questionnaire – Psychological Disorders | IND017E
  • Questionnaire – Intestinal Disorders | IND018E
  • Questionnaire – Driving Record | IND020E
  • Questionnaire – Drug or Opiate Use | IND021E
  • Questionnaire – Criminal Record | IND022E
  • Questionnaire – Indoor and Outdoor Climbing | IND023E
  • Questionnaire – Aviation | IND024E
  • Questionnaire – Racing | IND025E
  • Questionnaire – Hang Gliding | IND026E
  • Questionnaire – Sky Diving | IND027E
  • Questionnaire – Scuba Diving | IND028E
  • Questionnaire – Hazardous Sports | IND029E
  • Questionnaire – Financial | IND030E
  • Questionnaire – Alcohol Use | IND031E
  • Questionnaire – Travel and Residence Abroad | IND032E
  • Verification of an Entity's Identity | IND034E
  • Verification of Tax Classification (FATCA AND CRS) – Individual | IND040E
  • Verification of Tax Classification (EATCA AND CRS) – Entity | IND041E
  • Questionnaire – Declaration of Insurability | IND043E
  • Questionnaire – Children's Life Insurance Rider | IND045E
  • Questionnaire – Children's Critical Illness Rider | IND046E
  • Declarations for Designation or Change of Irrevocable Beneficiary in Nova Scotia | IND051E
  • Authorization to Disclose Information to the Advisor or to the General Agent | IND058E
  • Identification of politically exposed persons | IND075E
  • Change of Beneficiary – Life Insurance | IND078E
  • Resolution of the Board of Directors | IND080E
  • Extra Premium Review – Exclusion Review | IND100E
  • Changing of Premium Payment Method | IND102E
  • Preauthorized Debit (PAD) Agreement | IND103E
  • Release from assignment | IND104E
  • Reinstatement | IND106E
  • Cancellation – Surrender | IND108E
  • Hypothecation of Rights under an Insurance Contract – Quebec | IND117E
  • Verification of an Individual's Identity | IND121E
  • Questionnaire – Epilepsy | IND134E
  • Designation or Change of Contingent Beneficiary | IND139E
  • Declaration of Name | IND147E
  • Confirmation of Insurable Risk | IND153E
  • Medical Authorization | IND177E
  • Contract Change | IND206E
  • Claim – Total Loss of Autonomy – Long Term Care – Insured's Statement | IND224E
  • Claim – Total Loss of Autonomy – Attending Physician's Statement | IND227E
  • Claim – Total disability – Insured's Statement | IND228E
  • Claim – Hospitalization due to COVID-19 | IND232E
  • Request for change to a non-smoker rate | IND241E
  • Policy Assignment | IND242E
  • Claim – Death – Claimant’s Statement | IND244E
  • Claim – Disability Income Benefit – Physician's Declaration | M311 A
  • Opinion Request
  • Application – Simplified Advantage | T032
  • Application – Affirmative | T056
  • Application – Life Insurance and Critical Illness | T073
  • Transfer of Coverage
  • Claim – Claimant's Preliminary Report | Z178

  • Required Documents and Consent Transaction Fees – Service Fees
  • Underwriting Requirements | IND133
  • Immigration and foreign residency guidelines | IND212

  • Enhanced T100 – Brochure | K002
  • Affirmative – Brochure | K014
  • Loan Insurance Solution – Brochure | K040
  • Loan Insurance Solution – Worksheet | K042
  • Loan Insurance Solution – Table | K050
  • Succession advantage | K055
  • Rent Insurance Solution – Brochure | K058
  • Children's Insurance Solution – Brochure | K060
  • Simplified Advantage – Brochure | K079
  • Support Payment Insurance Solution – Brochure | K099
  • Life Insurance Summary | K1001E
  • Family of Products | T085
  • Comparison table Pure and Enhanced series | T1004E

Critical illness insurance

  • Critical Illness Insurance - Protect every precious moment | Editable Admat

  • Beneva eSignature Policy
  • Authorization for the Disclosure of a Driving Record by the SAAQ
  • Claim – Accidental Fracture
  • Authorization to Disclose Medical Information
  • Collateral Assignment – Outside Quebec
  • Claim – Death – Physician's Declaration
  • Designation of Subrogated Policyholder
  • Designation of Two Subrogated Policyholders
  • Claimant’s Questionnaire – Foreign Death
  • Questionnaire – Musculoskeletal Disorders | IND012E
  • Questionnaire – Back or Neck Disorders | IND013E
  • Questionnaire – Respiratory Disorders | IND014E
  • Questionnaire – Diabetes | IND015E
  • Questionnaire – Disabilitiy Income Benefit | IND016E
  • Questionnaire – Intestinal Disorders | IND018E
  • Questionnaire – Driving Record | IND020E
  • Questionnaire – Drug or Opiate Use | IND021E
  • Questionnaire – Criminal Record | IND022E
  • Questionnaire – Indoor and Outdoor Climbing | IND023E
  • Questionnaire – Aviation | IND024E
  • Questionnaire – Racing | IND025E
  • Questionnaire – Hang Gliding | IND026E
  • Questionnaire – Sky Diving | IND027E
  • Questionnaire – Scuba Diving | IND028E
  • Questionnaire – Hazardous Sports | IND029E
  • Questionnaire – Alcohol Use | IND031E
  • Questionnaire – Travel and Residence Abroad | IND032E
  • Verification of an Entity's Identity | IND034E
  • Questionnaire – Declaration of Insurability | IND043E
  • Questionnaire – Children's Critical Illness Rider | IND046E
  • Authorization to Disclose Information to the Advisor or to the General Agent | IND058E
  • Change of Beneficiary – Critical Illness | IND069E
  • Identification of politically exposed persons | IND075E
  • Changing of Premium Payment Method | IND102E
  • Preauthorized Debit (PAD) Agreement | IND103E
  • Reinstatement | IND106E
  • Cancellation – Surrender | IND108E
  • Hypothecation of Rights under an Insurance Contract – Quebec | IND117E
  • Verification of an Individual's Identity | IND121E
  • Questionnaire – Epilepsy | IND134E
  • Declaration of Name | IND147E
  • Medical Authorization | IND177E
  • Contract Change | IND206E
  • Claim – Critical Illness – Attending Physician's Statement | IND217E
  • Claim – Critical Illness – Insured's Statement | IND218E
  • Critical Illness - Attending Physician's Statement – Coronary bypass surgery - Myocardial inEarction | IND220E
  • Claim – Critical Illness – Attending Physician's Statement - Coma | IND221E
  • Claim – Critical Illness – Attending Physician's Statement – Kidney Failure | IND223E
  • Claim – Hospitalization due to COVID-19 | IND232E
  • Request for change to a non-smoker rate | IND241E
  • Policy Assignment | IND242E
  • Claim – Death – Claimant’s Statement | IND244E
  • Opinion Request
  • Application – Life Insurance and Critical Illness | T073
  • Application – Simplified Second Chance | T079
  • Transfer of Coverage

  • Required Documents and Consent Transaction Fees – Service Fees
  • Underwriting Requirements | IND133

  • Extended Second Chance – Brochure | K004
  • Second Chance Children – Brochure | K012
  • Simplified Second Chance – Brochure | K032
  • Health Insurance products Summary | K036
  • Summary Critical Illness Term Insurance | K3005
  • Teladoc Brochure | M234
  • Family of Products | T085

Disability insurance

  • Protect yourself from the unexpected - Pillar Series

  • Beneva eSignature Policy
  • Authorization for the Disclosure of a Driving Record by the SAAQ
  • Authorization to Disclose Medical Information
  • Application – Income Protection – Pillar Series | F002
  • Simplified Accident Insurance, brochure – Application | F043
  • Application – Safe Driver | F3003
  • Claimant’s Questionnaire – Foreign Death
  • Accident and Sickness Declarations of Insurability | IND006E
  • Accident and Sickness Declarations of Insurability | IND007E
  • Request to Exercise the Future Insurability Option | IND010E
  • Questionnaire – Musculoskeletal Disorders | IND012E
  • Questionnaire – Back or Neck Disorders | IND013E
  • Questionnaire – Respiratory Disorders | IND014E
  • Questionnaire – Diabetes | IND015E
  • Questionnaire – Disabilitiy Income Benefit | IND016E
  • Questionnaire – Psychological Disorders | IND017E
  • Questionnaire – Intestinal Disorders | IND018E
  • Questionnaire – Driving Record | IND020E
  • Questionnaire – Drug or Opiate Use | IND021E
  • Questionnaire – Criminal Record | IND022E
  • Questionnaire – Indoor and Outdoor Climbing | IND023E
  • Questionnaire – Aviation | IND024E
  • Questionnaire – Racing | IND025E
  • Questionnaire – Hang Gliding | IND026E
  • Questionnaire – Sky Diving | IND027E
  • Questionnaire – Scuba Diving | IND028E
  • Questionnaire – Hazardous Sports | IND029E
  • Questionnaire – Financial | IND030E
  • Questionnaire – Alcohol Use | IND031E
  • Questionnaire – Travel and Residence Abroad | IND032E
  • Verification of an Entity's Identity | IND034E
  • Modification – Pillar series | IND038E
  • Verification of Tax Classification (EATCA AND CRS) – Entity | IND041E
  • Declarations for Designation or Change of Irrevocable Beneficiary in Nova Scotia | IND051E
  • Authorization to Disclose Information to the Advisor or to the General Agent | IND058E
  • Reinstatement | IND137E
  • Personal Needs Analysis for Accident and Sickness Insurance (Calculator) | IND143E
  • Confirmation of Insurable Risk | IND153E
  • Confirmation of Insurable Risk (Pillar Series) | IND159F
  • Questionnaire – Employment and Income | IND175E
  • Medical Authorization | IND178E
  • Claim – Enrolment for direct deposit of Benefits | IND235E
  • Request for change to a non-smoker rate | IND241E
  • Claimant's Preliminary Report – Safe Driver| Z178
  • Claim form | ZSA-3455
  • Cancellation | ZSA-4020

  • Advisor Guide – Pillar Series | F004
  • Occupation Guide – Pillar Series and Simplified Accident Insurance
  • Advisor Guide – Simplified Accident Insurance | F041

  • Income Protection – Brochure | F020
  • Hospital Care – At a glance | F022
  • Hospital Care – Brochure | F024
  • Safe Driver – At a glance | F026
  • Safe Driver – Brochure | F028
  • Disability – At a glance | F030
  • Disability – Brochure | F032
  • Income Protection – Client brochure | F038
  • Simplified Accident Insurance – Client Brochure | F045
  • Simplified Accident Insurance – At a glance | F1002
  • Family of Products | T085

Savings and investments

  • Investment accounts – The benefits of doing business with La Capitale | Admat
  • Our investment accounts - Advantages that add up| Editable Admat
  • Our investment accounts - Feature reference funds | Editable Admat

  • Beneva eSignature Policy
  • Simplified Instruction for Preauthorized Debit (PAD) Agreement | IND036E
  • Verification of Tax Classification (FATCA AND CRS) – Individual | IND040E
  • Change of Mailing Address and Email Address Form | IND047E
  • Change of Beneficiary | IND048E
  • Simplified Instruction | IND055E
  • Change or Termination of the Preauthorized Debit Agreement | IND073E
  • Identification of politically exposed persons | IND075E
  • Authorization to transfer non-registered fund | IND086E
  • Change Regarding Contribution Spouse | IND089E
  • Locked-in Funds Transfer Agreement | IND090E
  • Verification of an Individual's Identity | IND121E
  • Request for Cash Withdrawal | IND136E
  • Declaration of Name | IND147E
  • Letter of Indemnity | IND180E
  • Direct Transfer Between Institutions | IND2033E-T2033
  • Spousal consent to a transfer to a Life Income Fund (LIF) – Ontario | IND205E
  • Inter-Account Transfer | K044W
  • Redemption Fee Remittance Request | K091
  • Application-Instructions – Non-registered Savings Annuity Companies | K116
  • Investment Account Codes | T002W
  • Limited Authorization Form (LAF) | T036
  • Application-Instructions – Pan-Canadian Registered Plan (LIRA-LIF) | T053
  • Application-Intructions – TFSA | T087
  • Application-Instructions – Non-registered plan, RSP, RIF, LIRA (QC), LIF, Annuity, DLA, DLA-LIRA – QC | T097

  • Administrative Guide – Fundserv | IND054E
  • Administrative Guide – Savings and financial services | IND060E
  • Administrative Guide – LCFS | IND196E
  • Locked-in Plans Guide Operations | IND214E
  • User Guide – Mobile Office

  • Quarterly comments - 2022-03
  • Retirement Income – Brochure | K010
  • Profile Selector – Table | K018
  • Investment Accounts – Guide | K020
  • Investment Accounts – Table | K022
  • Saving Products – Table | K046
  • Savings Investments Summary | K052
  • Deferred Life Annuity LifeAnew – Brochure | K062
  • Equity Index GIC – Brochure | K097
  • Estate Planning | K3003
  • Quarterly comments - 2022-06
  • Family of Products | T085
  • Life Annuity LifeAnew – Table | T095
  • Assuris – Brochure | T255

Discontinued products

  • Claim – Total Loss of Autonomy – Long Term Care – Insured's Statement | IND224E
  • Claim – Long Term Care – Attending Physician's Statement | IND226E
  • Claim – Involuntary Loss of Employment – Insured's Statement | IND230E
  • Claim – Long term care – Insured's Declaration

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Quebec

Toll free: 1 888 392-2583

[email protected]
625 rue Jacques-Parizeau
Quebec City QC G1R 2G5

Ontario and Atlantic Canada

Toll free: 1 877 526-3211

[email protected]
7150 Derrycrest Drive
Mississauga ON L5W 0E5

Western Canada

Toll free: 1 877 526-3211

[email protected]
7150 Derrycrest Drive
Mississauga ON L5W 0E5