Industrial Alliance Pacific, Insurance and Financial Services


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Creditor Group Insurance & Specialized Products

Insurance Claim Forms

Cancellation of Insurance
      Forms

Specialized Product
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Creditor Group Insurance & Specialized Products
 

Cancellation of Insurance Forms

Please select from one of the options listed below:

Creditor Group Insurance – Cancellation Forms

Request For Refund* (PDF – 51 KB)

*If the Insured resides in the Province of Québec, please also complete one of the following forms:
Notice of Cancellation (Québec only) (to be completed if the cancellation occurs within ten days of the insurance purchase) (PDF - 32 KB)
Notice of Cancellation (Québec only) (to be completed if the cancellation occurs more than ten days after the insurance purchase) (PDF - 33 KB)
 
Replacement Insurance (Québec only) – Cancellation Forms 
Notice of Cancellation of an Insurance Contract (to be completed if the cancellation occurs within ten days of the insurance purchase) (PDF - 40  KB)
Cancellation form (to be completed if the cancellation occurs more than ten days after the insurance purchase) (PDF - 21 KB)

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