D-9.2, r. 8 - Regulation respecting distribution without a representative

Schedule Disposition versions

2012-09-01

SCHEDULE 1

(s.2)

NOTICE OF RESCISSION OF AN INSURANCE CONTRACT

NOTICE GIVEN BY A DISTRIBUTOR

Section 440 of the Act respecting the distribution of financial products and services (chapter D-9.2)

THE ACT RESPECTING THE DISTRIBUTION OF FINANCIAL PRODUCTS AND SERVICES GIVES YOU IMPORTANT RIGHTS.

· The Act allows you to rescind an insurance contract you have just signed when signing another contract, without penalty, within 10 days of its signature. To do so, you must give the insurer notice by registered mail within that delay. You may use the attached model for this purpose.

· Despite the rescission of the insurance contract, the first contract entered into will remain in force. Caution, it is possible that you may lose advantageous conditions as a result of this insurance contract; contact your distributor or consult your contract.

· After the expiry of the 10-day delay, you may rescind the insurance at any time; however, penalties may apply.

For further information, contact the Autorité des marchés financiers at [phone] or 1-877-525-0337.

NOTICE OF RESCISSION OF AN INSURANCE CONTRACT

To: ________________________________________________________________________________________

(name of insurer)

_________________________________________________________________________________________

(address of insurer)

Date: _________________________________________

(date of sending of notice)

Pursuant to section 441 of the Act respecting the distribution of financial products and services, I hereby rescind insurance contract no.: ________________________________________________________________________

(number of contract, if indicated)

Entered into on: ________________________________

(date of signature of contract)

In:___________________________________________

(place of signature of contract)

___________________________________________ ___________________________________________

(name of client) (signature of client)

The distributor must first complete this section.

This document must be sent by registered mail.

Sections 439, 440, 441, 442 and 443 of the Act must be reproduced on the back of this notice.

Decision 99.06.45, Sch. 1; M.O. 2010-18, s. 4.