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

Schedule Disposition versions

2012-09-01

SCHEDULE 4

(s. 3)

DISTRIBUTION GUIDE

Name of Insurance Product:

Type of Insurance Product:

Name and Address, etc., of Insurer:

Name:

Address (electronic address, where applicable):

Telephone and fax numbers of client services:

Name and Address, etc., of Distributor:

Name:

Address (electronic address, where applicable):

Telephone and fax numbers of client services:

Responsibility of the Autorité des marchés financiers

On the title page of the guide, in a different character style, indicate the following warning:

“The Autorité des marchés financiers does not express an opinion on the quality of the product offered in this guide. The insurer alone is responsible for any discrepancies between the wording of the guide and the policy.”

Introduction:

Explain the role of the distribution guide, which is to describe the insurance product offered and facilitate the client’s comprehension by transmitting the information in a user-friendly form. The objective of the guide is to enable the client who is not in the presence of an adviser in insurance of persons or an agent or a broker in damage insurance to evaluate whether the insurance product offered corresponds to his needs.

Item 1: Description of the Product Offered

(a) Nature of the Coverage

Specify the nature of the insurance product.

(b) Summary of Specifics Features

Describe the important features of the insurance offered, including, in particular: (“di” for damage insurance and “ip” for insurance of persons)

· persons to whom protection (ip) applies;

· amount of the protection (ip);

· property or risks covered by the insurance (di);

· amount of the coverage (di);

· procedure involved in designating a beneficiary (ip);

· person to whom the benefit will be paid (di);

· premiums to be paid by the insured, whether guaranteed or not, and the payment frequency (di and ip);

· deductible applicable to claims (di);

· waiting period in the event of a claim (ip);

· benefits table (di);

· term of the contract (di and ip);

· the effective date or the expiry date of the insurance contract and the conditions attached thereto, if any, for example, a medical examination (ip);

· confirmation of the insurer set out in section 444 of the Act (ip);

· renewal procedures or conditions (di and ip);

· if the renewal of the contract (or the coverage offered) is guaranteed or not (di and ip);

· grace period pertaining to premium non-payment (di and ip);

· any other item that is likely to influence a client’s decision (di or ip).

Reference may be made to specific clauses in the policy provided that the guide has already highlighted the coverage provided.

Exclusions, restrictions or reduction in coverage

Clearly state the rules and events that may give rise to exclusions, restrictions or reduction in coverage of the insurance dealt with in the distribution guide. The exclusions must be drafted so as to allow the client to ascertain if he falls within an exclusion situation.

In addition to being in bold-face characters, the exclusions must be presented in boxes preceded by the word: “Caution”.

A reference to specific clauses in the policy may be made provided that the guide has already highlighted the exclusions.

To facilitate comprehension on the part of the client, the exclusions may, at the option of the insurer, be placed immediately following each type of coverage provided.

Cancellation

Indicate the procedure to be followed in order to cancel the insurance contract, including, in particular, the documents required, the time limit provided for the cancellation, the penalties applicable, if any, the name and address of the person to whom the notice is to be sent, and the effect of the cancellation;

(c) End of the Insurance Coverage

Explain the other circumstances terminating the protection offered by the insurance product;

(d) Other Information

Indicate how a client may obtain additional information on the product offered. Indicate that he may join the insurer or the distributor and how he may obtain a copy of the insurance contract described in the distribution guide.

Item 2: Proof of loss or claim

Explain the various steps involved in the submission of a claim, namely:

(a) Submission of a Claim

Indicate the procedure that must be followed by an insured or a beneficiary in order to submit a claim to an insurer and, in particular, specify the nature of the documents to be transmitted, the number of copies, the method of completing a claim, and the person or persons authorized to submit the claim.

Also indicate the period during which the claim or the notice of claim must be sent to an insurer.

Indicate the specific measures that must be taken by a loss victim.

(b) Insurer’s Reply

Indicate the period during which the insurer must inform the insured or a beneficiary that his claim is accepted as well as the period during which the insurer must pay the benefit. Also indicate the period during which the insurer must inform an insured or a beneficiary that his claim is refused and the reasons that warranted the decision made.

(c) Appeal of an Insurer’s Decision and Recourses

Describe the procedure to be followed by an insured or a beneficiary in the event of the refusal of his claim or non-settlement by an insurer.

Specify, in general terms, the rights of an insured in the event that an insurer fails to respect its commitments and, in particular, include a reference to the effect that the consumer may consult the Autorité des marchés financiers or his own legal adviser.

Item 3: Similar Products

Indicate whether other insurance that may include coverage similar to the insurance described in the distribution guide exists on the market.

Item 4: Referral to the Autorité des marchés financiers

For all additional information on an insurer’s and a distributor’s obligations toward a client, indicate the name, address, etc., of the Autorité des marchés financiers.

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| PERSONAL NOTES:                                                                 |
| Coverage amount:                                                                |
| Premium:                                                                        |
| Other:                                                                          |
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|_________________________________________________________________________________|

OPTIONAL

ACKNOWLEDGEMENT OF RECEIPT:

You acknowledge receipt of this ditribution guide when you acquire the following insurance produts:

_____________________________________________________________________________________

(name of the insurance product)

Date: _____________________________________________________________________________________

(date of acknowledgement of receipt)

Per: ______________________________________________________________________________________

(name of distributor)

_____________________________________________________________________________________

(signature of client)

_____________________________________________________________________________________

(name of client)

_____________________________________________________________________________________

(address of client)

Decision 99.06.45, Sch. 4.