PRELIMINARY INSURANCE APPLICATION

Let’s get the underwriting process started

A short, comfortable first step with no obligation to proceed

This form gives Brian’s team the basic information needed to begin preparing your Manulife application and arrange the telephone interview.

You are not committing to purchase insurance, and you do not need to decide on a coverage amount today. Ownership, beneficiaries, coverage and final policy structure can all be reviewed later.

A SIMPLE START

Complete one form for yourself or both spouses

Most clients can provide the essentials quickly. Approximate financial information is fine, and insurance documents can follow later.

Step 1

Share the basics

Short preliminary form

Provide the information needed to prepare the application.

One person may complete the form for both insured people.
Step 2

Complete the interview

Usually 30 to 40 minutes

Dynacare contacts each insured person on Manulife's behalf.

Have your medications, doctor information and identification nearby.
Step 3

Review your options

No obligation

Decide on coverage and structure only after more is known.

Medical evidence may generally remain usable for up to 12 months, subject to Manulife’s requirements.

Your information is private

This form contains personal financial and preliminary medical information. Access is limited to Brian, Leisha, and other authorized personnel who require it to prepare your application.

5% complete1 of 22 essential answers
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1

Who is applying?

One person may complete the form for both insured people

How many people are applying for insurance? *
2

Insured person 1: Personal information

The basic information needed to prepare the application

Sex *
Are you a Canadian citizen or permanent resident? *
Are you a U.S. citizen or permanent resident? *
3

Insured person 1: Smoking status

A simple preliminary classification

How to answerFor insurance purposes, smoking is broader than being a regular cigarette smoker. You will generally be considered a smoker if you have used cigarettes, cigars, tobacco, nicotine vaping products, or other nicotine products within the past 12 months, even occasionally. Cannabis use does not automatically make you a smoker, although the amount and frequency may affect Manulife's assessment. If you are uncertain, select I am unsure and Brian will clarify it with you.
Based on the information above, which best describes you? *
4

Insured person 1: Financial information

Approximate amounts are completely fine

In the past five years, have you or your business experienced major financial difficulties? *
Does your business require a licence or permit? *
5

Insured person 1: Telephone interview

Dynacare will contact each insured person on Manulife's behalf

Preferred interview language *
Best time to call *
6

Insured person 1: Existing insurance

Provide what is convenient now. The rest can follow later.

Do you have individual life, critical illness, disability, or long term care insurance outside of an employer or group plan? *
7

Insured person 1: Questions for Brian

Optional preliminary medical context

Why we askThis is not the formal medical interview. It simply helps Brian identify potential underwriting considerations and gives you a private place to raise questions before Dynacare contacts you on Manulife's behalf.
Is there anything in your medical history that you think Brian should know about before the telephone interview, or anything you would like to ask him about? *
8

What to expect

A soft start with no obligation to proceed

Dynacare will call each insured person

Dynacare completes telephone interviews and medical requirements on Manulife's behalf. The confidential telephone interview usually takes approximately 30 to 40 minutes. It covers medical history, medications, smoking history, alcohol use, driving history, and other information required to assess the application.

A little preparation helps

Have your driver’s licence, medication information, family doctor’s contact information, and details of any specialists nearby. Depending on age and the coverage eventually considered, Dynacare may arrange routine testing or Manulife may request additional medical information.

No obligation and no coverage decision today

Completing the application and medical assessment does not require you to purchase insurance. Coverage amounts, premiums, ownership, beneficiaries, and final policy structure will be reviewed later. The preliminary application will use personal ownership and Estate as beneficiary.

Your medical information may remain useful

Medical evidence may generally remain usable for up to 12 months, subject to Manulife’s requirements and any changes in health or the application. Starting underwriting now gives you time to understand your options before making a decision.

READY WHEN YOU ARE

Review before submitting

Submitting starts the application process but does not create coverage or obligate anyone to proceed.