New Program Enhancements:
- If you are a new graduate that is in, or starting, their first year of coverage you will be eligible for a 50% premium discount.
- If you are a new graduate that is in, or starting, their second year of coverage you will be eligible for a 25% premium discount.
- If you are on maternity/parental leave and working less than 6 consecutive months during the membership year, you will be eligible for a 50% premium discount.
We are unable to process these applications online, so if any of the above options apply to you, then please contact us directly to complete your application.
Please note that if any of the following scenarios apply to you, then you will need to contact our office directly to complete your application as we are currently unable to process them automatically online.
I hereby acknowledge that the information collected in the Application form is acquired by my insurance broker to be transmitted to Intact Insurance for the sole purpose of obtaining an insurance policy, and will be kept confidential.
Moreover, I authorize Intact Insurance, its insurers or service Providers to:
- conduct verification, using outside sources, of the information contained in the Application form, in attached documentation and in subsequently provided documentation;
- in the event of a claim, transmit the submitted and verified information to loss adjusters, lawyers or other similar offices for the purposes of investigating, defending, negotiating or settling any claims, as required.
For more information on Intact Insurance's privacy policy, please contact privacy@intact.net.
Declarations and Signature
By submitting this application for insurance, the applicant declares that, to the best of his/her knowledge and belief, the statements set forth herein are true and correct and that reasonable efforts have been made to obtain sufficient information to facilitate the proper and accurate completion of this Application form. The applicant further agrees that if any significant change in the condition of the Applicant is discovered between the date of this Application form and the effective date of the policy, which would render this Application form inaccurate or incomplete, notice of such change will be reported immediately in writing to the Insurance Manager.
Although submission of this Application form does not bind the Applicant to Purchase the insurance, the Applicant agrees that this form and the information furnished pursuant hereto shall be the basis of the contract should a policy be issued and this form will become part of the policy.
It is also agreed that should a policy be issued, it is understood that eligibility for this program is contingent upon membership in good standing in the Society of Alberta Occupational Therapists.
