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Application for Insurance

An application for insurance is the formal process of requesting coverage from an insurance company. It includes providing personal, medical, and financial information that allows the insurer to evaluate eligibility, assess risk, and determine the appropriate premium and coverage terms. The application serves as both a request for protection and a legal declaration of the information provided by the applicant.

In health, dental, life, and disability insurance, the application may include sections for personal details, lifestyle questions, and medical history. For medically underwritten plans, applicants must disclose pre-existing conditions, medications, and recent medical consultations. Guaranteed issue or simplified issue plans require fewer questions but typically offer lower benefit limits in exchange for reduced underwriting.

Once submitted, the insurer reviews the application, verifies information, and decides whether to approve, modify, or decline coverage. Acceptance of the application by the insurer, along with payment of the first premium, activates the policy.

Example:

If you apply for a personal health insurance plan, the application will ask for your age, province of residence, health conditions, and any other coverage you currently have. The insurer reviews your answers to determine eligibility and finalize your premium.

What to Watch For:

Provide complete and accurate information when completing an application. Any misrepresentation or omission could lead to claim denials or cancellation of the policy later. Review your application summary before signing, and keep a copy for your records as proof of disclosure.

Related Terms

Underwriting

Underwriting is the process by which an insurance company evaluates an applicant’s risk to determine whether coverage can be offered, what terms will apply, and how much the premium will cost. It involves reviewing personal, medical, occupational, and lifestyle information to assess the likelihood of future claims. The goal of underwriting is to ensure fairness by matching the cost of coverage to the level of risk presented by each applicant.

Premium

A premium is the amount of money an individual or organization pays to an insurance company in exchange for coverage under an insurance policy. It is the cost of maintaining protection against financial loss and ensures that the insurer can pay claims, manage risk, and cover administrative expenses. Premiums can be paid monthly, quarterly, semi-annually, or annually, depending on the policy and payment arrangement.

Policy (Contract)

A policy, also referred to as a contract, is the legally binding agreement between an insurance company (the insurer) and the policyholder that defines the terms, conditions, and obligations of coverage. It outlines what is insured, the benefits provided, the premium amount, exclusions, and the responsibilities of both parties. Once the insurer accepts the application and the first premium is paid, the policy becomes active and enforceable.

Provider

A provider is a licensed healthcare professional, facility, or service organization that delivers medical, dental, vision, or paramedical care to patients. In the context of insurance, a provider is any individual or entity authorized to perform covered services and submit claims for reimbursement to an insurer. Providers include physicians, dentists, pharmacists, physiotherapists, chiropractors, optometrists, hospitals, and clinics.

Treatment

Treatment refers to any medical, dental, or therapeutic care provided by a licensed healthcare professional to diagnose, manage, or improve a health condition, injury, or disease. In the context of insurance, treatment includes all services, procedures, medications, and interventions that are deemed medically necessary to restore or maintain health. It can range from routine doctor visits and prescription drug use to surgery, rehabilitation, and specialized therapies.

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