Application for student membership and insurance

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If you have any question or concerns we are here to help. Contact an Insurance Administrator by emailing .

Application for Membership, Benefits and Backpack

We are happy to welcome you to med school and offer you some OPTIONAL and NO-COST benefits during medical school. There is no obligation to register and you may cancel at anytime without penalty.

Multipage

includes entry for stethoscope draw prize

Please note that by choosing not to apply for Doctors of BC membership you are not entitled to enrol in the NO-COST Doctors of BC Disability or Life Insurance program.

Membership Application

Date of birth *
Select a month, day, and year from the drop down list.
123-123-1234

Your medical student membership is provided complimentary when you join either or both Doctors of BC and CMA. Membership will give you access to special benefits provided by each organization and will cover you for all consecutive years you are enrolled as a medical student. You may cancel at any time.

I hereby apply for membership in either or both the Doctors of BC and the CMA, and that applying for each membership you agree to abide by either or both of the By-laws, Rules and Regulations of Doctors of BC and/or the By-laws, Rules and Regulations of the CMA.

Check the box to indicate your agreement with the above statements.
You will receive your member ID and login credential within 10 business days

includes entry for stethoscope draw prize
I am opting out of the insurance program and I understand I will not be covered for Disability or Life insurance. For full coverage details, see: www.doctorsofbc.ca/member-services/ insurance-student-life-disability

 

Doctors of BC Insurance Application

Insurance Coverage Included

Life and Disability insurance will be provided to you for all four years of medical school without charge (September 1, 2020 to June 30, 2024). You must apply to receive this coverage by completing this form.

For full coverage details, see www.doctorsofbc.ca/member-area/insurance/life-disability-accident-illness/students

Disability Income Benefits

Monthly tax free income if you are unable to attend medical school, train or work due to accident or illness:

  • $1,500 Monthly Tax Free Benefit (Year 1 & 2)
  • $2,500 Monthly Tax Free Benefit (Year 3)
  • $2,500 (or option of $4,000) Monthly Tax Free Benefit (Year 4)
  • 90 day Elimination period
  • Disabled claimants covered to age 65.
  • Cost of Living Allowance (COLA) & Guaranteed Insurance Benefit (GIB) included

Elimination period: The period a claimant must wait spanning from the date of disability to being eligible for benefits.

COLA: increases your monthly disability benefit each year that you remain disabled, up to age 65, by the lesser of the change in the Consumer Price Index or 3%.

GIB: allows you to increase your insurance coverage as your needs increase, without having to provide proof of good health.

Life Insurance Benefits

$100,000 tax free payout if you die to your loved ones to help repay debt, support family, or to pay for funeral expenses.

Any death benefits from this insurance will be paid to your estate unless you name a beneficiary. A Beneficiary Designation form will be sent to you in the future so you can name a beneficiary.

Non smoker means that you have not used any tobacco or tobacco cessation products including the use of e-cigarettes and vaporizers within the past 12 months.

Insurance carriers still require information regarding gender at birth for underwriting purposes. Please select your gender at birth.

Other Insurance Information

If no, please skip below to Authorization and Declaration section.
CAD
Date of issue
Select a month and year for your date of issue from the drop down list.
(e.g. 90 days)
(e.g. to age 65)

Will any Disability insurance be discontinued if the coverage you have applied for is issued?

If yes , provide full details below:
CAD

Authorization and Declaration

I declare that my answers in this application are true and complete and I understand that any material misrepresentation shall render the insurance voidable at the instance of the insurer, and that suicide within two years of the effective date is a risk not covered.

I understand and agree that this application form is void unless (a) I am a member of Doctors of BC or Yukon Medical Association (b) I am enrolled full time in medical school in British Columbia on the date of this application, (c) I am not presently on a personal or medical leave, and (d) I reside in Canada on the date of this application.

I understand that insurance will become effective on the later of the date my application for coverage is received by Doctors of BC or the date I begin medical school.

I authorize Manulife to hold a personal file about myself and my insurance coverage. I authorize Manulife, Doctors of BC, and their authorized staff, agents, representatives, advisors and service providers to use and exchange information needed for underwriting, financial management, administration and adjudication of claims under this insurance coverage with any person or organization who has relevant information about me including institutions, investigative agencies, insurers, and reinsurers.

I acknowledge and certify that I have read, understood and agree with the terms and conditions and declaration and authorization outlined above. I understand that checking this box constitutes my electronic signature of this application.

By checking this box you agree to the above statements.

Respecting your privacy

Doctors of BC respects the privacy of its members and is committed to protecting your personal information. Please refer to the Privacy Commitment. Contact and demographic information provided on this application will be shared with CMA and used in accordance with the CMA's Privacy Policy, which can be viewed at www.cma.ca in the footer on the home page.

To protect the confidentiality of this information, Manulife will establish a “financial services file” from which this information will be used to process the application, offer and administer services and process claims. Access to this file will be restricted to those Manulife employees, mandataries, administrators or agents who are responsible for the assessment of risk (underwriting), marketing and administration of services and the investigation of claims, and to any other person you authorize or as authorized by law. These people, organizations and service providers may be in jurisdictions outside Canada, and subject to the laws of those foreign jurisdictions. Your consent to the use of personal information to offer you products and services is optional and if you wish to discontinue such use, you may write to Manulife at the address shown below. Your file is secured in our offices or those of our administrator or agent. You may request to review the personal information it contains and make corrections by writing to: Privacy Officer, Manulife, P.O. Box 1602, Waterloo, ON N2J 4C6.

Please check the box below to indicate that you understand this privacy information.

Thank you for using our online registration.

You will receive your member ID and login credential within 10 business days. Within 4-6 weeks, Doctors of BC will notify you that your insurance certificate is
available on the Doctors of BC Member website.