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with your quotes.

Let's get you an instant quote!

Let's get you an instant quote!

Tell us about you

The more information we have, the better we are able to serve you.

Tell us about your needs

We need to know a few more details to help provide you with a recommended coverage amount.

Mortgage and other debts
Enter the approximate outstanding balances of your mortgage, lines of credit, credit cards, etc.

Children's Education
Enter the number of children for whom you will provide education support. Consider including children you plan to have within the next 1-3 years.

Beneficiary support
Try to estimate the amount of your after-tax income that can help cover your annual living expenses. Do not include debt repayments and education expenses.

Other needs
Do you want to make sure your funeral expenses are covered? Leave a legacy or inheritance? Include any other special life insurance needs here.

Current resources
Do you already have life insurance coverage personally or through employment? Do you have savings or investments that would be left to your estate? Include other resources here.

Here's what we recommend for you

Assumptions

  • Total debt amounts are added.
  • Total education amounts are added.
  • Beneficiary support amounts are added.
    (annual income x percentage of income for beneficiaries x amount of years)
  • Other needs amounts are added.
  • Current resources amounts are subtracted.
  • Recommended amount is to give you a general idea of how much coverage you should consider.
  • Always consult with a licensed life insurance agent before purchasing a life insurance policy to review policy options, amounts and available life insurance companies.

If you're ready to see how much it will cost, click the button below. You can adjust your coverage amount and term length on the next page.

Thank You!

We will be in touch with you shortly.

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for Life Insurance

My Life Insurance application with

Personal
Lifestyle
Health
Beneficiary
Contact
Summary
Coverage Amount
Term Length
Rates

Personal Information

Enter your personal information

Please specify your citizenship

Please specify other reason for insurance

Has there been any change in name in the last 5 years?

Please specify other purpose for insurance

Are you a US citizen or US resident for US tax purposes?

Are you a tax resident of a jurisdiction other than Canada or the U.S.?

Do you have any other life insurance policies currently in force with any companies? You do not need to disclose policies through work or mortgage life insurance. Do you have any other life insurance policies currently in force or pending, including any with RBC Life? You do not need to disclose policies through work or mortgage life insurance.

Have you applied for life, critical illness or disability insurance with this application or within the past 12 months with any other company?

Is this policy going to replace any existing life insurance policies that you currently have?

Your Lifestyle

Are you employed?

Please specify your employment status

What is your annual earned income from employment in Canadian dollars?
What is your estimated net worth in Canadian dollars?
Amount of mortgage outstanding on personal residence and/or cottage
If not self supporting, what is the annual gross amount of the family earned income?
What is your annual income in Canadian dollars from other sources?
Describe other sources of income (max. 2 of max. 30 characters each)

Have you within the past 5 years declared personal or corporate bankruptcy?

Your Health

In the last 12 months have you used any tobacco or nicotine products including cigarettes, cigarillos, colts, cigars, pipes, chewing tobacco, snuff, e-cigarettes, vaporizers, nicotine gum or patches, or any form of nicotine substitute?

Have you collected EI (Employment Insurance) disability benefits, workers’ compensation benefits, CPP or QPP disability benefits, income replacement benefits, or any form of social assistance in the past 12 months?

Have you within the past 12 months been a student pilot, or piloted a plane, ultra-light glider, or do you have any intention of doing so in the future?

Have you within the past 12 months traveled outside Canada or the United States of America, or do you intend to do so within the next 12 months?

Add another location of travel?

Have you within the past 12 months engaged in any hazardous or contact sports or activities, including, but not limited to racing, scuba diving deeper than 100ft (30m), skydiving, heli-skiing or back-country skiing, or do you intend to do so?

Have you ever had life, disability or critical illness insurance rated, modified, rejected, rescinded or have you been denied renewal or reinstatement?

Have you within the past 10 years been convicted of any criminal offence, or are there any such charges pending?

Have you within the past 10 years been convicted of any driving offenses or violations, including impaired driving, and/or have you had a drivers license revoked or suspended, or are any such charges pending?

Your Beneficiaries

Primary beneficiaries

Do you want to name any secondary beneficiaries?

Secondary beneficiaries

Contact Information

Address

Contact details

Best time to be contacted to complete the telephone health questionnaire

Review your application and submit

approximately to complete application

Thank you for your application

We will contact you soon.