Client area • Engineer Disability

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All Life Disability Critical illness Secure file deposit

Unless otherwise noted, please complete, print and return your form to Sogemec Insurance:

BY secure file deposit
or
to the following address:
Sogemec Assurances
2, Complexe Desjardins, C.P. 217, Succ. Desjardins
Montréal (Québec) H5B 1G9

Enrolment

Enrollment form – Disability Insurance | PDF 330.93 KB Enrollment form – Disability Insurance Important note
BEFORE RETURNING YOUR APPLICATION FORM, AND TO HELP EXPEDITE REVIEW OF YOUR REQUEST FOR INSURANCE, PLEASE MAKE SURE THAT YOU:
- Included all documents relevant to your situation:
  - Employee: Pages 1, 2 and 3 of the last two years of your tax return (T1 General) and letter from your employer confirming your annual salary, if you are a new employee.
  - Self-employed-Unincorporated: Pages 1, 2 and 3 of the last two years of your tax return (T1 General) plus Statement of Professional or Business Activity.
  - Self-employed-Incorporated: Pages 1, 2 and 3 of the last two years of your tax return (T1 General) plus latest Corporate Financial Statement
  - Notice of assessment or Summary are not accepted by the Insurer
- Given the necessary details for questions to which you have answered “Yes”;
- Signed the application form on pages 11, 12 and 13;
- Included a cheque payable to Sogemec Assurances Inc., representing the equivalent of one month’s premium if eligible to term insurance (section 12);
- Included a specimen check (marked VOID), if you have opted for the direct method.
Do not hesitate to contact us by email at or by phone at 514 350‑5070 or 1 800 361‑5303.