Policy Change Application

SKU: LP386 / LP386FR


Use this application when applying for any changes to in force Life and Critical Illness policies such as:

• Addition of lives/coverage for Term and Critical Illness Protection insurance only
• Reinstatement
• Reduce or remove rating or change in risk classification
• Changes to non-smoker
• Addition of Children’s Insurance Rider
• Change of Death Benefit Option
• Increase in Face Amount*
• Conversion with underwriting*
• Change of Cost of Insurance* (COI)
• Substitution of life*
• Replacement of an existing ivari policy*

*Effective January 1, 2017 new tax legislation came into effect. This legislation will have an impact on policies issued before January 1,
2017 if certain changes are made to the policy after December 31, 2016

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