Your Application

  • Before we start your application, we first need to get you a quote. Your insurance application will be based on the quoted coverage, and it's important that we complete this step first.

    To obtain a quote, tell us a bit about yourself and enter the amount of coverage you want. A quote for the monthly premium and suggested product will follow.

    Date of Birth MonthDate of Birth DayDate of Birth Year
  • Gender
    Gender Male
    Gender Female
  • What is the definition of a non- smoker? Means an individual who has not used any form of tobacco, nicotine, or marijuana, including the use of cigarettes, e-cigarettes, cigars, cigarillos, chewing tobacco, nicotine gum or patches or marijuana product, during the twelve (12) month period before the Application date
    Smoker Status
    Smoker Status Smoker
    Smoker Status Non Smoker
  • Where do you currently live?
Coverage Amount
  • CIBC Term Life Insurance
    CIBC Critical Illness Insurance

Don't know how much coverage you need? Try our coverage calculator