DISCLOSURE TO CLAIMANT under the AUTOMOBILE INSURANCE REGULATIONS Pursuant to paragraph 14 (1) of the Automobile Insurance Regulations, the following form is hereby approved for use in the Province.

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How to fill out the Canada Disclosure To Claimant online

The Canada Disclosure To Claimant form is an essential document for individuals making automobile insurance claims. This guide provides a clear and user-friendly approach to completing the form online, ensuring you understand each section and field.

Follow the steps to complete the disclosure form online.

  1. Click ‘Get Form’ button to access the Canada Disclosure To Claimant form and open it in your preferred editor.
  2. Review the introductory information on surveillance and your rights as a claimant. This section explains how insurance companies may gather information and the importance of being truthful in your claim.
  3. Fill in your personal information accurately in the designated fields. This includes your full name, contact information, and claim details.
  4. Acknowledge your understanding of the implications of making a false claim. This acknowledgment is important for legal compliance.
  5. If applicable, provide details regarding your economic loss or body injury claims. Be sure to mention any deductions that may apply based on Employment Insurance or Canada Pension Plan contributions.
  6. Confirm if you were wearing a seatbelt at the time of the accident, as this may influence your claim.
  7. Sign and date the form to confirm you have read and understood the disclosure. Ensure to keep a copy for your records before submitting.

Complete your Canada Disclosure To Claimant form online today.

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