Apply Now


Want to apply for a plan? Here's how:

  1. Select from the following:
  2. Complete the application in full.
  3. Mail your completed application along with a cheque for your first month's premium, if applicable, to Industrial Alliance at the following address:

    Special Markets Solutions
    Industrial Alliance Insurance and Financial Services Inc.
    400 - 988 Broadway W.
    PO Box 5900
    Vancouver BC, V6B 5H6

Please note you will need Adobe Acrobat Reader, available free from Adobe, to view and print the application form.

Request an Application

To request an application: Email Industrial Alliance at or call 1 (800) 266-5667 for any of the above products.

Questions? We're here to help.
Call 1 (800) 266-5667 or email