Forms available from the Superintendent of Insurance

On this page

This page contains forms provided by the Alberta Superintendent of Insurance, the Federal Office of the Superintendent of Financial Institutions, and the Canadian Council of Insurance Regulators.  See the links to your right for the different categories of forms.

The forms below will open in a separate window.  For MS Word and Excel forms, you will be prompted to open or save the document.


Accident Benefit Claim and Minor Injury Prescribed Forms and related Documents

These documents are available on the following pages.  The set provided differs slightly, depending on the audience.  Please choose the appropriate link:

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Standard Policy and Application Forms

Click here for previous standard policies, and endorsements.

Insurance Form (alphabetical order)
Intended
for:
Format
Date
mm/dd/yy

Automobile Insurance Application Form (SAF #1), approved for use in Alberta
Effective January 1, 2006 (see Superintendent of Insurance Bulletin 07-2005)
Consumers
and
Insurers
07/22/05

FUTURE Standard Automobile Insurance Policy (SPF #1)
- Effective September 1, 2013
Revised to revised to include the limitation period in the Section B benefits portion of the policy, and the addition of a section in the preamble of the statutory condition section of the policy.  See Superintendent of Insurance Bulletin 03-2013

Consumers
and
Insurers
pdf
September
2013
05/16/13

CURRENT Standard Automobile Insurance Policy (SPF #1)
- Effective July 1, 2012
Revised to reflect the changes which became effective July 1, 2012 with the implementation of the Insurance Amendment Act, 2008.  See Superintendent of Insurance Bulletin 02-2012 and Section 556 (statutory conditions)
Consumers
and
Insurers
pdf
July 2012
05/17/12

Standard Garage Automobile Application Form (SAF #4)
Effective September 1, 2007 (see Superintendent of Insurance Bulletin 04-2007)
Consumers
and
Insurers
06/14/07

Standard Garage Automobile Policy (SPF #4)
Effective September 1, 2007 (see Superintendent of Insurance Bulletin 04-2007)
Consumers
and
Insurers
06/14/07

Other Insurance Forms

Insurance Form (in order by the intended audience)
Intended
for:
Format
Date
mm/dd/yy
Forms for Consumers and Insurers:

Life Insurance Disclosure Form
Consumers
and
Insurers
05/00

Life Insurance Replacement Declaration Form

  • Efffective date October 13, 2010
Consumers
and
Insurers
10/13/10

Motor Vehicle Inspection Report (effective May 1, 2012)
Consumers
and
Insurers
01/19/12
Forms for Insurers:

Insurance Licence Application Form (CCIR-1)
This is a Canadian Council of Insurance Regulators (CCIR) Form
Insurers
03/06/12

Attorney for Service Forms (CCIR-1 Appendix VII)
CCIR forms to change the Attorney for Service in Alberta (includes Power of Attorney, Affidavit of Execution and Consent of Attorney)
Insurers
11/01/12

Life Insurer - Life-1 Annual and Interim Returns:

  • These forms are posted on the Federal Office of the Superintendent of Financial Institutions (OSFI) website.  - Life Insurance Companies and Fraternals (Financial Returns and Instructions page).
Insurers
See link

Personal Questionnaire for Provincial Insurer Directors and Officers
Insurers
02/17/12

Property and Casualty Insurer - P&C-1 Annual and Interim Return Forms:

  • These forms are posted on the Federal Office of the Superintendent of Financial Institutions (OSFI) - Property and Casualty Insurance Companies (Financial Returns and Instructions page).
Insurers
See link
Forms for Reciprocal Insurance Exchanges:

Affidavit verifying Annual Return - for Reciprocals Form
(modified slightly to meet Alberta legislative requirements)

  • See above for P&C-1 Annual and Interim Return Forms
Reciprocal Insurance Exchanges
06/29/12

Reserve and Guarantee Fund Worksheet
Reciprocal Insurance Exchanges
02/17/12
Forms for Special Brokers:

Special Broker Application Form
Special Brokers
02/17/12
Special Broker Monthly Reporting Form
Special Brokers
02/17/12
Unlicensed Insurance Reporting Form
Companies /
Brokers
02/17/12
Page last updated:  May 15, 2013