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Forms


The following forms are Fillable PDFs and can be completed electronically. An e-signature can be created in Adobe Acrobat Pro, or the forms can be printed, signed, scanned and emailed. Claims forms can be sent to claims@suttonspecialrisk.com. Underwriting forms can be sent to ccarr@suttonspecialrisk.com. If you prefer, contact us via email or by phone and we would be happy to fax you a copy of the form(s) you require.

Personal Accident Insurance Forms
    Underwriting
  1. New Business Application
  2. Renewal Application
    Make a Claim
  1. Proof of Death
  2. Proof of Dismemberment
  3. Proof of Dismemberment - Physician


Disability Insurance Forms
    Underwriting
  1. Personal Accident or Sickness - New Business
  2. Personal Accident or Sickness - Renewal Application
  3. Medical Examiner's Report
    Make a Claim
  1. Sutton Temporary Disability - English



Professional Sports Disability Insurance Forms

    Underwriting
  1. Sports Application - Short Form
  2. Sports Health Declaration Form
    Make a Claim
  1. Concussion Questionnaire - Player
  2. Concussion Questionnaire - Physician
  3. Exclusion Review Form
  4. Proof of Permanent Total Disability - English
  5. Proof of Permanent Total Disability - Spanish



Amateur Sports Insurance Forms

    Underwriting
  1. General Liability- New Application
  2. General Liability-Renewal Appication
  3. Personal Accident- Renewal Application
  4. Hockey School/Camp Application
  5. Sports Camp Application
  6. Martial Arts Application
  7. Event Liability Application
  8. Fitness Club Application
  9. Fitness Instructor/Personal Trainer
  10. Arenas, Multiplexes and Sports Domes
  11. Directors and Officers



Major Medical Insurance Forms

    Underwriting
  1. New Business Application
  2. Renewal Application
    Make a Claim
  1. Medical Expense Form - English
  2. Medical Expense Form - Spanish



Life Insurance Forms

For forms and information pertaining to this product, please contact:
Chris Carr, Manager, Special Risk Underwriting



War Risk and Terrorism Forms

    Underwriting
  1. War Risk Only Application

Note: This application is for stand-alone War Risk Only coverage. To be underwritten for 24-hour coverage including War Risk, complete only the application specific to the product i.e. Major Medical Application, Personal Accident Application etc.



Kidnap Ransom & Extortion Insurance Forms

    Underwriting
  1. Corporate Application - New and Renewal
  2. Family Application - New and Renewal


Contingency Insurance Forms

    Underwriting
  1. Event Cancellation (including appendix for outdoor events and non-appearance)
  2. Cancellation of Conferences or Exhibitions
  3. Death, Disgrace, Disablement
  4. Golf Hole-In-One Prize Indemnity
  5. Transmission Failure
We can also cover you for the following classes, however one application does not fit all as each event or promotion can vary so much. If you’d like us to look at any of the following please contact our office.
  • Prize Indemnity
  • Contract Bonus
  • Weather Day



Miscellaneous Forms

    Underwriting
  1. Declaration of Health
  2. Fasting Full Blood Profile Components
  3. Diabetic Questionnaire
  4. Neck and Back Pain Questionnaire
  5. Pilot History Questionnaire
  6. Declaration for Voice-Related Occupations
  7. Diving Questionnaire
  8. Mountain Climbing
  9. Motorcycle Racing
  10. Freestyle Motorcross Questionnaire








 
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