I understand that to qualify for a driver’s licence, drivers:

• Must not suffer from any mental, emotional, nervous or physical disability that significantly interferes with the driver’s ability to safely drive an automobile of the class they are licensed for;
• Must not be addicted to alcohol or a drug to the extent that it significantly interferes with the driver’s ability to safely drive an automobile; and
• Must notify the Ministry of Transportation immediately if the driver becomes physically or mentally disabled to the extent that it might interfere with the driver’s ability to safely drive an automobile.

To the best of my knowledge:

• All listed drivers are qualified and hold a driver’s licence , and
• The information I have provided is correct.

Inspection:

My Insurer may require my automobile to be inspected. If I do not co-operate with any reasonable arrangements to inspect my automobile, I understand my optional loss or damage coverages may be cancelled, and any claims filed under those coverages may be denied.

Warning – The Insurance Act provides that where:

(a)    an Applicant for a contract, (i) gives false particulars of the described automobile to be insured to the prejudice of the Insurer, or (ii) knowingly misrepresents or fails to disclose in the application any fact required to be state therein; or

(b)    the Insured contravenes a term of the contract or commits a fraud; or

(c)    the Insured willfully makes a false statement in respect of a claim under the contract, a claim by the Insured, for other than such statutory accident benefits are set out in the Statutory Accident Benefits Schedule, is invalid and the right of the Insured to recover indemnity is forfeited.

Warning – Offences

It is an offence under the Insurance Act to knowingly make a false or misleading statement or representation to an Insurer in connection with the person’s entitlement to a benefit under contract of insurance, or to willfully fail to inform the Insurer of a material change in circumstances within 14 days, in connection with such entitlement. The offence is punishable on conviction by a maximum fine of $250,000 for the first offence and a maximum fine of $500,000 for any subsequent conviction.

It is an offence under the federal Criminal Code for anyone to knowingly make or use a false document with the intent it be acted on as genuine and the offence is punishable, on conviction, by a maximum of 10 years imprisonment.

It is an offence under the federal Criminal code for anyone, by deceit, falsehood or other dishonest act, to defraud or to attempt to defraud an insurance company. The offence is punishable, on conviction, by a maximum of 10 years imprisonment for fraud involving an amount over $5,000 or otherwise a maximum of 2 years imprisonment.