Privacy Policy And Malpractice Application Form

After reading this Privacy Policy, simply click on the "I AGREE" button at the end of this
page to download and print the Chiropractic Malpractice Insurance Program Application Form.


Walter Roberts Insurance Brokers Inc. is committed to protecting your privacy and the confidentiality
of your personal information. In order to comply with privacy legislation, known as Bill C-6 Personal
Information and Electronic Documents Act (PIPEDA)
effective January 1, 2004, we have developed
this Privacy Policy.

Walter Roberts Insurance Brokers Inc. only collects, uses and discloses Personal Information for
the following purposes:

Identified Purposes
Offering and providing insurance and financial products and services to you;
Establishing and maintaining communications with you;
Verifying your identity and the accuracy of your Personal Information with insurers, government
agencies and financial institutions;
Determining and facilitating your payment of fees and premiums;
Investigating and paying claims;
Detecting and preventing fraud or other illegal activities;
Complying with the law or the requests of law enforcement agencies or regulators; and
Notifying you or allowing our affiliated companies to notify you of certain products or services
offered by us, or our affiliated companies.

Consent
Your knowledge and consent of Walter Roberts Insurance Brokers Inc.’s collection, use and
disclosure of your Personal information is critical. We rely on the following actions by you as
indications of your consent to our existing and future Personal Information practices:
Your voluntary provision  of Personal Information directly to Walter Roberts Insurance Brokers
Inc. through a registered insurance broker or representative for the purpose of acquiring an
insurance contract or financial service or product (including information previously provided to
Walter Roberts Insurance Brokers Inc.).
Your express consent or acknowledgement contained within a written, verbal or electronic
application process
Your consent solicited by Walter Roberts Insurance Brokers Inc. for a specified purpose;
Your receipt of the Privacy Policy, until you notify Walter Roberts Insurance Brokers Inc. of
a withdrawal of this consent; or
Your consent given through your authorized representative such as a legal guardian, agent
or holder of a power of attorney.

Subject to certain legal or contractual restrictions and reasonable notice, you may withdraw
this consent at any time. Walter Roberts Insurance Brokers Inc. will inform you of the
consequences of withdrawing your consent. In some cases, refusing to provide certain
Personal Information or withdrawing consent for Walter Roberts Insurance Brokers Inc.
to collect, use or disclose your Personal Information could mean that we cannot provide
you with insurance coverage or other requested products, services or information. If you
wish to withdraw your consent to be notified of marketing initiatives, please call us at
905-764-8061 Ext # 226.

Accuracy
Walter Roberts Insurance Brokers Inc. will maintain your Personal Information as accurate,
complete and up-to-date as is necessary for the Identified Purposes.

Safeguards
Walter Roberts Insurance Brokers Inc. will protect your Personal Information by security
safeguards appropriate to the sensitivity of the information. Safeguards will vary depending
on the sensitivity, format, location and storage of the Personal Information.

Accountability, Openness & Customer Access
When you telephone our office, we may confirm your identify by requesting certain Personal
information, and you may be directed to provide your request in writing.

Walter Roberts Insurance Brokers Inc. will only collect Personal Information by fair and lawful
means. We will retain Personal Information only as long as is necessary for the fulfillment of the
Identified Purposes. Walter Roberts Insurance Brokers Inc. is responsible for all Personal
information under its control, and has designated a Privacy Officer who is accountable to our
Board of Directors.

Limiting Collection & Retention of Personal Information
Walter Roberts Insurance Brokers Inc. will only collect, use or disclose Personal Information
that is necessary for the Identified Purposes or as required by law. If we require Personal
Information that for any other purpose, you will be notified of the new purpose, and subject
to your consent, that new purpose will become an Identified Purpose.

Walter Roberts Insurance Brokers Inc. will only collect Personal Information by fair and lawful
means. We will retain Personal Information only as long as is necessary for the fulfillment of
the Identified Purposes.

Challenging Compliance
If you are not satisfied with the Walter Roberts Insurance Brokers Inc. response to a privacy
related inquiry or complaint, you may contact the Office of the Privacy Commissioner of Canada
during business hours at 1-800-282-1376 or at www.privcom.gc.ca

Chiropractic Malpractice Policy Features

How To Apply
Chiropractic Malpractice Insurance Application

To read the following documents you will need Adobe PDF Reader to open the
files. If you don't already have it, you can download it for free here.

Policy Wordings
Request A Certificate Of Insurance
Change of Banking Information
Change of Mailing Address