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Life and Accident & Sickness Forms

Life and Accident & Sickness Forms

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Recommended Materials prior to applying for a licence:

  • Refer to the User Guides and Applying for a Licence page on the ICM website before submitting an application to the ICM, as these materials outline the required items needed to apply for a licence.

Life and Accident & Sickness Licences:

  • Please note that Life and Accident & Sickness licences are two different licence classes in Manitoba and are two separate licences. If you intend to sell Group, Critical Illness or Disability insurance in addition to Life, you will need to apply for both licences.
  • If you want to sell policies that have components of both Life and Accident & Sickness coverage, you must hold both licences.
  • Must be recommended/approved by a licensed insurance company.
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Certificate of Authority / Non-Resident Endorsement Request Form

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Online Application

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Online Application for Provincial Examination

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Supervision Certificate
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Supervision Statement
* This form is not a mandatory form under ICM’s licensing framework. The form was designed to assist the Life licensed agent, that requires supervision for LIFE insurance, and their supervisor to collect the applicable information depending on the type of insurance being applied for. Completion of this form may require further discussion between the agent requiring supervision and their supervisor.

Licence Holders

The Insurance Council of Manitoba is the Regulatory Body responsible for the licensing and discipline of insurance agents, brokers and adjusters in the Province of Manitoba.

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