Client Disclosure Statement

Client Disclosure Statement



When considering the purchase of life insurance, travel insurance, income protection, critical illness insurance, health, drug and dental insurance, investment, or banking products, it is important to have an understanding of the product and how it meets your needs. In addition, it is important to know the company which is offering/supplying the product or service as well as the advisor who is recommending it. The following information will assist you in making an informed decision, and will provide insight into my relationship with the companies I do business with, and how I am compensated.


I receive customer referrals from insurance brokersand investment firmsas well as from existing clients. I have been asked to contact you to discuss possible financial strategies and insurance requirements pertaining to your personaland business insurance and financial planning needs. My services pertain to the requested services only and do not expand beyond this arena into tax planning or other activities. I am unable to advise you on any financial products where I do not hold the appropriate authorized regulatory certificates or licensing.

Companies I Represent:

As a licensed insurance broker, I represent several insurance carriers offering life insurance, living benefits and investment products. My recommendations are based on my assessment of your financial and security needs and are selected from a broad range of products. I am currently contracted with the following companies, as a sole proprietor using the marketing name ProInsure-Professional Insurance Advisors.


  • Assumption Life
  • AXA Financial
  • BMO Life Assurance
  • Blue Cross
  • Canada Life
  • Empire Life
  • Equitable Life
  • GMS
  • Transamerica
  • Industrial Alliance
  • Foresters
  • Manulife Financial
  • Manulife Bank
  • Standard Life
  • Desjardins Financial
  • Sun Life
  • TIC
  • Canada Protection Plan

Nature of Relationship with Companies I Represent:

No Insurer holds ownership or interest in ProInsure, nor does ProInsure or Ihold an interest in any Insurance Company.

I am authorized to sell life, health and Insurer investment products in the province of Ontario and Alberta.



If you choose to purchase an insurance product through me, I will receive remuneration from the company that offers the product. I am compensated by either a sales commission or referral fee at the settlement of the product or service. In addition, I may also receive renewal (or service) commissions from the Insurer where clients decide to keep the policy or contract in-force.

I may also be eligible for additional compensation, such as bonuses, non-monetary benefits and travel incentives, depending on various factors such as the volume or persistency of business that I place with a particular company. I may also receive compensation in the form of a referral fee for the recommendation of the Manulife ONE product offered by Manulife Bank. I may also receive referral fees where the sale of a business or financing is involved.

As part of our discussions pertaining to product requirements and selection, the amount of compensation received will not play a factor in the recommendations made to you.


Conflicts of Interest:

I take the potential of a conflict of interest very seriously. I will notify you verbally and in writing if there is a potential or real conflict of interest of which I become aware. My overall recommendations are unbiased and, where possible, are based on an independent survey of companies which provide the products the client is interested in.

Other Business Activity:

My only business is that of a licensed insurance broker in the province of Ontario.

My recommendations are selected from a broad range of products from various companies. A careful assessment of your financial and security requirements have been considered as part of my overall review. Growing and protecting your assets is paramount to your financial health. I encourage you to take the time to carefully read policy and account information to ensure your full understanding. Please do not hesitate to contact me if you need further clarification on the recommended products, my qualifications, or the nature of my business relationships.


Nick Godfrey – Financial Security Advisor

ProInsure – Professional Insurance Advisors

This statement has been prepared by Nick Godfrey who is alone is responsible for its accuracy.



Client Acknowledgment:

I acknowledge that I have been informed of, and understand this disclosure. I accept the information disclosed to me and understand that I may ask for further information regarding this disclosure.

Client Name: ___________________________________________________________________

Client Signature: ________________________________________________________________

Date: __________________________________________________________________________




The privacy of your confidential information is important to me. If you choose to work with me, I will be required to share your confidential information with all parties relevant to the transactions agreed upon. I will notify you immediately upon identifying any potential breaches of your personal information which may occur.