Supplementary Policy

CPBA recognizes that some pharmacists may be provided automatic E&O coverage through their employer. In order to have peace of mind, pharmacists now have the option to purchase a “supplementary” policy that will help cover you for potential possible coverage gaps in your employer’s policy. It is important to note that you must have VALID primary coverage in order for the supplementary insurance to respond. Please ensure that the primary coverage has not lapsed, was cancelled nor is invalid.


  • CONTACT INFORMATION

  • MEMBERSHIP INFORMATION

  • Important: Enter license Number as XX - XXXX (include the dash)
  • Supplementary Liability Coverage

    Coverage period: July 1, 2021 to July 1, 2022

    NOTE: Members with other eligible coverage may purchase a supplementary policy ($3 000 000 per occurance/$5 000 000 aggregate) for the great rate of $35 premium to cover gaps to their employer's policy and/or increase limits of an employer's policy.
  • $3 Million per occurrence
    $5 Million aggregate
    _______________________
    $35.00 - Premium
    $5.25 - RST (Insurance Premium Tax)
    $15.00 - Brokerage fee to CPBA waived as per decision of CPBA
    $15.00 - PANL Administration Fee
    $2.25 - HST
    Total - $57.50
    Price:
  • $15 +HST
    Price:
  • I declare that during the last five years no insurer has cancelled, declined or refused to issue me any form of liability insurance and that this application discloses the hazards known to exist at the date of this application. I declare that the statements made herein are in every respect true and correct and hereby apply for a contract of insurance to be based upon the truth of the said statements. Submitting this form does not bind the Applicant or company to complete the insurance but is agreed that this form shall be the basis of the contract should a policy be issued. The insurance premium is fully retained and not refundable.
  • Proof of Coverage & Consent

    Section 14(e) of the Pharmacy Act, 2012 requires that "pharmacists' provide proof that he or she has obtained professional liability insurance coverage in a form and amount satisfactory to NLPB. The malpractice insurance policy purchased through PANL satisfies this requirement under the ACT.
  • I hereby acknowledge that the information collected in the Application form is acquired by my insurance broker to be transmitted to the insurer for the sole purpose of obtaining an insurance policy, and will be kept confidential.
  • I consent to be contacted directly by e-mail by BMS Canada Risk Services Ltd. concerning the professional liability insurance coverage (primary and supplementary), they make available to me through the Canadian Pharmacists Benefit Association and the Pharmacists' Association of Newfoundland and Labrador, and my eligibility and application for, and renewal of, such insurance coverage. I understand that I may withdraw this consent at any time.
  • I declare that the above statements are true and that I have not omitted, suppressed or misstated any material facts.
  • PAYMENT

  • Please note that this form is used for Liability insurance. If you have any questions, please contact PANL Office at 709-753-7881 prior to submitting. If there is an error in selecting the appropriate form and a refund is required, there will be a $15.00 administration fee applied automatically.
  • Price:
  • $ 0.00 CAD
  • $ 0.00 CAD
  • This field is for validation purposes and should be left unchanged.

Telephone:

(709) 753-7881

Toll Free:

(866) 753-7881

Fax:

(709) 753-8882

Email:

email@panl.net