Pre-authorized debits are a practical, secure and efficient way to make premium payments and keep insurance coverage in force.
To encourage clients to use this payment method, we’ve updated the
09312E Pre-Authorized Debit (PAD) Agreement form to simplify the signature process.
Starting July 15, 2026, we’ll no longer accept the old versions of this form.
What’s changing
- Only the payor’s signature is now required
- We’ve removed the section that required the policyowner’s signature
When to use the PAD form
You need to use it for the following situations:
- Submitting a new insurance application on paper
- Changing a policy (including the exercise of a right or privilege)
- Making a one-time payment (like additional deposits, advance repayments, additional deposit option)
- Changing a payor (other than the policyowner)
- Changing the payment method or frequency through pre-authorized debit
You don’t need to use it for the following situations:
- Changing a bank account without making any other changes
- Changing a billing day
You can email these requests to
Desjardins_Service@desjardins.com or through the
Service Inquiries application.
Clients who pay after receiving a notice
To change the payment method, call 1-888-558-5525. In most cases, no form is required if the policyowner is paying the premium.
Best practices
- Use one form per policy and clearly indicate the policy number
- Fill out the required sections carefully, paying special attention to sections B and C
-
Enclose a personal cheque marked "VOID"
- Choose a withdrawal date that’s between the 1st and 28th (the 29th, 30th and 31st aren’t permitted)
- Send the form in its entirety, including the pages that don’t have any information
To ensure the form is processed as quickly as possible, you must send the PAD form together with the insurance application or change request.
Questions?
Call our Client Relations Centre: 1-888-558-5525
