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The document describes the personal file establishment, confidentiality controls, access and correction rights, and consent use for additional insurance requests or contract modifications. It also outlines required insured and owner information, coverage options with premiums, and banking/payment instructions for enrolling.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/homecare-assistance-authorization-to-obtain-and-release-personal-information/307829/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/homecare-assistance-authorization-to-obtain-and-release-personal-information/307829.png","ImageObject",300,407,{"name":92,"@type":93},"Jordan Avery","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-07","2026-09-19",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Who is covered by the authorization to obtain and release personal information?","Question",{"text":113,"@type":114},"The authorization applies to the insured, their spouse, and any dependents subject to the insurance application.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What personal information can be shared and why?",{"text":118,"@type":114},"Personal information, including health information, medical history, and eligibility for claims, may be transmitted to the insurer, agents, or reinsurers to assess insurability and support file and claims assessment.",{"name":120,"@type":111,"acceptedAnswer":121},"Can the proposed insured access or correct their personal file information?",{"text":122,"@type":114},"Yes. The insured may access their file and request correction of information that is inaccurate, incomplete, ambiguous, outdated, or unnecessary by sending a written request to the officer in charge of access to information.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},307829,1790073667,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":46,"preview_page_count":4},1099523882367,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","HomeCare Assistance  \nPlan offered by Odyssey Financial Group (a division of People Corporation)  \nUnderwritten by Humania Assurance Inc.  \nAUTHORIZATION TO OBTAIN AND RELEASE PERSONAL INFORMATION TO A THIRD PARTY  \nNOTICE : This authorization applies to the insured, their spouse, as well as any dependents who are the subject of the insurance application.  \nIn order to assess insurability, maintain your file and claims assessment, any individual or legal entity holding personal information about you including any health information, medical history or eligibility for claims, are authorized to transmit such information to the insurer, its agents or its reinsurers upon request. This includes physicians or other practitioners, hospitals, medical clinics or paramedical companies, laboratories, insurance companies or reinsurers, personal information agencies, financial advisors, any financial institutions, the owner, your employer or previous employer, the CNESST or other Workmen’s Compensation Board, Canada or Quebec Pension Plan, the SAAQ or other Department of Motor Vehicles, the RAMQ or other provincial Health Departments, security and investigation agencies, claims and underwriting agencies, crime prevention or detection agencies.  \nFurthermore, the insurer or its agents are authorized to transmit the information to such third parties as well as its reinsurers. For the same purpose and to gather the same type of information, the insurer, its agents or its reinsurers may request an investigative report about you and to use information in their possession in other files.  \nThis consent may also be used for a request for additional insurance or a contract modification.  \nAGREEMENT FOR THE ESTABLISHMENT OF A PERSONAL FILE  \nThe insurer may retain the servicesof a specialized administrator to manage your insurance file as well as your claims.To ensure the confidentiality of your personal information, the insurer will establish a file in which such personal information will be held, and whose purpose is to allow you to benefit from an insurance coverage and additional financial services the company offers. Only authorized employees of the insurer or specialized administrator will have access to this file.  \nYou may access your file and request the correction of any information if you demonstrate that it is inaccurate, incomplete, ambiguous, outdated or unnecessary.  \nTodo so, a written request must be sent to the Officer in charge of the access to information to the Insurer's representative at the following address:  \nOdyssey Financial Group (a division of People Corporation)  \n3 Turgeon St,  \nSte-Thérèse, Québec, J7E 3H2  \nGive this copy to the proposed insured  \nPlan offered by Odyssey Financial Group (a division of People Corporation)  \nUnderwritten by Humania Assurance Inc.  \nCLEAR FORM  \n| APPLICATION |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- |\n| New enrolment Contract No.: |  |  |  |  |  |\n| For agent use |  | Advisor information |  | Code | % |\n| MGA (if applicable) |  | Name of advisor (administrator) |  |  |  |\n|  |  | Name of advisor (2) |  |  |  |\n| 1. INSURED INFORMATION |  |  |  |  |  |\n| First Name: Last Name: |  |  |  |  |  |\n| Date of Birth: / / \u003Cbr>D D / M M / Y Y Y Y | Gender: M F |  | Language Preference: English French |  |  |\n| Address:  \u003Cbr>P.O. Box No. & Street Apt. No. City Province Postal Code |  |  |  |  |  |\n| Telephone:  \u003Cbr>Home Office Cell |  |  |  |  |  |\n| E-mail: |  |  |  |  |  |\n| 2. OWNER (IF DIFFERENT FROM THE INSURED) |  |  |  |  |  |\n| First Name: Last Name: |  |  |  |  |  |\n| Date of Birth:/ / \u003Cbr>D D / M M / Y Y Y Y | Gender: M F |  | Language Preference: English □ French |  |  |\n| Address:  \u003Cbr>P.O. Box No. & Street Apt. No. City Province Postal Code |  |  |  |  |  |\n| Telephone:  \u003Cbr>Home Office Cell |  |  |  |  |  |\n| E-mail: |  |  |  |  |  |\n\nPlan offered by Odyssey Financial Group (a division of People Corporation)  \nUnderwritten by Humania Assurance Inc.  \n| 3. CHOICE OF COVERAGE ","cbCaipLnY5s4byvl","https://ap.wps.com/l/cbCaipLnY5s4byvl","pdf",1928394,"English","# Authorization to Obtain and Release Personal Information to a Third Party\n# Agreement for the Establishment of a Personal File\n# Insured Information and Owner Information\n# Choice of Coverage\n# Banking Information\n# Premiums and Method of Payment\n# Pre-Authorized Debit (PAD) Agreement","[{\"question\":\"Who is covered by the authorization to obtain and release personal information?\",\"answer\":\"The authorization applies to the insured, their spouse, and any dependents subject to the insurance application.\"},{\"question\":\"What personal information can be shared and why?\",\"answer\":\"Personal information, including health information, medical history, and eligibility for claims, may be transmitted to the insurer, agents, or reinsurers to assess insurability and support file and claims assessment.\"},{\"question\":\"Can the proposed insured access or correct their personal file information?\",\"answer\":\"Yes. The insured may access their file and request correction of information that is inaccurate, incomplete, ambiguous, outdated, or unnecessary by sending a written request to the officer in charge of access to information.\"}]","HomeCare Assistance Authorization to Obtain and Release Personal Information | PDF",1789855927]