Notice of Rescission of an Insurance Contract
Q.P.F. No. 1 – Owners’ Form
– Coverage for Civil Liability – Underwritten by Intact Insurance
Please fill out this form to obtain your refund.
Any refund owed will be paid within 30 days following receipt.
IT IS RECOMMENDED THAT YOU KEEP A COMPLETED COPY OF THIS FORM FOR YOUR RECORDS. INTACT INSURANCE COMPANY RESERVES THE RIGHT, FOR A PERIOD OF ONE YEAR FROM THE DATE THIS NOTICE IS SENT, TO VIEW THE ORIGINAL OR TO DEMAND A COPY OF YOUR TRAIL PASS AND YOUR PINK INSURANCE CERTIFICATE FOR THE CIVIL LIABILITY COVERAGE PROVIDED BY INTACT INSURANCE.