#29 St. Vincent Street, Port of Spain              +1(868) 625-4444           info@clico.com

CLICO (Trinidad) Ltd © 2016  |  All Rights Reserved

​Legal & Privacy Policies

Contact

FORMPURPOSE
Check ListThis form must be completed by all clients and submitted with Application.

Payment Request Application Form

This form must be completed by all clients to access the Final payment of Short Term Investment Products (STIPs)

(Print this form on legal-sized paper 8.5 x 14 inches)

Third Party Statutory Declaration Form                      

This form must be completed by all clients to confirm that they are neither presently nor have been in 2008 - 2009 a Director or Officer of CLICO Investment Bank, Colonial Life Insurance Company [Trinidad] Limited, British American Insurance Company (Trinidad) Limited, Caribbean Money Market Brokers or CL Financial Limited (see definition of 3rd Party here

(Print this form on legal-sized paper 8.5 x 14 inches) 

Statutory Declaration of Lost Policy Form
This form must be completed by clients who have lost their original STIPs contract.  The completed form must be witnessed by a Commissioner of Affidavits.  Upon completion, the policy will be advertised in the press for six weeks before final processing.


These STIP holders are persons with the following policy contracts:
* Executive Flexible Premium Annuity (EFPA) * Executive Flexible Premium Annuity I (EFPA I)
* Group Advance Protection (GAP) * Colonial Life Core Fund Series (CSI)
* Executive Single Premium Annuity (ESPA) * Executive Flexible Premium Annuity II (EFPA II)
* Executive Flexible Premium Investment (EFPI)


STIP holders must complete the following steps to facilitate payments:
1. Download the Application Form and Statutory Declaration Form above (STIP holders may also obtain Forms from CLICO’s Head Office at 29 St. Vincent Street, Port of Spain between the hours 8:00 am – 4:00 pm)
2. Complete Application Form and attach the following documents:

  • Two original valid forms of identification - ID Card, Passport, Driver’s Permit
  • Original Policy Contract (If lost, a Declaration of Lost Policy Form witnessed by a Commissioner of Affidavit)
  • Signed Statutory Declaration Form (and witnessed by a Commissioner of Affidavits)*
  • Release of Assignment duly stamped by the Board of Inland Revenue (If Applicable)
  • Power of Attorney if the applicant is unable to attend in person (If Applicable)
  • Official documentation from your bank showing branch and bank account number; such as bank statements, cheque books etc.
  • A letter from your bank indicating wire transfer instructions for foreign currency policy contracts to facilitate foreign currency payments. All related fees will be for the account of the Payee

3. Submit completed and signed Application Form together with accompanying documents to customer service representatives at CLICO’s Head Office in accordance with the Schedule below:

STIP HOLDERS ARE ASKED TO NOTE THE FOLLOWING INFORMATION:

  • Where there are multiple/joint owners (“And/OR”, “AND”), all parties MUST sign the Application Form
  • Payment will be made within fourteen (14) working days from the date of submission of a completed Application Form with supporting documents, subject to verification of the liability, (including the approval of the Central Bank), any set off of sums due to CLICO or waiver/withdrawal of related claims/court proceedings against CLICO
  • All foreign currency policy contracts will be paid in the currency that is stated in the contract
  • Payment will be directly deposited into a bank account of an eligible STIP holder ONLY
  • ONLY the ASSIGNEE on record is authorized to apply for the payment

*A third party is a party that is not connected/related to CLICO as described in the Statutory Declaration Form which must be completed and submitted with ALL third party Applications
For further information please contact CLICO’s Head Office - 625-4444 or email us at stipsqueries@clico.com

Download and print the forms that are applicable to you

STIP Holders: Payment to Residents 

and Non-Residents

Further to directions issued by the Central Bank of Trinidad and Tobago following consultation with the Minister of Finance pursuant to section 44D of the Central Bank Act Ch. 79:02, Colonial Life Insurance Company [Trinidad] Limited (CLICO), will begin the final payment to all third party resident and non-resident STIP holders and holders of mutual fund contracts (including the Government in respect of assigned contracts). This payment will meet the final contractual liability.