The following forms are available online to make it easier to manage your group insurance plan.
- Certain forms require Word software, whereas for others you will need Acrobat software.
- Complete the selected form by clicking on each empty field.
- It may take a few seconds before the text appears onscreen, depending on your Internet connection.
- Save and print the form in order to sign it. Send us the original copy by mail, unless indicated otherwise below.
- Canada Life
(T) 1 888 878-6059
Email : email@example.com
- La Capitale
(T) 1 800 463-4856
(T) 1 877 849-8509
Courriel : firstname.lastname@example.org
- Desjardins Insurance
(T) 1 800 463-7843
- Humania Assurance
(T) 1 800 818-7236
Courriel : email@example.com
- iA Financial Group (Industrial Alliance)
(T) 1 877 422-6487
- iA Financial Group AD&D
(T) 1 800 266-5667
(T) 1 866 236-6313
- SSQ Insurance
(T) 1888 651-2307
Courriel : firstname.lastname@example.org
- UV Insurance (Union-Vie)
(T) 1 800 567-0988
Courriel : email@example.com
We suggest you keep the originals for your records. All requests must be sent by fax or by email to firstname.lastname@example.org.
Situation – If your weekly income replacement benefits are placed with one of the following insurers, please click on the appropriate link to directly access their claim form:
Click on the appropriate link, according to the insurer with which your long term disability coverage is subscribed:
To complete your request, attach a copy of all medical certificates on file since the work stoppage, a copy of the job description in your company and a copy of the last two pay stubs before disability.
If your insurance is with Assumption Life or Blue Cross insurers, please provide a birth certificate and a copy of your last employment insurance payment slip.
In the event of a diagnosis of critical illness, insurance against serious diseases provides a lump sum payment. To know the eligible health states and eligibility requirements, please consult the contract and/or brochure.
If your critical illness coverage is subscribed with one of the following insurers, please select the link of your insurer :