Instructions
- Fill out and sign the form
- Gather the required supporting documents
- Send everything to the address indicated on the form
Solo products Forms
Claim for Dental Care Expenses – SOLO – 1911099A (PDF, 1.6 MB) Opens in a new window.
This form is used to submit claims for dental care expenses.
Important :
You can also use the claim form that your dentist's office gives you. Be sure to clearly indicate your contract and certificate numbers.
Vision Form
Claim for Dental Care Expenses – 19110A (PDF, 1.6 MB) Opens in a new window.
This form is used to submit claims for dental care expenses.
Important :
You can also use the claim form that your dentist's office gives you. Be sure to clearly indicate your contract and certificate numbers.