Disability insurance

Important: before you begin

  1. Please call us prior to sending one of the following forms. Other documents may be required.

    Vision insurance: 1-866-608-4746 This link will launch your default phone software. or 1-800-294-5399 This link will launch your default phone software. (outside Canada) or 514-875-9170 This link will launch your default phone software. (call collect)

    Other insurance: 1-888-558-5525 This link will launch your default phone software. or 514-285-3000 This link will launch your default phone software., 1-800-361-7285 This link will launch your default phone software. (U.S.)

  2. Print, fill out and sign the form.

  3. Gather original supporting documents.

  4. Send everything to the address indicated on the form.

General forms


Important : These three forms need to be transmitted at the same time.

Disability claim – Disabled person’s statement – 17001E (PDF, 869 KB) Opens in a new window.
To be completed when submitting a claim for disability benefits.

Attending physician’s statement – Original request – 020255A (PDF, 145 KB) Opens in a new window.
Must be filled in by the claimant’s personal physician to describe the claimant’s current health status.
Important : The insured is responsible for any fees related to this form.

Authorization to collect and communicate personal information (disability) – 98185E (PDF, 285 KB) Opens in a new window.
Must be completed when submitting a disability claim.
Important : Original document required.


Attending physician’s statement – Additional report – 020265A (PDF, 237 KB) Opens in a new window.

Must be filled in by the claimant’s personal physician to describe the claimant’s current health status.

Important : The insured is responsible for any fees related to this form.


Information about eligible loans for SOLO Loan Insurance benefits – 17013E (PDF, 261 KB) Opens in a new window.

To submit a claim for SOLO Loan Insurance disability benefits (description of all eligible loans).


Specific forms

Specific form

Loss of employment coverage


Claim for loss of employment benefits – 17004E (PDF, 770 KB) Opens in a new window.

To submit a claim for disability benefits in the event of job loss.

Important : Must be completed by the claimant and the employer.


Residual or Partial Disability coverage


Additional statement regarding a disability – Employer or self-employed individual’s statement – 17011E (PDF, 809 KB) Opens in a new window.

To be completed when submitting a claim for partial disability benefits.

Important : Contract must include partial disability.



Our clients say it best

“The employees were all very caring and polite: ‘Hello, how are you? Are you feeling better?’ They didn’t just do their job.”*


1. This feedback was obtained when clients called us for service or a claim and may be a translation.