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Can't find the form you need?

Check out the list of all our forms.

Instructions

Forms you need to submit claims under your group insurance plan (ex: for drugs and other healthcare expenses, dental care, vision care, disability benefits, travel insurance benefits)

So we can process your claims as quickly as possible, please:

  • Complete the required forms in full  (forms can be completed online);
  • Print the form and sign it;
  • Send the completed form and the required original documents to the address shown at the top of the form.

These forms, automatically filled out with your group's information, are available on your secure site.

Results
Claim for Health Care Benefits - 19132A
Used to submit claims for prescription drugs, services provided by a healthcare professional, or paramedical or vision care. Insureds have a maximum of 1 year from the date on which the expenses are incurred to submit a claim.
Claim Adjudication Guidelines for the Extended Healthcare Benefit - 13068E
Document with important information on health claims processing.
Request for reimbursement of brand name medications - 12126E
Authorization form to be reimbursed for a brand name drug when the generic equivalent cannot be taken due to medical reasons.

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