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Individual Insurance
Group Insurance
Representatives
Products
Life Insurance
Health Insurance
Mortgage Insurance
Disability Insurance
Critical Illness Insurance
Children Insurance
Accident Insurance
Travel Insurance
Support Centre
FAQ
Find an advisor
About us
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Our History
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Social responsibility
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Contact us
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Notice of loss
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Notice of loss
Type of loss *
Accident
Illness
Hospitalisation
Dismemberment
Death
Waiver of premiums
Complete this Notice immediately to inform the Company of any event involving the insured.
This Notice should be mailed within 30 days of the date of the event to LS Mutual Life Insurance Company, P.O. Box 10 000, Saint-Hyacinthe(Québec) J2S 7C8
1-800-773-8404
.
Upon receipt if this notice, the Head Office Benefits Department will contact you as soon as possible.
Coordinates of the insured
Last name *
First name *
Address
N° *
Street *
City *
Province *
Postal code *
Phone *
Policy n° *
Date of birth *
About the loss
Date of event *
Last name of policyholder *
First name of policyholder *
Circumstances of the accident *
Nature of injury *
Cause of death *
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