Claimant’s Charter of Rights and Responsibilities

Disability

We recommend that you fill the direct deposit request so that your benefit payments are deposited directly into your bank account. Just download the form, fill it and send it to us.

• Complete the Claimant's Statement in the Disability claim form and, for General fees benefit, the Overhead Expenses Claim Form (Insurance Select Plus/Paie)
• Fill the Physician's statement that applies to your medical condition, either the Physical illnesses form or the Psychological illnesses form
• Complete the Standard Authorization for disclosure of information

Additional reports to fill during your claim's life only upon demand of your analyst:

• Physical illnesses - Additional report
• Psychological illnesses - Additional report

If the police was purchased less than two years ago, complete the authorization specific to the province:

• Authorization for disclosure of information (Alberta)
• Authorization for disclosure of information (British Columbia)
• Authorization for disclosure of information (New Brunswick)
• Authorization for disclosure of information (Nova Scotia)
• Authorization for disclosure of information (Quebec)
• Authorization for disclosure of information (Ontario)

Fracture

We recommend that you fill the direct deposit request so that your benefit payments are deposited directly into your bank account. Just download the form, fill it and send it to us.

• Complete the sections A, B, F and G from Claim form - Medical and paramedical fees
• Attach the X-ray protocol

Critical Illness

• Complete the Claim Form for Critical Illness Insurance
• Complete the Standard Authorization for disclosure of information

Attach the Physician's Statement that applies:

• Autism - Only available in French
• Cancer
• Coronary surgery - Only available in French
• Deafness - Only available in French
• Heart attack - Only available in French
• Multiple sclerosis - Only available in French
• Stroke - Only available in French

If the police was purchased less than two years ago, complete the authorization specific to the province:

• Authorization for disclosure of information (Alberta)
• Authorization for disclosure of information (British Columbia)
• Authorization for disclosure of information (New Brunswick)
• Authorization for disclosure of information (Nova Scotia)
• Authorization for disclosure of information (Quebec) (French only)
• Authorization for disclosure of information (Ontario)

Critical Illness for children

• Complete the Child Insurance - Initial Statement
• Complete the Standard Authorization for disclosure of information

Attach the Physician's Statement that applies:

• Autism - Only available in French
• Cancer
• Coronary surgery - Only available in French
• Deafness - Only available in French
• Heart attack - Only available in French
• Multiple sclerosis - Only available in French
• Stroke - Only available in French

If the police was purchased less than 2 years ago, complete the authorization specific to the province:

• Authorization for disclosure of information
• Authorization for disclosure of information (British Columbia)
• Authorization for disclosure of information (New Brunswick)
• Authorization for disclosure of information (Nova Scotia)
• Authorization for disclosure of information (Quebec) (French only)
• Authorization for disclosure of information (Ontario)

Compassion related to a critical illness insurance for children

We recommend that you fill the direct deposit request so that your benefit payments are deposited directly into your bank account. Just download the form, fill it and send it to us.

• Complete the Compassionate leave benefit - Critical illness
• Complete the Standard Authorization for disclosure of information

Dismemberment

• Complete the Claimant's Statement - Dismemberment
• Attach the Physician's Statement - Dismemberment
• Complete the Standard Authorization for disclosure of information

If the police was purchased less than 2 years ago, complete the authorization specific to the province:

• Authorization for disclosure of information (Alberta)
• Authorization for disclosure of information (British Columbia)
• Authorization for disclosure of information (New Brunswick)
• Authorization for disclosure of information (Nova Scotia)
• Authorization for disclosure of information (Quebec) (French only)
• Authorization for disclosure of information (Ontario)

Medical, paramedical and dental fees

We recommend that you fill the direct deposit request so that your benefit payments are deposited directly into your bank account. Just download the form, fill it and send it to us.

Option 1: Online claim

Online claim for health and dental benefits

Option 2: Claim by email, fax or mail

• Dental claim
• Medical and paramedical fees claim