Obtain a form

Obtain a Group Insurance Form

Plan Member

Direct deposit*

Direct Deposit - Disability

Conversion Request

Group Insurance - Conversion Application

Change of Beneficiaries or Marital Status

*For Short and Long-Term Disability insurance only. This Direct Deposit form cannot be used for medical and/or dental reimbursements.

Plan Administrator

New enrolment

Claim forms

Life Insurance

Disability

Compassion Care Leave

Compassionate Care Leave – Claim Form

Critical Illness

Dismemberment or loss of use

Medical, paramedical and dental care

Authorizations

Direct deposit

Request for enrolment, modification or termination of direct deposit

Medical or lifestyle habits questionnaires

Lifestyle Habits

Activities

Medical Conditions

To send us your documents

Three options for you

By email

adm.coll@humania.ca

By fax

450-823-0734

By mail

Humania Assurance Inc.
1555, Girouard Street West
St-Hyacinthe (Quebec) J2S 2Z6

Obtain a Group Insurance Form

Plan Member

Direct deposit*

Conversion Request

Change of Beneficiaries or Marital Status

Plan Administrator

Changes to the Group or to its Members

Banking Information

Plan administrator change (to add or remove)

New enrolment

Claim forms

Life Insurance

Disability

Compassion Care Leave

Critical Illness

Dismemberment or loss of use

Medical, paramedical and dental care

Authorizations

Direct deposit

Medical or lifestyle habits questionnaires

Lifestyle Habits

Activities

Medical Conditions

To send us your documents