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File a critical illness claim

This form allows you to file a critical illness claim online. It will take you about 20 minutes to complete. An initial follow-up with the policyowner will take place within five business days once the claim is filed.

Your claim

You will need:

Information about family members who have a similar health problem.

Are you filing this claim for yourself?

Yes

Please make a selection.

About the claim follow-up

Whom should we contact to follow up on the claim?

First name Veuillez inscrire un prénom.

Last name Veuillez inscrire un nom.

Initials

Primary telephone number Please enter a valid telephone number.

ext. Please enter a valid extension.

Secondary telephone number (optional) Please enter a valid telephone number.

ext. Please enter a valid extension.

Email address used for claim follow-up

You will receive an acknowledgement of receipt after the claim is sent. Please enter a valid email address.

I don't have an email address

Please check the box if you do not have an email address.

Cancel

Do you have questions about your claim?

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1 844 442-4636

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Contact the Customer Service Department

Do you need more time?

File a critical illness claim

Your claim

You will need:

Are you filing this claim for yourself?

In what capacity are you filing this claim?

About the claim follow-up

Whom should we contact to follow up on the claim?

Mailing address used for the claim process

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