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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
No
Please make a selection.

About the claim follow-up

Whom should we contact to follow up on the claim?

Veuillez inscrire un prénom.
Veuillez inscrire un nom.
Please enter a valid telephone number.
Please enter a valid extension.
Please enter a valid telephone number.
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.
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