File a claim

This form makes it possible to file a claim online. It should take about 10 minutes to complete this form. An initial follow-up with the policyowner will take place within five business days once the claim is filed.

Do you want to file your claim by phone? Dial 1-844-442-4636.

Your claim

The insured may qualify for different coverages. Consult the insurance policy first to determine the coverage held.

Do you want to file a disability claim?
Do you want to file an accidental fracture claim?
Do you to file a claim for loss-of-use of a limb or loss of sight?
Do you want to file a claim for hospitalization costs or home care services costs?
Do you want to file a claim for paramedical costs resulting from an accident?

Are you filing this claim for yourself?
You will receive an acknowledgment of receipt of your claim.

You will receive an acknowledgment of receipt of your claim.

Insurance policy

If the claim pertains to more than one insurance policy, enter all policy numbers.

File a claim

This form makes it possible to file a claim online. It should take about 10 minutes to complete this form. An initial follow-up with the policyowner will take place within five business days once the claim is filed.

Do you want to file your claim by phone? Dial 1-844-442-4636.

About you About

Date of birth
About your disability About ’s disability
Disability start date
Maximum of 5,000 characters 0 character(s)
Is the disability the result of an accident?
Date of the accident
Have you returned to work? Has the insured returned to work?
Since the onset of your disability, have you done any work for wich you received compensation (light duties, temporary assignement, etc.)? Since the onset of the insured’s disability, has he/shed one any work for which he/she received compensation (light duties, temporary assignment, etc.)? Since , have you done any work for which you received compensation (light duties, temporary assignment, etc.)? Since , has the insured done any work for which you received compensation (light duties, temporary assignment, etc.)?
Start date
End date (if applicable)
Date of return to work
Anticipated date of return to full-time work (if known)
About your accidental fracture About ’s accidental fracture
Maximum of 5,000 characters 0 character(s)
Is the fracture the reason for your disability? Is the fracture the reason for the insured's disability?
Date of the incident causing the fracture
Date of the incident causing the fracture
Maximum of 5,000 characters 0 character(s)
Is the fracture caused by a motorized vehicle accident?
Were you driving at the time of the accident? Was the insured driving at the time of the accident?
Was a specialist consulted?
About your loss-of-use of a limb or loss of sight About ’s loss-of-use of a limb or loss of sight
Is the loss-of-use of a limb or loss of sight the reason for your disability? Is the loss-of-use of a limb or loss of sight the reason for the insured's disability?
Date of the incident causing the loss-of-use of a limb or loss of sight
Maximum of 5,000 characters 0 character(s)
Date of the incident causing the loss-of-use of a limb or loss of sight
Maximum of 5,000 characters 0 character(s)
Is the loss-of-use of a limb or loss of sight caused by a motorized vehicle accident?
Were you driving at the time of the accident? Was the insured driving at the time of the accident?
Was a specialist consulted?
Supporting document and comment
No supporting documents are required at this time. We will contact the policyowner as needed.

A copy of the following document is required to review the claim.

Copies of the following documents will facilitate the review of your claim.

A copy of the following document will facilitate the review of your claim.

  • Summary of hospitalization confirming duration and reason of stay 
  • Invoices for home care services expenses being claimed (if applicable)
  • Radiologist’s report
  • Doctor’s note confirming date, cause and nature of loss
  • Invoices for paramedical expenses being claimed
  • Medical documentation confirming date, cause and diagnosis
  • Settlement papers received from other insurers (if any) 

Do you have these documents? Send them now.
Is a document missing? Request it as soon as possible. Doing so will help you avoid slowing down the claim review process. Do you have this documents? Send it now.
Is the document missing? Request it as soon as possible. Doing so will help you avoid slowing down the claim review process.

Maximum of 5,000 characters 0 character(s)

Information summary

This form makes it possible to file a claim online. It should take about 10 minutes to complete this form. An initial follow-up with the policyowner will take place within five business days once the claim is filed.

Do you want to file your claim by phone? Dial 1-844-442-4636.

Your claim

About you About

About your disability About ’s disability

About your accidental fracture About ’s accidental fracture

About your loss-of-use of a limb or loss of sight About ’s loss-of-use of a limb or loss of sight

Supporting document and comment

Declaration

Information summary

Your claim

About you About

About your disability About ’s disability

About your accidental fracture About ’s accidental fracture

About your loss-of-use of a limb or loss of sight About ’s loss-of-use of a limb or loss of sight

Supporting document and comment

Need help?

Do you have questions about your claim?