Here you'll find the forms to fill out for the different services we offer so we can serve you quickly and efficiently, whatever your situation. Tell us what you need, and we'll take care of the rest!
Frequently viewed
Auto and home insurance
Claims
- File a claim
- Track a claim
- Request a roadside assistance reimbursement
- (This coverage must be included in your contract)
For all other requests, please contact customer service by completing this form.
Individual insurance
Extended medical care
- Claim form accident, health insurance benefit (PDF 157.47 kB)
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For all claims made under complementary medical/dental care coverage.
- Exceptional drug authorization request (PDF 131.97 kB)
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For all claims made under complementary medical/dental care coverage.
Group insurance
Most popular
- Claim Form – Medical Expenses (PDF 177.37 kB)
- Claim Form – Dental Care (PDF 172.92 kB)
- Direct Deposit and Notification Request – Medical and Dental Care Expenses (PDF 191.85 kB)
- Claim Form – Health Spending Account (HSA) (PDF 269.38 kB)
- Claim Form – Travel Insurance (emergency medical care) (PDF 670.29 kB)
- Claim Form – Disability – Initial Request (PDF 107.39 kB)
- Claim Form – Trip Cancellation (PDF 1.16 MB)
- Prior Authorization Drug Form (PDF 228.96 kB)
- List of drugs requiring prior authorization (PDF 196.77 kB)
Claim forms
- Wellness Account - Claim Form (PDF 156.29 kB)
- Claim Form – Medical Expenses (PDF 177.37 kB)
- Claim Form – Dental Care (PDF 172.92 kB)
- Claim Form – Health Spending Account (HSA) (PDF 269.38 kB)
- Direct Deposit and Notification Request – Medical and Dental Care Expenses (PDF 191.85 kB)
- Claim Form – Disability – Initial Request (PDF 670.29 kB)
- Direct Deposit Request – Disability Benefits (PDF 191.23 kB)
- Claim Form – Disability – Extension of Benefits (PDF 2.54 MB)
- Claim Form – Travel Insurance (emergency medical care) (PDF 107.39 kB)
- Claim Form – Trip Cancellation (PDF 1.16 MB)
- Prior Authorization Drug Form (PDF 228.96 kB)
- List of drugs requiring prior authorization (PDF 196.77 kB)
- Prior Authorization Drugs (PDF 438.42 kB)
- Request for Brand Name Drug Exception (PDF 85.68 kB)
- Request for reference biologic drug exception (PDF 108.58 kB)
- Request for Prior Authorization – FreeStyle Libre Sensor (PDF 256.83 kB)
- Request for Prior Authorization – OZEMPIC and RYBELSUS (PDF 105.84 kB)
- Claim Form – Life Insurance (PDF 138.68 kB)
- Claim Form – Critical Illness Insurance (PDF 1.2 MB)
- Claim Form – Accidental Dismemberment (PDF 181.81 kB)
- Claim Form – Dental Care following an accident (PDF 156.55 ko)
- Claim Form – Disability – Collection of personal information (PDF 127.35 kB)
- Claim Form – Disability – Policyholder’s statement (PDF 247.79 kB)
- Nursing care questionnaire (PDF 199.72 kB)
Administrative forms
- My client space access request (PDF 420.06 kB)
- Enrolment Request (PDF 415.26 ko)
- Enrolment Request – with online beneficiary designation (PDF 365.13 ko)
- Change Request (PDF 350.02 ko)
- Change Request – with online beneficiary designation (PDF 294.6 ko)
- Conversion request – Group life insurance (PDF 112.5 ko)
- Evidence of Insurability (PDF 656.86 ko)
- Appointment or change of Beneficiary (PDF 84.04 ko)
- Transit – Individual Health Insurance Application (PDF 686.56 ko)
- Transit – Brochure (PDF 277.24 ko)
- Transit – Rates Table (PDF 111.5 ko)
- Modification of status smoker to non-smoker (PDF 130.56 ko)
- Overage dependent with a disability (PDF 93.25 ko)
Guides and brochures
- Make your life easier with our digital services (PDF 1.41 MB)
- My Client Space – Plan Member My Client Space Online Registration Guide (PDF 550.04 kB)
- Coordination of Benefits (PDF 1.45 MB)
- Your Health Spending Account (PDF 913.97 kB)
- Transit Brochure (PDF 298.18 kB)
- Guide to Foot Orthotics (PDF 1.48 MB)
- Guide to Orthopedic Shoes (PDF 1.73 MB)
- Quick Tips (PDF 1.1 MB)
- Certificate of insurance – Loan Insurance – Laurentian Bank (PDF 836.38 kB)
- Summary of insurance – Line of Credit Insurance – Laurentian Bank (PDF 803.47 kB)
- Summary of insurance – Mortgage Loan Insurance – Laurentian Bank (PDF 787.33 kB)
- Summary of insurance – Personal Loan Insurance – Laurentian Bank (PDF 823.69 kB)
- Certification of insurance product Loan Insurance for Investment Funds (PDF 953.77 kB)
- Summary of insurance product Loan Insurance for Investment Funds (PDF 953.77 kB)
- Certificate of insurance – Travel insurance – Laurentian Bank Visa (PDF 1.74 MB)
- Summary of insurance – Travel insurance – Laurentian Bank Visa (PDF 782.71 kB)
- Certificate of insurance – Purchase insurance and extended warranty – Laurentian Bank Visa (PDF 1.88 MB)
- Summary of insurance – Purchase insurance and extended warranty – Laurentian Bank Visa (PDF 751.65 kB)
- Certificate of insurance – Assur-payment – Laurentian Bank Visa (PDF 202.49 kB)
- Summary of insurance – Assur-payment – Laurentian Bank Visa (PDF 784 kB)
- Distribution guide – Creditor insurance (PDF 179.45 kB)
- Travel assistance benefit (PDF 1.98 MB)
- Creating your account in My Client Space: Quick and easy! (PDF 274 kB)
Savings and retirement
Special markets
Claim forms
Please contact our Claims Department toll-free at 1 800 266‑5667 for the appropriate form and details on claims procedures.
Client change forms
- Request for Pre-Authorized Debit (PAD) Payment (PDF 210.68 kB)
- Request to Add a Child to Your Existing Plan (PDF 93 kB)
- Termination of Coverage Request (PDF 195 kB)
- Supplemental Questionnaire for Dependent Child Insurance (PDF 121.31 kB)
- Name and Address Change (PDF 81.05 kB)
- Request for Non-Smoker Rates (PDF 273.48 kB)
- Beneficiary Designation Change (PDF 113.51 kB)
Forms for administrators of a group plan
- Basic Group Critical Illness Insurance Enrolment Request Form (Employee and Dependent Child) (PDF 141.13 kB)
- Group Insurance Change Request Form (PDF 90.03 kB)
- Basic Group Critical Illness Insurance Enrolment Request Form (Employee Only) (PDF 64.01 kB)
- Late Application for Spouse (PDF 273.47 kB)
- Late Application for Dependent Child (PDF 171.33 kB)
- Late Application for Employee (PDF 185.57 kB)