Forms and Guides
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Claim Form – Medical Expenses
Claim Form – Dental Care
Direct Deposit and Notification Request – Medical and Dental Care Expenses
Claim Form – Health Spending Account (HSA)
Claim Form – Disability – Initial Request
Claim Form – Travel Insurance (emergency medical care)
Claim Form – Trip Cancellation
Prior Authorization Drug Form
List of drugs requiring prior authorization
Categories
Wellness Account - Claim Form
Claim Form – Medical Expenses
Claim Form – Dental Care
Claim Form – Health Spending Account (HSA)
Direct Deposit and Notification Request – Medical and Dental Care Expenses
Claim Form – Disability – Initial Request
Claim Form – Disability – Authorization to collect personal information
Claim Form – Disability – Policyholder Statement
Direct Deposit Request – Disability Benefits
Claim Form – Disability – Extension of Benefits
Claim Form – Travel Insurance (emergency medical care)
Claim Form – Trip Cancellation
Prior Authorization Drug Form
List of drugs requiring prior authorization
Request for Brand Name Drug Exception
Claim Form – Life Insurance
Claim Form – Critical Illness Insurance
Claim Form – Accidental Dismemberment
Claim Form – Dental Care following an accident
Home Care Questionnaire
Nursing Care Questionnaire
Claim Form – Accigroup & Accigroup Plus
Claim Form – Accigroup & Accigroup Plus – BCI (CREPUQ)
Modification of Status Smoker to Non-Smoker
Enrolment Request
Enrolment Request – with online beneficiary designation
Change Request
Change Request – with online beneficiary designation
Request for Conversion
Evidence of Insurability
Appointment or change of Beneficiary
Transit – Individual Health Insurance Application
Transit – Brochure
Transit – Rates Table
Undergraduate Insurance Certificate – Standard – Accigroup & Accigroup Plus – BCI (CREPUQ)
Undergraduate Insurance Certificate – with coverage for elite sporting activities – Accigroup & Accigroup Plus – BCI (CREPUQ)
Graduate and Post Graduate Insurance Certificate – Standard – Accigroup & Accigroup Plus – BCI (CREPUQ)
Graduate and Post Graduate Insurance Certificate – with coverage for elite sporting activities – Accigroup & Accigroup Plus – BCI (CREPUQ)
E-services Brochure
My Client Space – Plan Member My Client Space Online Registration Guide
Coordination of Benefits Guide
Travel Insurance Brochures
Your Health Spending Account
Prior Authorization Drug Brochure
Transit Brochure
Guide to Foot Orthotics
Guide to Orthopedic Shoes
Quick tips
Universities with group accident insurance for students – Accigroup & Accigroup Plus – BCI (CREPUQ)
Laurentian Bank Mortgage Insurance
Laurentian Bank Personal Loan Insurance
Laurentian Bank Personal Line of Credit Insurance
Laurentian Bank Visa Travel Insurance
Laurentian Bank Visa Purchase Insurance and Extended Warranty
Creditor Insurance
My Client Space
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