Trip cancellation or interruption claim form
Bought Freedom to Choose™ health and dental insurance coverage directly through Canada Life? You’re in the right place.
If you have coverage through your employer or plan sponsor, use our workplace benefits insurance forms. If you have coverage through an advisor, use our personal insurance forms.
Start a paper claim
Use this form to request reimbursement for expenses you incurred if your trip was cancelled or interrupted due to illness. You'll find instructions on how to return the completed form on the form itself.
Standard claim form
Download the form and print it, or fill it out in Adobe Reader XI or higherOpens a new website in a new window - Opens in a new window (not your browser) and save.
Use this form to make a claim for expenses from a trip being cancelled, interrupted or extended. You will need the doctor to fill in some sections.