How to make a claim
Use this form to apply for disability benefits under your personal policy.
To submit a claim:
- Print the appropriate form, and complete Part 1.
- Have your doctor fill out Part 2.
- When both parts are completed, please send a scanned copy to us via email at firstname.lastname@example.org or by fax at (204) 946-4030.
In light of COVID-19, we ask that you do not mail these forms to us.