If you have coverage through your employer or plan sponsor, use these forms to make an accidental death or dismemberment claim.
To make a claim, follow these steps:
Download the form and print it or fill it out in Adobe Reader XI or higher (not your browser) and save. You’ll need your employer to fill in some sections.
Download the form and print it or fill it out in Adobe Reader XI or higher (not your browser) and save. You’ll need your employer to fill in some sections.
Ask your doctor to complete this form.
You can email your completed forms to grouplifebenefits@canadalife.com or fax them to 204-946-8783.
In light of COVID-19, we ask that you do not mail these forms to us.