If you have coverage through your employer or plan sponsor, use our workplace benefits insurance forms. If you purchased coverage directly through Canada Life, use our Freedom to Choose™ forms.
Use these forms to apply for critical illness benefits for yourself or your child.
If you’re uncertain about your coverage, you can contact us for an initial assessment of your medical condition before starting a claim.
Step 1: Choose how you’d like to submit your claimant form.
Complete a Claimant Statement online through DocuSign.
Download and complete a Claimant Statement form.
Complete a Claimant Statement online through DocuSign to make a claim for yourself or your child.
Note that if you're completing your Claimant Statement online, you'll still need to ask your doctor to complete and return a Physician's Statement to us.
Complete the form that applies for you, depending on whether you’re applying for benefits for yourself or a child. Download this form and print it, or fill it out in Adobe Reader XI or higher Opens a new website in a new window(not your browser) and save. Please note that forms must be signed using a pen, and forms returned with Adobe signature won’t be accepted.
Step 3: Submit your claim.
To submit a paper claim or Physician's Statement please mail, email or fax to the contact information indicated on the claim form.