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Critical illness claim forms

Have coverage through an advisor? You're in the right place.

If you have coverage through your employer or plan sponsor, use our workplace benefits insurance forms instead.

Start a claim

Use these forms to apply for critical illness benefits for yourself or your child.

To make a claim:

Step 1: Complete a claim form.

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 in a new window (not your browser) and save.

Step 2: Ask your doctor (or your child’s doctor) to complete a claim form.

Step 3: Submit your claim.

When both forms are completed, please send the originals by mail to PO Box 6000, Winnipeg, MB R3C 3A5, or a scanned copy to us via email at or by fax at (204) 946-4030.