Disability benefits 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 this form to apply for disability benefits.
To make a claim:
Step 1: Complete part 1 of the claim form.
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. You'll need to complete part 1.
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This form is to be completed by the insured and their attending physician in order to submit a claim for individual disability benefits.
Step 2: Have your doctor fill out part 2 of the claim form.
Step 3: Submit your claim.
When both parts are completed, please send a scanned copy to us via email at lbclaims@canadalife.com or by fax at (204) 946-4030.
In light of COVID-19, we ask that you do not mail these forms to us.
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