Skip to main content

Your web browser is out-of-date. For the best experience, please update to a modern browser like Chrome, Edge, Safari or Mozilla Firefox.

Individual benefits - 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 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.

Step 2: Ask your 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.