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Individual Health & Dental

Health Benefit Claim Form

  • This form is used for health care benefits such as medical or paramedical expenses, drugs or vision care.
  • Complete this form online, save it, print and sign it, and mail it to us along with your original receipts.

    Important: Claims must be submitted no later than twelve months after expenses are incurred.

Standard Dental Claim Form

  • This form is used for dental claims. In most cases, your dentist will be able to submit claims automatically through a system called EDI (electronic data interchange).
  • If your dentist has EDI, you'll just need to provide your policy and ID numbers. Your dentist will electronically submit your claim to us. We'll mail you or your dentist a reimbursement cheque for any eligible expenses.
  • If your dentist does not have EDI, please submit the completed and signed dental claim form provided to you by your dentist.

To download a claim form, you need Acrobat Reader.
You can download it free of charge:

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