Claim Forms
In order to notify us of a claim, click on the link below which corresponds to the type of policy that you are claiming under. You can then print the form complete it and return it to us by fax or mail ONLY.
Motor
Home
Health
- Application for Group Insurance
- Continued Insurability
- Death Claim Form
- Death Notification Form
- Proof of Death Form
- Dental Claim Form
- Group Insurance Enrollment Form
- Insured Change Request Form
- Medical Claim Form
- Pre Determination Form
- Termination Advice Form No. GLH05 Aug 10 2010
- Vision Claim Form No. GIS07 Aug 10 2010