Forms

For your convenience, all our claims and services forms are available online.

Claim Forms

Accident

Cancer/
Illness

Preventive
testing

Initial
disability

Disability continuity

Decease

Service Forms

Request for amendment or service

Payroll deduction authorization

Electronic transfer authorization

Application for reinstatement Cancer and Supplementaries

Supplementary plan conversion

Privacy Policy

Direct Deposit of Claim Payment

List of claim requirements

Requirements for Cancer Única

Requirements for
Cancer Elite

Requirements for Organ Transplant

How can I make a current claim?