Find a Form
Download and print the most common forms for group insurance claims, individual insurance claims, and investment.
The following are different forms for filing a a group insurance claim with SSQ Insurance.
To save time, opt for the personalized form available in your Customer Centre . Simply fill them out, print and sign them.
For plan members covered with a comprehensive group insurance coverage, including travel insurance
For plan members covered with travel insurance only
- Request for brand name drug coverage (PDF, 44 kB)
- Health insurance claim form (PDF, 85 kB)
- Authorization request form flash glucose monitoring system (PDF, 107 kB)
- Authorization request to increase the number of blood glucose test strips eligible for reimbursement (PDF, 219 kB)
- Type-2 Diabetes - Prior Authorization (PDF, 117 kB)
- Form - Convalescent care (PDF, 50 kB)
- Form - Insurance for children with disabilities (PDF, 64 kB)
- Form - Exceptional Patient (QC) (PDF, 64 kB)
- Form - Medical use of Cannabis (PDF, 83 ko)
A reimbursement is possible only if your insurance contract includes the benefit “Cannabis for medical purposes”.
- Form - Exception Request Biosimilar (PDF, 79 kB)
Contact us
For any other claim information, contact us.
By email
By phone
Quebec
1-877-651-8080
Other provinces
1-888-651-8181
Visit the Forms and Documents section on Beneva's website to find all our individual insurance forms.
Visit the Forms and Documents section on Beneva's website to find all our individual insurance forms.
Here are the forms used to submit claims for coverage obtained through a dealership.
Group Credit Insurance
In case of death
- SSQ Insurance - Claimant's Statement (PDF, 63 kB)
- Canassurance - Claimant's Statement (PDF, 82 kB) (French only)
- Authorization to collect and disclose personal information (PDF, 64 kB)
Sign up for pre-authorized debit 