Submit a Claim Form

For Personal Health Plan Claims:

The Submit a Claim Form is intended for personal health plan members. If you’re a group/employer plan member please log in to Group Member portal or download the app for a more efficient claims experience.

For Travel Claims, please call the Travel Assistance Provider. For Disability Claims, please use the Disability documents section here.

You will need an electronic version of your claim receipts.

  • 1
    Submit a Claim
  • 2
    Review/Agreement
  • 3
    Complete
Contact Information
Member/Policy Holder Information
Date of Birth
Other Coverage

Do you or any of your dependants have coverage under any other plan?

Spending Account

Please apply the attached receipts or any outstanding amount from this claim to my:

A Health Spending Account is a group/employer benefit that provides reimbursement for a wide range of health-related expenses, over and above regular benefit plans. HSAs are administered in accordance with Canada Revenue Agency guidelines.

A Wellness Spending Account is a group/employer benefit that provides reimbursement for wellness‐related activities.

Upload Receipts
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