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This claim form has been sent to you as requested in anticipation of a claim being filed. We will be unable to begin processing your claim until all completed forms and documents are received by Monumental Life insurance Company.
To submit a claim to Canada Life for reimbursement, please submit it online on the Canada Life GroupNet portal (opens in a new tab). You can also complete the form we sent you with your Confirmation Statement when you retired and send it to Canada Life directly for processing.
Monumental Life Insurance Company. If we do not receive the completed claim form within 30 days of your receipt of the claim form, we will assume you no longer wish to file a claim.
We are requesting this information in order to process the claim you are presenting to our company. Therefore, please complete in detail, sign, date and return the following form to us.
Find the right form to make a claim, manage benefits, submit a request, etc. Start by choosing how your got your coverage.
employer to provide (Monumental Life Insurance Company – Direct Response Division) with financial or employment-related information. A photostatic copy of this form will be as valid as the original.
