June 2, 2020  
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Types Form Names
Enrolment & Administration

Group Enrolment

Change Form

Health Evidence Questionnaire Form

Optional Group Life Insurance Application

Smoking Status Declaration Form

Declaration of Student Eligibility

Life Claims

Notice of Death to Co-operators Life Insurance Company - Claimants Statement

Notice of Death to Co-operators Life Insurance Company - Plan Sponsor Statement

Proof of Death - Physician’s Statement

Disability Claims

Application for Group Weekly Indemnity Insurance - Plan Sponsor Statement

Application for Group Weekly Indemnity Insurance - Attending Physician's Statement

Application for Group Weekly Indemnity Insurance - Claimant's statement

Application for Long Term Disability Benefits - Plan Sponsor Statement

Application for Long Term Disability Benefits - Attending Physician's Statement

Application for Long Term Disability Benefits - Claimant's Statement

Group Benefits Return To Work Form

Health & Dental Claims

Extended Health Care Claim Form

Dental Claim Form

AD&D

Notice of Death to Co-operators Life Insurance Company Form - Claimant's Statement

Notice of Death to Co-operators Life Insurance Company Form - Plan Sponsor Statement

Notice of Death to Co-operators Life Insurance Company Form - Proof of Death - Physician's Statement

Claim for Accidental Dismemberment Benefit - Dismemberment Statement

Claim for Accidental Dismemberment Benefit - Dismemberment Phycisian's Statement

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Last updated on:  July 25, 2012  Page: 

This information is not intended for use without professional advice. While we have attempted to make this site as accurate as possible, it is only a summary. For more information, see our disclaimer.

Copyright © 2002 Morneau Shepell.
All Rights Reserved.