Products

Forms

Please print and complete the appropriate form and mail it to the address provided.

 

PLAN ADMINISTRATION FORMS

Please mail the following forms to:
The Canadian Bar Insurance Association
5 Park Home Avenue
Suite 500
Toronto, Ontario
M2N 6L4

Pre-Authorized Payment Plan

Application for enrolment

Policyholder’s Request for Change

Request for Designation or Change of Beneficiary(ies) or Trustee

Evidence_insurability

Member’s change request

Declaration of Dependent Children

Notice of Return to Work

 

EMPLOYEE CLAIM FORMS

Please mail the following forms to:
Desjardins Insurance
C.P. 3950
Lévis, Quebec
G6V 8C6

Claim for Dental Care Expenses

Claim for Health Care Benefits

 

You can also submit your claims electronically, or view the status of claims by  clicking here.

 

Please mail the following forms to:
Desjardins Insurance
200, rue des Commandeurs
Lévis, Quebec
G6V 6R2

Request for Conversion

 

Please mail the following forms to:
Desjardins Insurance
C.P. 3000
Lévis, Quebec
G6V 9X8

Cost Plus Form 2015 Request for Cost Plus Reimbursement