Group insurance claims

Need to submit a group insurance claim? Find out how.

Before you start

Check your insurance booklet to see if the expense is covered.

Make sure you submit healthcare claims within 12 months of receiving the service.

Keep a copy of the receipt in case your claim is audited.

For health expenses expected to go over $500, submit a treatment plan first.

How to submit a claim

Types of claim – ways available to submit
Type of claim	Secure site	Omni app	Payment card	Claim form
Healthcare professionals	Available	Available	Available	Available
Vision care	Available	Available	Available	Available
Dental care	Available	Not available	Available	Available
Prescription drugs	Not available	Not available	Available	Available
Other (devices, equipment, etc.)	Not available	Not available	Not available	Available
Wellness account	Available	Available	Not available	Available
Travel insurance	Not available	Not available	Not available	Available
Disability / Death / Critical illness / Dismemberment or loss of use	Not available	Not available	Not available	Available

Have a health spending account?

You can use your health spending account to pay for medical and dental expenses not covered or not completely covered by your plan.

See how health spending accounts work

Online

Submitting online claims is easy with our secure site and the Omni app.

Secure site

You can submit claims for most healthcare services, including vision care and dental care.

Omni app

You can submit claims for various healthcare services, including vision care.

Download the Omni app

Sign up for direct deposit

To submit a claim online, sign up for direct deposit first. Go to the secure site (in the Quick links section) or the Omni app.

Payment card

With your payment card (Desjardins Insurance card), eligible healthcare expenses can be paid for right away. 1

Good to know

You can add your payment card to Apple Wallet on your iPhone.

How to use your card

Show your payment card to your pharmacist, dentist or healthcare professional. If they participate in the direct payment program, we pay the portion covered by your plan right away, and you pay the difference.

You get a receipt showing the claim amounts, which you can keep for tax purposes.

Where to find your card

You can find your card in the Omni app or on our secure site (under Your account).

Claim form

For some types of expenses, you need to submit a claim form.

Good to know

You can save time by using the pre-filled forms on our secure site.

Under Submit a claim, select Claim forms.

3 steps of the claims process

Documentation

Fill out the appropriate form (or forms) and gather the required supporting documents. Send everything online or by mail (address listed on the form).
Analysis

Once we receive the required documents, we review your claim. Then we contact you to let you know if your claim is approved.
Payment

If your claim is approved, you receive your payment based on the terms of your plan and on your preferred method (cheque or direct deposit).

Find the right claim form

Healthcare and medical expenses

Healthcare

Use this form to submit claims for healthcare expenses.

For example:

Devices and equipment
Prescription drugs
Medical care
Services provided by a healthcare professional
Vision care

Healthcare benefits claim – 19132A (PDF, 2.70 MB)

Convalescent care

Convalescent care claim – 98130E (PDF, 1.65 MB)

Home nursing care - Request for additional information – 09008E (PDF, 1.17 MB)

Prescription drugs

If medication requires prior authorization, be sure to get it approved before going to the pharmacy. Find out how to request prior authorization.

Request for reimbursement of reference biologic drugs – 21084E (PDF, 1.44 MB)

Request for reimbursement of brand name medications – 12126E (PDF, 1.43 MB)

Request for reimbursement of a medication not included in the Tier-1 managed formulary or of a brand name medication – 13175E02 (PDF, 1.87 MB)

Request for reimbursement of a medication not included in the Dynamic Therapeutic Formulary (DTF) or of a brand name medication – 13175E (PDF, 1.87 MB)

Dental care

Evidence of insurability for dental care – 20021A (PDF, 296 KB)

Dental care claim – 19110A (PDF, 2.31 MB)

Wellness account

Wellness account claim – 17111E (PDF, 2.23 MB)

Travel insurance

You can submit a claim online or by mail for:

Emergency healthcare
Accident while travelling
Trip cancellation
Baggage (damaged, lost, etc.)

Find the right claim form

Disability

If you have any questions, see our Disability claims guide This link will open in a new window. or call us at 1-800-463-7843 Phone number of Desjardins Insurance. This link opens your phone app.. We're here to help.

Initial forms

Submit each completed form as soon as you can. You don't need to submit all 3 forms at once.

If you have a doctor's note, send it to us so we can add it to your file.

Disability or waiver of premium claim – 06329E (PDF, 1.55 MB)

Disability or waiver of premium claim – Employer's statement – 08317E (PDF, 1.61 MB)

Disability claim – Initial attending physician's statement – 02025A (PDF, 1.14 MB)

Other form

Attending physician's additional report – 02026A (PDF, 1.14 MB)

Critical illness

If you have any questions, call us at 1-800-463-7843 Phone number of Desjardins Insurance. This link opens your phone app.. We're here to help.

Make sure you understand your coverage and the definitions of the critical illnesses, as well as any limitations and exclusions that apply. That way, you'll know if your condition is eligible for a payment.

Critical illness insurance guide (PDF, 1.27 MB)

Critical illness claim – 170252A (PDF, 192 KB)

Critical illness claim – Employer's statement – 12123E (PDF, 1.34 MB)

Critical illness claim – Attending physician's statement – 17026A (PDF, 769 KB)

Death

If you have any questions, call us at 1-800-463-7843 Phone number of Desjardins Insurance. This link opens your phone app..  We're here to help.

Initial forms

Death claim – Beneficiary's statement – 02227A (PDF, 1.30 MB)

Declaration of status for the deceased common-law spouse – 01311E (PDF, 2.28 MB)

Death claim – Employer's statement – 12123E (PDF, 1.34 MB)

Other form

Death claim – Physician's statement – 14153E (PDF, 1.14 MB)

Accidental death and dismemberment

If you have any questions, call us at 1-800-463-7843 Phone number of Desjardins Insurance. This link opens your phone app.. We're here to help.

Make sure you understand your coverage, the schedule of losses and any limitations and exclusions. That way, you'll know if you're eligible for a benefit.

Accidental dismemberment or loss of sight claim – 02809A (PDF, 1.37 MB)

Accidental dismemberment or loss of sight – Employer's statement – 12123E (PDF, 1.34 MB)

Administrative forms

Optional insurance – Notice of cancellation 19210E (PDF, 1.72 MB)

Declaration of dependent children aged 18 to 25 or 21 to 25 inclusive – 19131A (PDF, 1.40 MB)

Request for designation or change of beneficiary or trustee – 20007A (PDF, 1.49 MB)

Confirmation of a dependent child's functional impairment – 09296E (PDF, 2.26 MB)

Questionnaire on smoking habits – 02754A (PDF, 300 KB)

Life or critical illness insurance – Conversion request – 14141E (PDF, 1.45 MB)

Health and lifestyle questionnaire – 20009A (PDF, 677 KB)