Client area • Medical specialist all product forms

Subscriptions, claims, exemptions, modifications, etc.

Activate or change credit cards, bank accounts and direct debits.

Change of address, Sogemec Digital Service and File Deposit registration.

Product brochures and other general information documents.

Filter forms by product type

All Life Disability Office overhead expenses Drug, health and travel Dental Secure file deposit

Unless otherwise noted, please complete, print and return your form to Sogemec Insurance:

BY secure file deposit
or
to the following address:
Sogemec Assurances
2, Complexe Desjardins, C.P. 217, Succ. Desjardins
Montréal (Québec) H5B 1G9

Enrolment

Enrollment form – Drug/Health/Dental Care – 65 | PDF 268.33 KB Prescription drug, health and dental care insurance form Important note
Option 3 requires no medical questionnaire (guaranteed acceptance). This applies to all FMSQ members.

Option 1 (prescription drug, travel and travel cancellation insurance) and Option 2 (prescription drug, health, travel and travel cancellation insurance) are subject to the insurer receiving and approving the “Insurability Report” form for all medical specialists.

You can send your application using our secured page here or by fax at 514 350-5071 or by mail to our Montreal office.

The effective date of your coverage may not pre-date the date of the signature on the request for enrolment, except for enrolments that result from an end of exemption, in wich case, the applicant must prove that he/she was insured under a similar group insurance plan to the one he/she wishes to join.

The choice of plan must remain in effect for a minimum of two (2) years and no change is possible within such period.

For more details, please contact our Customer services team at 1 800 361-5303
Enrollment form – Life/Disability/Business overhead expenses/Critical Illness | PDF 295.43 KB Enrollment form – Life/Disability/Business overhead expenses/Critical Illness

Claims

Health insurance benefit claim form | PDF 550.01 KB Form must be used for health claims (drugs, health care professionals, etc.)
Direct deposit form | PDF 71.96 KB Direct deposit form
Disability claim form – Treating doctor statement | PDF 968.30 KB Disability claim form - Treating doctor statement

Modification

Modification or cancellation form – Drug/Health/Dental Care | PDF 117.22 KB Modification or cancellation form - Drug/Health/Dental Care
Modification or cancellation form – Life/Disability and other | PDF 1.08 MB Modification or cancellation form - Life/Disability and other
Beneficiary change request | PDF 45.00 KB Beneficiary change request form