Forms • Notary

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 – Life/Disability/Business overhead expenses/Critical Illness | PDF 402.83 KB Enrollment form - Life/Disability/Business overhead expenses/Critical Illness
• Enrollment form – Drug/Health/Dental Care Insurance | PDF 271.93 KB Enrollment form – Drug/Health/Dental Care Important note

  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

• Declaration of Insurability – Medical Questionnaire | PDF 357.44 KB Questionnaire to complete if you are enrolled in life/disability/business expenses/critical illness insurance

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 – Insured person’s statement | PDF 730.96 KB Disability claim form - Insured person's statement
• Disability claim form – Treating doctor statement | PDF 968.30 KB Disability claim form - Treating doctor statement

Modification

• Beneficiary change request | PDF 45.00 KB Beneficiary change request form