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Click ‘Get Form’ to open the datownley in the editor.
Begin by entering your Policy No. and I.D./Certificate Number at the top of the form.
Fill in your personal details: Member Last Name, First Name, Address, City, and Postal Code.
Indicate your Employer or Union Affiliation for proper identification.
List all expenses below, grouped by insured person. Ensure you include the Date of Purchase and Drug/Service Provided for each entry.
If applicable, provide information regarding any other insurance coverage and specify if any expenses are related to a motor vehicle accident or Workers Compensation claim.
Sign and date the form at the bottom to authorize the release of your information for claims processing.
Attach all relevant receipts before submitting via mail, fax, or email as indicated on the form.

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What is D.A. Townley known for?

D.A. Townley is western Canadas leading and largest employee benefits third party administrator (TPA).

Where is D.A. Townley from?

D.A. Townley Associates Ltd. is based in Burnaby, British Columbia.

Who owns D.A. Townley?

D.A. Townley is a wholly-owned subsidiary of Pacific Blue Cross and is Western Canadas largest third party employee benefits administrator.

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