Desjardins insurance claim forms 2026

The document outlines the process for submitting health care benefit claims to Desjardins Insurance, including options for online services and direct deposit. It details mandatory identification information required for claims, coordination of benefits when covered by multiple insurance plans, and instructions for using a Health Spending Account. Additionally, it includes sections for accident-related claims, out-of-province expenses, assignment of benefits to health care providers, and a declaration regarding personal information management.

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Click ‘Get Form’ to open the desjardins insurance claim form in the editor.
Begin with Section A: IDENTIFICATION. Fill in your policy number, name, certificate number, and personal details such as address and date of birth. Ensure all mandatory fields are completed accurately.
In Section B: DIRECT DEPOSIT SERVICE, provide your bank information or attach a void cheque to enable direct deposit for reimbursements. Don’t forget to include your email address for notifications.
Proceed to Section C: COORDINATION OF BENEFITS if applicable. Enter details about any other insurance plans you may have, including the insurer's name and coverage period.
Complete Sections D through H based on your specific claims, ensuring you check all relevant options and provide necessary documentation like receipts.
Finally, sign Section I: DECLARATION AND AUTHORIZATION. Review all entries for accuracy before submitting the form via our platform.

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Versions	Form popularity	Fillable & printable
2021	4.8 Satisfied (92 Votes)
2020	4.3 Satisfied (221 Votes)
2018	4.3 Satisfied (195 Votes)
2014	4.4 Satisfied (547 Votes)
2014	4.4 Satisfied (474 Votes)
2007	4.3 Satisfied (32 Votes)