Foursquare Group Insurance

Claims

All claims should be reported as soon as possible after the date of the loss or the date of the expense is incurred.

Need to make a claim?

Send forms directly to Manulife Financial

*Did you know that many pharmacies and dental offices can submit claims directly to Manulife. Claims submitted using this method are processed very quickly. Members can also submit several types of Extended Health Care claims electronically through the Plan Member Secure Site. If selected for random audit, members must submit receipts for review within the specified time period or their online claim submission privileges will be suspended.

Medical Claims
MANULIFE FINANCIAL HEALTH CLAIMS
PO BOX 1653 WATERLOO, ON N2J 4W1
Form GL3585 Extended Health Care Claim Form

Dental Claims
MANULIFE FINANCIAL DENTAL CLAIMS
PO BOX 1654 WATERLOO, ON N2J 4W2
Form GL3586 Dental Claim Form

Disability Claims
MANULIFE GROUP BENEFITS
ATTENTION: DISABILITY CLAIMS
PO BOX 400 STN PLACE-D'ARMES, MONTREAL, QC H2Y 3H1
Form GE10342L Disability Claim Form

Death Claim
MANULIFE GROUP BENEFITS
ATTENTION: DISABILITY CLAIMS DEPARTMENT
PO BOX 4002 STN B, MONTREAL, QC H3B 4M2
Form G2007P Death Claim Form

 

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