Spouse Disability Notice of Claim
When submitting a spousal disability claim, your spouse will need to complete this statement.
Note: The form also includes sections that must be completed by your employer and the treating physician.
Please follow these steps to complete and submit this form:
Claimant Instructions:
- Ensure that the Employer’s Statement is completed.
- Complete the Spouse’s Statement and return along with the Employer’s Statement to RBC Insurance.
- Send the Attending Physician’s Statement to the treating physician and have this for returned to RBC Insurance.
Employer Instructions:
- Complete the Employer’s Statement and attach Proof of Enrolment.
- Send this form along with the Spouse’s Statement and the Attending Physician’s Statement to the claimant.
Mail the completed form(s) to:
RBC Life Insurance Company, Life & Health Claims Department
P.O.Box 4435, Station A
Toronto, Ontario
M5W 5Y8
Or Fax to:
1-800-714-8861
Client’s Supplementary Statement
Your employer must complete this form if you are making a disability claim.
Mail the completed form to:
RBC Life Insurance Company, Life & Health Claims Department
P.O.Box 4435, Station A
Toronto, Ontario
M5W 5Y8
Or Fax to:
1-800-714-8861
Long Term Disability Group Claim Form – Employer Statement
Your employer must complete this form if you are making a disability claim.
Mail the completed form to:
RBC Life Insurance Company, Life & Health Claims Department
P.O.Box 4435, Station A
Toronto, Ontario
M5W 5Y8
Or Fax to:
1-800-714-8861
Long Term Disability Group Claim Form – Client’s Statement
Your employer must complete this form if you are making a disability claim.
Mail the completed form to:
RBC Life Insurance Company, Life & Health Claims Department
P.O.Box 4435, Station A
Toronto, Ontario
M5W 5Y8
Or Fax to:
1-800-714-8861
Short Term Disability Claim Form – Physician Statement
Choose the Form: Attending Physician’s Statement Short-term Disability.
