Group Life Insurance Accelerated Benefit Notice of Claim

This form is required in the event an employee (or member) elects to receive a portion of their life insurance benefit while living, becomes terminally ill and has been given a medical prognosis of 12 months or less to live. The benefit is paid in one lump sum to the employee (or member) and payable once during their lifetime.

Once these forms are returned to the Employer, send these documents to RBC Insurance at:

P.O. Box 4435,
Station A, Toronto, ON
M5W 5Y8
Or email intake@rbc.com

Group Enrolment Form

To enrol in group insurance, the employee and employer must fill out this form and return it to RBC Insurance.

Forward a copy of this form to RBC Insurance Customer Service, Refer to grid.
Retain the original form for your records.

Group Benefit Solutions Pre-Authorized Debit Agreement

For Group Benefit Solutions client, complete this form to sign up for pre-authorized debit payment of premium.

Forward a copy of this form via email to RBC Insurance Customer Service, admin@groupinsurance.rbc.com or fax to: 1-855-257-1599.
Retain the original form for your records.

Group Accident Insurance Conversion Notice ($200,000)

Policyholder completes this notice and provides it to any individual who is eligible to convert to an individual accident insurance policy. It provides an opportunity for those persons leaving the Group, who are under the age of 70 years and a resident of Canada, to convert to an individual accident insurance policy.

Mail along with payment to:
RBC Life Insurance Company
PO Box 1800, STN B
Mississauga, ON
L4Y 3W6

Group Accident Insurance Conversion Notice ($100,000)

Policyholder completes this notice and provides it to any individual who is eligible to convert to an individual accident insurance policy. It provides an opportunity for those persons leaving the Group, who are under the age of 70 years and a resident of Canada, to convert to an individual accident insurance policy.

Mail along with payment to:
RBC Life Insurance Company
PO Box 1800, STN B
Mississauga, ON
L4Y 3W6

Evidence of Insurability Form

Both the employee and the plan administrator must fill out this approval form for reasons specified within the insurance contract(s).

Forward a copy of this form via email to:
MedicalUnderwritingSupport@rbc.com
Retain the original form for your records.

Cost Plus Claim Form

Special claims reimbursement form. Employer must complete form and return to RBC Insurance.

Forward original form along with payment to:
RBC Life Insurance Company
PO Box 1600
8677 Anchor Drive
Windsor, Ontario
N9A 0B3
Attention: Client Administration