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Get Disability Or Job Loss Claim Form. 5534-2013/01
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How to use or fill out the Disability Or Job Loss Claim Form. 5534-2013/01 online
This guide provides a clear and supportive overview of how to complete the Disability Or Job Loss Claim Form. 5534-2013/01 online. The form is essential for users seeking benefits due to disability or job loss as outlined in their insurance coverage.
Follow the steps to accurately complete the claim form.
- Press the ‘Get Form’ button to obtain the form and open it in your preferred editing tool.
- Complete the Branch Statement section. Provide the name of the insured, branch address, branch telephone and fax numbers. Ensure your remarks are clear and direct. Have an authorized officer print their name, sign, and date the section.
- Fill out the Claimant Statement. Include personal details such as mailing address, date of birth, occupation, and employment type. Indicate your last day of work and any expected return dates. It's crucial to detail all employers from the last six months as requested.
- In the Claimant Statement, confirm if you are receiving any benefits from other sources. Describe the cause of your disability or job loss, and provide relevant dates and details.
- If applicable, complete the Employer Statement with your employer's details, including the reason for discontinuing work and dates associated with employment. This section must be filled out by the employer.
- The Attending Physician Statement is to be filled by your physician. Ensure your physician provides a clear history of your condition, treatment details, and a summary of your functional limitations.
- Review the entire claim form for completeness, making sure all necessary documents and additional pages are attached. Ensure that all signatures are provided.
- Once all sections are filled and reviewed, mail the completed document to the specified address: Creditor Customer Service, P.O. Box 3020, Mississauga STN A, Mississauga, ON L5A 4M2.
- After submission, keep a copy of the completed claim for your records. Monitor for any communication regarding further information requirements or claim approval.
Start your claim process today by completing the Disability Or Job Loss Claim Form online.
Disability Insurance Benefit Payments If you are eligible, you can receive about 60 to 70 percent (depending on income) of wages earned 5 to 18 months before your claim start date. You can be paid benefits for a maximum of 52 weeks. For more information, review Calculating Disability Benefit Payment Amounts.