Claim Forms

Claim Forms

CLICK HERE for the Health Claim Form.
CLICK HERE for the Dental Claim Form.

Where Do I Send My Claims?

Where do I send my claims?

Send your completed claim forms with your original receipts (note: you should always keep a photocopy of your receipts to have in your personal file) to:

The Great-West Life Assurance Company
Policy Number 161061
London Benefit Payment
255 Dufferin Avenue
London, ON     N6A 4K1