People insured under Scotiabank's commercial (business) credit insurance, group policy 10650 with Canada Life, use this claim form for life, disability, hospitalization or terminal illness claims. For a disability claim, the physician completes the attached Claim for Disability: Attending Physician's Statement. The printed version is 307 CAN-8/16, a Canada Life form.
The insured completes the claim form and Part I, an authorization releasing claim information to Canada Life, and the employer completes the disability section about job duties and dates. The attending physician completes Part II.
Download the current version from the source each time; forms change without notice.
Commercial Credit Statement of Claim Form – Claim for Disability: Attending Physician's Statement
Upload the fillable PDF once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
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It asks whether the patient could return to modified duties and, if yes, the start date, hours per day, days per week, expected duration and any limitations. It also asks whether a mental health patient has been referred to a psychologist or psychiatrist, and why not if no referral was made.
Canada Life. The form carries Canada Life's copyright, the authorization releases information to Canada Life, and the completed form goes to Canada Life's Creditor Claims office. The insured can also name a representative to deal with Canada Life on the claim using the third-party authorization section.