Beneva, the insurer formed from SSQ Insurance and La Capitale, lists its group disability claim forms by contract. Its group forms, including any statement the attending physician completes, appear only after the plan member enters a group or policy number, so the version you receive depends on the employer's contract. Plan administrators get the same forms in Beneva's Administrator Centre.
The attending physician completes the medical statements in the plan's claim package. The plan member retrieves the package with their group or policy number and gathers the other documents the plan requires.
Download the current version from the source each time; forms change without notice.
Group insurance forms
If your copy of the form is a fillable PDF, upload it 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.
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.
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Beneva lists group claim forms by contract. The plan member enters the group or policy number from their insurance card, 5 to 10 characters long, on Beneva's group forms page to see the forms for their plan, including any physician statement. Plan administrators can download the same forms from the Administrator Centre.
Beneva's disability claims page says that if long-term benefits would start within the first six months, the claim should arrive 30 days before the end of the waiting period in the contract. If benefits start more than six months after the leave began, send it 90 days before.
Yes. Beneva publishes its group insurance forms in English and French. Because the forms are listed by contract, the patient retrieves the version for their plan by entering the group or policy number on Beneva's forms page, or gets it from the plan administrator.