Sun Life uses this two-page physician statement in group life insurance claims after a plan member's death. A completed statement is accepted instead of an original or certified copy of the provincial death certificate, and Sun Life requires one, in addition to the official certificate, when death occurs within two years of coverage approval or when a benefit above Sun Life's set amount has been in force for under five years.
The attending physician completes the physician statement. The designated beneficiary completes the Group Life Claims Claimant Statement (490-CS-E), and the plan sponsor reports the death on the Notification of death form (020-3252).
Download the current version from the source each time; forms change without notice.
Election of method of settlement and statement of claim: Physician statement
Choix du mode de règlement et déclaration de sinistre : Déclaration du médecin
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.
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Sun Life's forms page says a completed physician statement is required if death occurs within two years of coverage being approved, or if the benefit exceeds a set amount and coverage has been in effect for less than five years. In those cases it is needed in addition to an official death certificate.
Sun Life says a completed Physician Statement is acceptable in lieu of an original or certified copy of a provincial death certificate. Where the statement is required because of recent coverage or a large benefit, however, it must accompany an official death certificate rather than replace it.
Yes. The French version is 490-PS-F, Choix du mode de règlement et déclaration de sinistre : Déclaration du médecin. Both versions are listed under Life on Sun Life's workplace forms page, alongside the Group Life Claims Claimant Statement (490-CS-E / 490-CS-F) completed by a designated beneficiary.