Make a follow-up

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Individual insurance

Make a follow-up on a individual insurance claim

Need information about a individual insurance claim that you submitted? Fill out the form below. A member of our team will contact you shortly.

* Fields marked with an asterisk are mandatory.

I am*(Required)

Full name*(Required)

First name of plan member*(Required)

Last name of plan member*(Required)

Type of claim*(Required)

Nature of inquiry

Please note that our standard turnaround time is 2 to 3 business days from the date of reception of this form.

Telephone number*(Required)

At what time would you like one of our employees to contact you by telephone?

Email address*(Required)

Note: If you wish to retain a copy of this Claim Tracking form, please print the form before submitting it.

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Name

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