Canada life income protection claim form

The Great-West Life Assurance Company, London Life Insurance Company and The Canada Life Assurance Company have become one company – The Canada Life Assurance Company. Discover the new Canada Life

Your web browser is out-of-date. For the best experience, please update to a modern browser like Chrome, Edge, Safari or Mozilla Firefox.

Freedom 55 Financial is a division of The Canada Life Assurance Company and the information you requested can be found here.

If you have coverage through your employer or plan sponsor, use our workplace benefits insurance forms. If you purchased coverage directly through Canada Life, use our Freedom to Choose™ forms. Notify us of a death and/or make a claim on a wealth or life insurance policy bought through an advisor.
Use this form if you are a beneficiary or estate executor making a claim on a life insurance or wealth policy. Download this form and print it, or fill it out in Adobe Reader XI or higher (not your browser) and save. When you have completed the claimant's statement, please send to us:

Wealth claims :

For segregated funds, GIO or annuity death claims anywhere in Canada excluding Quebec, email our London wealth office.
For segregated funds, GIO or annuity death claims in Quebec, email our Montreal wealth office.

Life insurance claims:

For life insurance death claims anywhere in Canada excluding Quebec, email our London insurance office or fax 519-435-7177.
For life insurance death claims in Quebec, email our Montreal insurance office.