Claim Guide – FAQ – Mortgage Disability Claims

This guide will help you through the claim submission process and to answer any initial questions you may have with respect to filing a claim. Please review your Certificate of Insurance for details regarding your coverage prior to submitting a claim. There is a 30 day Qualifying Period before any benefits are paid.

Disability means that you are prevented by bodily injury, disease, mental infirmity, sickness or complications due to pregnancy and any related medical conditions, from performing all or substantially all of the essential duties of your own job, and you do not engage in any occupation or employment for wage or profit.




How do I obtain the claim package?

The package can be obtained from your nearest BMO Bank of Montreal branch or downloaded and printed directly by clicking here.

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When should I submit a Disability claim?

Disability claims must be submitted to the Insurer within 120 days from the disability date, otherwise your claim may be declined. If you are submitting a claim outside this period, please include a note outlining the reasons for the late filing and Sun Life Assurance Company will determine if you are entitled to benefits.

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What information is required in order to process my claim?

A complete claim package must include:

The Attending Physician’s Statement provides Sun Life with specific medical information about your condition and your expected recovery. This form can be completed by your family doctor, your treating Specialist, or any medical professional who is a doctor of medicine and that has treated you for your condition. If your doctor has conducted tests, all of the findings must be included on or with the Statement. If you have seen a specialist for your condition, be sure to have your physician include copies of all consultations and clinical notes with the Statement.

Please read all instructions on each form and complete fully. Failure to provide all necessary information could result in delays in processing your claim.

Note: The expense of the completion of this form is your responsibility.

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What happens if my doctor does not provide the necessary information in a timely manner?

Sun Life can only process your claim once they have received all requested information. In order to facilitate this process, you may wish to make an appointment with the doctor to ensure that this information is provided promptly and that he is aware of the urgency of this request.

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Where do I send the completed claim package?

Once all the claim forms are completed, send the entire claim package to:

Sun Life Assurance Company of Canada
Creditor Team – Disability Claims
P O BOX 100 STN C
Kitchener, ON
N2G 3W9

Alternatively, you may also return the claim package to your branch in a sealed envelope and they will forward to the Insurer by courier or you may fax the claim package to: 1-866-209-7215.

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What happens when Sun Life receives my claim?

The claims analyst will consider a number of different factors when assessing your claim. They will review the medical information provided by your doctor and determine if you are totally disabled from performing the duties of your occupation. As part of this review they may need to contact you directly to obtain additional medical information or contact your doctor for further medical history if your claim is being made within the first 2 years from the effective date of your insurance coverage.

Note: Any payments required on your loan must continue to be made until such time as your claim is approved.

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How will I be notified of Sun Life’s decision?

Your claim will be reviewed by Sun Life Assurance Company within 14 days after Sun Life receives all the necessary information. Sun Life will advise you in writing if your claim is approve or declined. If declined, Sun Life will include an explanation for why the claim was declined. Your branch will also be notified of Sun Life’s decision, but if declined, will not be provided with any details.

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What if my claim has been declined and I do not agree with the decision?

If you do not agree with Sun Life’s decision on your claim, you may provide new or additional information for Sun Life to review. Please ensure this information is provided as soon as possible or, you may call Sun Life Assurance Company directly to discuss further.

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How and when are payments made once the claim is approved?

Benefits are paid on the date a payment is due on your Mortgage. The benefit amount will be pro-rated for any partial period in which a benefit is due. Benefits will begin, following approval of your claim, on the first scheduled payment due after a 30 day Qualifying period following the date of your Disability.

Note: There is a maximum of 24 months of benefits per Disability, either paid consecutively or in aggregate.

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When does the Insurer stop paying Disability benefits?

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Examples of when the Insurer will not pay a claim

Please review your certificate of insurance for a full and complete listing of all coverage a Limitations and Exclusions under this certificate.

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Who do I contact for a status update or more information on my claim?

If you have any questions or require information about the status of your claim, please call Sun Life Assurance Company directly at 1 877-271-8713.

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