04. Claim Form – Total Incapacity

Submit your form along with any required documents.

If you need assistance, please don’t hesitate to contact us.

Forms to complete

Complete and submit this form if you wish to take a lump sum payment of your pro-rata entitlement after becoming totally incapacitated.

(Note: a medical practitioner must complete the Certification by Medical Practitioner section of the claim form.)

For instructions on how to submit a claim in the client portal, visit this guide.