HERE YOU'LL FIND YOUR CLAIM FORMS!

Claim forms are available from the Administrative Agent or downloaded online. The downloadable claim forms are for eligible active members and eligible dependents of the Local 183 Members Benefit Fund as listed below.
Please be sure to complete them fully, attach necessary original paid in full invoices along with any other original documentation where applicable and keep a copy for your records to substantiate your claims, and submit to the following mailing address:
LiUNA Local 183 Trust Administration
1263 Wilson Avenue – Suite 205
Toronto, ON M3M 3G2

LIFE INSURANCE

MEMBER / SPOUSE / DEPENDENT
Policy 158000

LIFE INSURANCE - SPECIAL NEEDS

MEMBER ONLY
Policy GL10363501

ACCIDENTAL DEATH & DISMEMBERMENT

MEMBER / SPOUSE / DEPENDENT
Policy ABT10241001

OCCUPATIONAL ACCIDENTAL DEATH & DISMEMBERMENT

MEMBER ONLY
Policy AB10357401

SHORT TERM DISABILITY

MEMBER ONLY
Policy 158000

LONG TERM DISABILITY

MEMBER ONLY
Policy 158000

PERMANENT TOTAL DISABILITY ACCIDENT

MEMBER ONLY
Policy SG10395001

LONG TERM CARE

MEMBER & SPOUSE
Policy SRG9134041

CRITICAL ILLNESS

MEMBER & SPOUSE
Policy CI9105655

HOSPITAL CASH BENEFIT

MEMBER / SPOUSE / DEPENDENTS
Policy SG10395001

EXTENDED HEALTH CARE BENEFITS

MEMBER / SPOUSE / DEPENDENTS
Policy 158000

PRESCRIPTION DRUG BENEFIT

MEMBER / SPOUSE / DEPENDENTS
158000

VISION CARE

MEMBER / SPOUSE / DEPENDENTS
Policy 158000

DENTAL CARE BENEFITS

MEMBER / SPOUSE / DEPENDENTS
Policy 158000

SPECIAL MEDICAL / HOSPITAL COVERAGE WHILE IN CANADA

MEMBER / SPOUSE / DEPENDENTS
Policy SRG9114253

EMERGENCY OUT-OF- PROVINCE MEDICAL

MEMBER / SPOUSE / DEPENDENTS
Policy BSC9020978

BEREAVEMENT PAY

MEMBER ONLY

PARENTAL LEAVE

MEMBER ONLY

JURY DUTY

MEMBER ONLY

REGISTERED EDUCATION SAVINGS PLAN (RESP)

MEMBER ONLY

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