Pre-Authorized Payment Application Form

Application for Extended Healthcare Insurance

Claim Forms

Claim form for Extended Health Benefits

Application for Life Insurance

Life Insurance Change Form

Life Insurance Non-Smoker Declaration

Claim Forms

Contact Doctors Manitoba for more information and to request a claim form.

Mark Venton
(204) 985‑5846
mventon@​doctorsmanitoba.​ca

Benefit Type

(For Student Disability and PARIM Insurance, see below)

Application for Disability Income and Office Overhead Expense Insurance 

Future Insurance Option Application to Exercise FIO2

Claim Forms

Disability Insurance Childbirth Claim form

To request a claim form for Disability Income insurance please contact:

Insurance Services
(204) 985‑5888
insurance@​doctorsmanitoba.​ca

Application for Disability Income and Office Overhead Expense Insurance

Claim Forms

To request a claim form for Office Overhead Expense insurance please contact:

Insurance Services
(204) 985‑5888
insurance@​doctorsmanitoba.​ca

Accident Death & Dismemberment Insurance Application and Change Form

Claim Forms

To request a claim form for Disability Income or Office Overhead Expense insurance please contact:

Mark Venton
(204) 985‑5846
mventon@​doctorsmanitoba.​ca

Critical Illness Insurance Application

Claim Forms

To request a claim form for Critical Illness insurance please contact:

Mark Venton
(204) 985‑5846
mventon@​doctorsmanitoba.​ca

Applications for the Student Disability Insurance — Open Enrollment — are available in September and October each year. If you would like to apply an any other time throughout the year, please contact our office.

Claim Forms

To request a claim form for Disability Income insurance please contact:

Insurance Services
(204) 985‑5888
insurance@​doctorsmanitoba.​ca

Application for PARIM Group Insurance

Claim Forms

To request a claim form for Disability Income insurance please contact:

Insurance Services
(204) 985‑5888
insurance@​doctorsmanitoba.​ca