Medical & Dental Forms

SIU Medical Plan Contact Information

200 – 1333, rue St-Jacques Montreal, Quebec, H3C 4K2

T (514) 931-785

F (514) 931-3667

TF 1 (855) 605-0550

Attention Lyne Leblanc
E medical@seafarers.ca

When sending claims, dues etc. to the Montréal office, it is important that the address be indicated as follows. If the envelope if not addressed as indicated below, Canada Post will not deliver and will return the envelope to sender.

Please note

The SMP will require that all Members submitting claims be done electronically and no longer by regular mail.

Claims can still be submitted to the SMP by regular mail, or by email, at medical@seafarers.ca until September 30, 2020.

As of October 1st 2020, all claims must be submitted by email at medical@seafarers.ca

Need some guidance on how to submit your medical claims electronically to the Seafarers’ Medical Plan? See here for a step-by-step guide on submitting your claims via email.

Claiming Care Benefits Form

Form to be completed if claiming for hospital, medical, dental care or vision care benefits.

Download

Reimbursement Form

Reimbursement of prescribed medication and injections.

Download

Wage Loss Benefits Form

Form for claiming short term wage loss benefits or if you wish to have your disability period counted as a sailing period.

Download

Dental Claim Form

Standard dental Claim Form.

Download

Death Benefits Form

Standard Death Benefits form.

Download

Application Forms

Request for Training Form

Change of Address Form

SIU Medical Plan Contact Information

Please note

Need some guidance on how to submit your medical claims electronically to the Seafarers’ Medical Plan? See here for a step-by-step guide on submitting your claims via email.

Claiming Care Benefits Form

Reimbursement Form

Wage Loss Benefits Form

Dental Claim Form

Death Benefits Form