BMO Insurance | Submit a Claim

Please tell us about you

* mandatory fields

Your title * Your first name Please enter your first name. * Your last name Please enter your last name. * Your relationship to the Insured Please specify your relationship.

* Other (please specify) Please specify your relationship.

* Your email address Please enter a valid email. * Confirm email Please confirm email address. * Your daytime phone number Please enter a valid 10 digit phone number.

Please provide us with the policy details

* Policy number Please enter the Policy Number (7-12 characters). * Insured’s first name Please enter the Insured's first name. * Insured’s last name Please enter the Insured's last name. * Type of claim Please specify the type of claim. * Date of death Please enter the date of death. * Other (please specify) Please specify the type of claim. * Country of death Please enter the country of death. * Cause of death Please enter the cause of death.
NOTE: The information you provide will only be used for the purpose of this claim. We will not retain the information you submit for any other purpose. By selecting Submit within this form, you are consenting to sending the information.

Thank you

Thank you for providing us with this information. We understand that this is a difficult time and we will do our best to make the claim process as simple as possible.

What happens next:

We will review the information you have provided.
If we have enough information to send you the claim forms we will email them to you securely at the email address you provided.
If we require further information we will contact you by telephone.

If you need to contact us at any time, we are here to help. Please give us a call or send us an email at:

1-800-387-9855
8am-5pm (ET)

Insurance.DirectAdmin@bmo.com