Accidental Death (Basic)
Choose how to get the form and submit
Step 1
Print the form and read the instructions carefully, along with the application checklist
Step 2
Fill in the form using blue ink pen
Step 3
Once the form is completely filled out, please submit all documents in person or courier to the address below:
CCWU
1263 Wilson Avenue, Suite 205
Toronto, ON M3M 3G2
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We know that you may have questions or need assistance to find the information you are looking for. We’re here to offer answers and help in any way we can. Please don’t hestitate to Contact Us if you have questions about the following, or anything else.
Finding what you need on the
CCWUcare website
Accessing claim EOBs
(Explanation of Benefits)
Registering or updating your
CCWUcare accounts
Downloading mobile apps and
using our web portal
Updating banking information for claims direct deposit (Electronic Funds Transfer)
Acquiring Member
Advantage benefit cards
Submitting online claims forms