Claim forms may be obtained from the Administrative Agent.

You should acquaint your beneficiary/beneficiaries with the fact that in the event of your death, they should contact your employer, the union, and the Trust Fund’s Administrative Agent immediately. A claim form will then be forwarded with specific instructions as to how it is to be completed.

Before submitting the claim form, your beneficiary or Executor must ensure that all questions have been answered, that the claimant and the insured are clearly identified by full name, return mailing address, and the name of your employer and Union. Faulty or missing information will only result in a delay in processing the claim.

When the above has been completed, forward the form and all attachments to the Administrative Agent. The claim will be validated by the Administrative Agent and forwarded to the insurance carrier for settlement.

Proof of Loss

Written proof stating the occurrence, character and extent of loss must be submitted to the Administrative Agent within 12 months after the date of death for Life Insurance, and within 18 months after the date the Member ceases active work because of total and permanent disability under the disability provision for Life Insurance.

Insulators Local 95 Benefit Trust Fund c/o Benefit Plan Administrators 
90 Burnhamthorpe Road West, Suite 300 Mississauga, Ontario L5B 3C3