FNIS Group Mandatory Critical Conditions Insurance

FNIS Group Mandatory Critical Conditions Insurance for Your Employees

An employer wishing to add this coverage to their current plan must submit their request in writing including plan identification and date they wish coverage to take effect. Once elected their coverage becomes mandatory for all eligible employees.

Application for Critical Condition Benefit

Written notice of a claim must be given to the company no later than one year from the
date on which a claim arises on account of diagnosis or surgery. The Plan SponsorĀ  complete, sign and date the “Employer Statement” section on this form and the Plan Member/Claimant must complete, sign and date the “Claimant’s Statement” of this form, in full and provide a copy to First Nations Insurance Services Limited Partnership.

Attending Physician's Statement Critical Condition Benefit

The Plan Member/Claimant must have this form completed by the doctor who is providing treatment upon diagnosis of an insured critical condition. Please note that FNISLP and the underwriter are not responsible for any expenses that may be charged by medical authorities for providing medical information. In most cases, the form will be given back to the Plan Member/Claimant by the doctor; however, there may be cases in which the doctor wishes the report to be treated confidentially and would therefore, send it directly to FNISLP, or the underwriter.