Forms Income Care

Our forms are different depending on your plan type. In order to better meet your needs, we request that you use the correct forms.

You can ask your human resources department for information about your plan.

Report an occupational incapacity
Claim notification	NL	FR	EN	DE
Medical certificate	NL	FR	EN	DE
Occupational incapacity insurance
Request for individual continuation coverage	NL	FR

Insurance Product Information Document (IPID)
Corporate-sponsored Income Protection insurance	NL	FR	EN
Corporate-sponsored Waiver of Premiums insurance	NL	FR	EN