Accident Victim

Claim for Death Benefit Compensation - Guide and Forms

Remember: Before mailing the Claim for Death Benefit, a claimant must phone the SAAQ to have a claim file opened and be assigned a claim number.

To submit a claim, you will need:

1. Forms
   These include:
   • forms that must be filled out:
     • the Claim for Death Benefit form
     • appendices:
       • Employment – Training
       • Employment History– Qualifications – Disability
   • schedules that might be needed:
     • Schedule 2 Attestation of income by the employer
     • Schedule 3 Confirmation of employment insurance benefits lost due to the accident – Confirmation of employment assistance allowance lost due to the accident
     • Schedule 4D Attestation of School Attendance
2. Guide to the Claim for Death Benefit
   The guide contains all the information you will need to fill out a claim for the various types of compensation paid by the SAAQ
3. The Table of Death Benefits

Before submitting your claim to the SAAQ, make sure:

1. You enclose all supporting documents and vouchers on hand;
2. You enter the claim number you were assigned on all pages of the  forms and on supporting documents, such as receipts and invoices, that you enclose;
3. You sign all document where required;
4. You put sufficient postage on the return envelope before mailing it to this address:

Société de l'assurance automobile du Québec
Services aux accidentés (D.I.)
Case postale 2500, succursale Terminus
Québec (Québec) G1K 8A2

Send in the claim as soon as possible, even if you still don't have some supporting documents from another person or institution. These can be submitted later.

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