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Request for refund/ Refund appeal form Language of preference: English French Please check one of the following: Initial request for refund appeal Policy numbers Sun Life Assurance Company of Canada
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How to Fill out SM-084-E UHIP Request Form:

01
Start by obtaining the SM-084-E UHIP Request Form from the appropriate authority, such as your employer or insurance provider.
02
Begin filling out the form by providing your personal information, including your full name, date of birth, and contact details. Ensure all the information is accurate and up-to-date.
03
The next section of the form may require you to provide information about your current health insurance coverage. This may include details about your existing insurance policy or any coverage provided by your employer.
04
If you are holding any other health insurance policies, regardless of whether they are through your workplace or privately obtained, disclose that information in the relevant section of the form.
05
Next, you may need to provide information about your dependents, if applicable. This may include their names, dates of birth, and relationship to you.
06
The form might also require you to answer questions regarding your health status, such as any pre-existing medical conditions or ongoing treatments. Be thorough and provide accurate information.
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In the final section of the form, you may be required to sign and date it, indicating that all the information provided is true and correct to the best of your knowledge.
08
Make a copy of the filled-out form for your records before submitting it to the relevant authority.

Who Needs SM-084-E UHIP Request Form?

01
Individuals who are eligible for the University Health Insurance Plan (UHIP) in Canada may need to fill out the SM-084-E UHIP Request Form. UHIP is designed to provide health insurance coverage for international students, scholars, and their dependents who are studying or working in Canada.
02
Universities, colleges, and educational institutions in Canada may require their international students to complete the SM-084-E UHIP Request Form as part of the enrollment or onboarding process.
03
International employees or workers coming to Canada for employment purposes may also need to fill out the form to ensure they receive the necessary health insurance coverage during their stay in the country.
It is essential to consult the specific guidelines and requirements provided by your institution or insurance provider while filling out the SM-084-E UHIP Request Form, as they may vary slightly.
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