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C. P. 3950 L is (EU BEC) G6V 8C6 Fax: 418-838-2134 1-877-838-2134 GROUP INSURANCE HEALTH CLAIMS PRIOR AUTHORIZATION REQUEST XYLEM (SODIUM OXALATE) Please read the instructions on the back of this
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XYREM - Desjardins Life is a form used for reporting life insurance policy information to the insurance company.
Policyholders who have life insurance policies with Desjardins Life are required to file XYREM form.
XYREM form can be filled out online on the Desjardins Life website or by contacting their customer service for assistance.
The purpose of XYREM form is to provide updated information about the policyholder's life insurance policy to the insurance company.
Information such as policyholder's name, policy number, coverage amount, beneficiaries, and any changes to the policy must be reported on XYREM form.
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