Maternity Form – Tip Friendly Society

OVERVIEW

This form provides the requirements for submitting a maternity claim. Only the claimant statement is completed online. All maternity-related documents must be downloaded, completed by the appropriate authority, and re-uploaded. For miscarriages or caesarean deliveries, a Physician’s Statement is mandatory.

Required Documents:

✓ Member’s (Claimant’s) Identification
✓ Birth Certificate (Child) or Registry of Birth
✓ Completed Maternity Claim Form: - Important: if Caesarean section was done, the physician’s statement should be accurately filled out, signed and stamped.
✓ If member’s married name is on the child’s birth certificate but not on the ID, the member must submit their marriage certificate.
✓ Completed Authorization for Direct Deposit Form-Proof of banking information.

MEMBER DETAILS

*Full Name

*TRN

*Phone Number

*Member Number

*Email

Alternate Phone Number

*Current Address

PHYSICIANS STATEMENT

The Physician’s Statement must be completed by the doctor who treated the member for the injury or illness. It provides TIP Friendly Society with the essential medical details required to assess the claim—diagnosis, treatment dates, level of disability, hospitalization information, prognosis, and confirmation of when the member can resume work. This form must be completed directly by the attending physician, signed, and stamped.

The Society requires this form as part of the mandatory Proof of Death documents for Kids Benefit claims.

Download the official Attending Physician/Surgeon Statement. This form must be printed and completed by the physician. TIP Friendly Society does not accept versions filled out by the member.

File Download

After the physician has fully completed, signed, and stamped the form, upload the scanned copy here to proceed with your claim.

*File Upload

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ADDITIONAL DOCUMENTS REQUIRED:

Your maternity claim must include the child’s original Birth Certificate or Birth Registration, as required by TIP Friendly Society. Ensure this document is available and properly scanned before uploading your claim package

BIRTH CERTIFICATE / BIRTH REGISTRATION

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Valid Identification (Member)

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