Important notice

Class action against tobacco companies

If you need the Health Insurance Number of a tobacco victim, you must file a request for access to information for a deceased person. Find out more

Gouvernement du Québec
Régie de l’assurance maladie
  • 1 Vos coordonnées
  • 2 Informations sur la demande
  • 3 Résumé
  • 4 Fin
webform_started

Send documents related to a request already in progress

If you have already applied for a reimbursement, you can attach additional documents to support your request. Further information may be required to ensure that your request is processed effectively.

Protection of your personal information
In order to offer you certain services, we need to collect, use, and sometimes disclose your personal information. To find out more about our privacy practices on our website, please refer to our Privacy policy webpage.

Your contact information

Example: Four letters “A”, followed by four nines, followed by four nines

If you wish to receive an acknowledgment, enter your email address.