Understanding the SAAQ Authorization to Disclose Information

Understanding the "Authorization to Disclose Information by Telephone" Form from the Société de l’assurance automobile du Québec

If you've been involved in a vehicle accident in Quebec and are dealing with the Société de l’assurance automobile du Québec (SAAQ), you may encounter the need to authorize the agency to communicate certain information about your claim over the phone. The form titled "Authorization to Disclose Information by Telephone" (code 6088A) is designed precisely for this purpose. Here’s what you need to know about this official document, who should fill it out, and how to do so correctly.

What is the Purpose of this Form?

This form allows the accident victim or their authorized representative to give permission to SAAQ staff to share specific information related to a claim by telephone. This information might include medical details, decisions made regarding the claim, documents received, or payments issued. The primary goal is to facilitate efficient communication, especially when the claimant cannot be reached directly or prefers verbal updates.

It’s important to note that under articles 2840 and 2841 of the Civil Code of Québec, a photocopy, fax, or scanned reproduction of this authorization is as valid as the original document. The authorization remains valid until the claim process is complete unless it is withdrawn in writing.

Who Should Fill Out the Form?

The form should be completed by the accident victim or their authorized representative. The person signing must have the legal authority to grant such authorization. In cases where the victim is unable to sign, a legal representative or power of attorney holder can complete and sign the form on their behalf.

It is essential to provide accurate personal details, including the full name of the accident victim, the claim number, and the name and contact information of the authorized person.

How to Fill Out the Form Correctly

Step-by-Step Instructions

• Effective date of authorization: Indicate the date when the authorization begins.
• Accident victim’s details: Write the full name and claim number.
• Authorized person’s details: Fill in the last and first name, along with a contact telephone number.
• Signature: The accident victim must sign the form. If an authorized person is filling it out, their signature is required.
• Title: Specify whether the signer is Mr., Ms., or prefers not to answer.

Additional Tips

Ensure all information is legible and accurate to prevent delays. The form can be signed electronically if submitted via the online service, or physically signed if submitted by fax or mail. Remember to keep a copy for your records.

Where and How to Submit the Form

There are three official methods to submit the completed authorization form:

1. Online: Use the SAAQ’s Reimbursement of Expenses and Document Submission online service available at saaq.gouv.qc.ca/documentsubmission.
2. Fax: Send the signed form to 1-866-289-7952.
3. Mail: Address it to:
   Société de l’assurance automobile du Québec Case postale 2500, succursale Terminus Québec (Québec) G1K 8A2

It is recommended to keep the original or a copy of the submitted form for your records. Ensure the information is complete and correct to avoid processing delays.

Protection of Personal Information

The SAAQ is committed to protecting your personal data. The information collected via this form is necessary for the administration of your claim and is handled confidentially. It may be shared with licensing agents or other government departments, including those outside Québec, in accordance with applicable privacy laws. The agency may also use the data for statistical, audit, or investigative purposes.

If you wish to review, correct, or request a copy of your personal information, you can contact the SAAQ’s privacy office or consult their privacy policy available on their website.

Important Reminders

Always ensure the form is fully completed and signed before submission. An incomplete or unsigned form could result in delays or refusal of the authorization. If you need assistance, contact the SAAQ’s customer service for guidance.

By understanding and properly completing this form, you help ensure smooth communication with the SAAQ and a more efficient handling of your vehicle accident claim.