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Administered by: Group Life and/or Accident Coverage Disability Claim Form for Employee or Dependent IMPORTANT INSTRUCTIONS FOR COMPLETING CLAIM FORM(s) To the Employer/Employee, as applicable: We

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What is group life and/or accident?

Group life and/or accident insurance provides coverage for a group of individuals against the risks of death, disability, or injury.

Who is required to file group life and/or accident?

Employers or organizations providing group life and/or accident insurance to their employees or members are required to file.

How to fill out group life and/or accident?

Group life and/or accident insurance forms can be filled out by providing relevant information about the insured individuals, their beneficiaries, coverage details, and any applicable claims.

What is the purpose of group life and/or accident?

The purpose of group life and/or accident insurance is to provide financial protection and support to the insured individuals and their beneficiaries in case of death, disability, or injury.

What information must be reported on group life and/or accident?

The information required to be reported on group life and/or accident includes details about the insured individuals (such as name, age, and occupation), coverage details (such as policy number and benefits), and beneficiary information.

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