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TOTAL CARE GAP COVER APPLICATION FORM 2012 Authorized financial services provider, FSP No 40815 IMPORTANT INFORMATION!! Please complete this form and send it to Total Risk Administrators (ERA), as
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Gap cover application is a form that individuals or organizations fill out to apply for a gap cover policy. Gap cover is a type of insurance that covers the financial gap between the cost of medical treatments and the amount covered by a primary health insurance plan.
Individuals or organizations who wish to obtain a gap cover policy are required to file a gap cover application.
To fill out a gap cover application, you need to provide personal information such as name, address, contact details, and relevant medical history. You may also need to provide details about your primary health insurance plan.
The purpose of a gap cover application is to apply for a gap cover policy, which helps individuals or organizations mitigate the financial burden of medical treatments not fully covered by their primary health insurance plan.
On a gap cover application, you usually need to report personal information, contact details, medical history, and details about your primary health insurance plan.
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