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LOSS OF HEARING CLAIM FORM (To be completed by medical attendant) Please note that Holland Life will not pay for the completion of this form. The following copies must be included when submitting
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Loss of hearing claim is a legal claim filed by individuals who have experienced a decline in their hearing abilities.
Individuals who have suffered a loss of hearing and believe it was caused by a specific event or exposure are required to file a loss of hearing claim.
To fill out a loss of hearing claim, individuals need to provide information about their hearing loss, the events or exposures that may have caused it, and any supporting medical documentation.
The purpose of a loss of hearing claim is to seek compensation for the impact that hearing loss has had on an individual's life, such as medical expenses, lost wages, and pain and suffering.
Information that must be reported on a loss of hearing claim includes details about the individual's hearing loss, medical records documenting the loss, and any relevant evidence of the cause of the hearing loss.
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