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CIA THE ACCIDENT/MEDICAL QUOTATION COSSIM Insurance Agency 8646880121 Fax: 8646880138 PO Box 188 Simpsonville SC 29681 DIRECTIONS: 1. Complete the application (all pages) in full by filling in the
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How to fill out accident-medical-quotation-bullsindd

How to fill out accident-medical-quotation-bullsindd:
01
Open the accident-medical-quotation-bullsindd document on your computer.
02
Fill in the required personal information, such as your name, address, and contact details.
03
Provide details about the accident, including the date, time, and location.
04
Describe the nature of the accident and any injuries sustained.
05
Indicate whether medical attention was sought and if any treatment was received.
06
Include information on any medical expenses incurred as a result of the accident.
07
Specify whether any insurance coverage is available and provide relevant policy details.
08
Sign and date the form to certify that the information provided is accurate.
Who needs accident-medical-quotation-bullsindd:
01
Individuals who have been involved in an accident and need to submit a claim for medical expenses.
02
Insurance companies or their representatives who require detailed information for processing accident-related claims.
03
Medical professionals who need to document and assess the injuries and medical treatment received by the accident victim.
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