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HSBC Total & Permanent Disability×Disability×Accidental Dismemberment Claim Form Policy No. Date : PICS 2014 Jun CLAIMS DOCUMENT CHECKLIST Part I is fully completed & signed by the Policyholder×Insured

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How to Fill out Total & Permanent Disability/Accidental Disability:

1. Start by carefully reading the instructions: Before filling out the Total & Permanent Disability/Accidental Disability form, make sure you read the instructions provided. It is essential to understand the requirements and information needed to complete the form accurately.
2. Gather necessary documents: Collect all the necessary documents that may be required to complete the form, such as medical records, accident reports, and any other relevant documentation. Having these documents readily available will help ensure you provide accurate and detailed information.
3. Begin with personal details: The form will typically require you to enter your personal details, such as your full name, address, contact information, date of birth, and social security number. Ensure all the information is correct and up to date.
4. Describe the disability: Next, provide a detailed description of the disability or accident that has resulted in permanent or total disability. Explain the circumstances, including the date and location of the incident if applicable. Be thorough and concise in your description.
5. Include medical information: In this section, you will be asked to provide medical information related to your disability. This may involve detailing the specific diagnosis, treatment received, and any ongoing medical care or medications. Make sure to provide accurate dates and names of healthcare professionals involved.
6. Discuss work history: The form may also request information about your work history and occupation prior to the disability. Include details about your previous job roles, responsibilities, and the impact the disability has had on your ability to perform work-related tasks.
7. Supplemental information: Depending on the form, there may be additional sections requiring you to provide further details or documentation. This could include information about any additional sources of income or financial assistance you are receiving or any other relevant information related to your disability.

Who needs Total & Permanent Disability/Accidental Disability:

1. Individuals who have sustained a severe disability: Total & Permanent Disability or Accidental Disability benefits are usually intended for individuals who have suffered a severe injury or disability that prevents them from engaging in gainful employment. This could include individuals who have become permanently disabled due to a workplace accident, severe illness, or critical injury.
2. Workers unable to perform their previous job: These benefits are typically aimed at individuals who are unable to perform the work they were previously engaged in due to their disability. It is important to have medical evidence and documentation supporting your disability claim.
3. Those seeking financial support due to a disability: Total & Permanent Disability/Accidental Disability benefits provide financial support to individuals who are unable to work and therefore require assistance to meet their daily living expenses and medical needs.

Note: The requirements for Total & Permanent Disability/Accidental Disability benefits may vary depending on the country and the specific insurance or government program involved. It is advisable to consult the specific guidelines and regulations applicable in your jurisdiction to ensure accurate and complete information is provided in the form.

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What is btotalb amp bpermanentb disabilitydisabilityaccidental?

Total and permanent disability caused by an accidental event.

Who is required to file btotalb amp bpermanentb disabilitydisabilityaccidental?

Individuals who have suffered total and permanent disability due to an accident.

How to fill out btotalb amp bpermanentb disabilitydisabilityaccidental?

You can fill out the form provided by the relevant authority and submit all required documentation.

What is the purpose of btotalb amp bpermanentb disabilitydisabilityaccidental?

To provide financial assistance to individuals who have become totally and permanently disabled as a result of an accident.

What information must be reported on btotalb amp bpermanentb disabilitydisabilityaccidental?

Personal details, medical information, accident details, and supporting documentation.