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GROUP ACCIDENT CLAIM FORM CSCLA14 PART I Insureds Particulars Policy No. () Name of Employer (Policyholder) / Name of Employee×Insured : Age and Sex / I.D. Card/ Staff no. () Claimed Benefit’s)
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How to fill out group accident claim form

How to fill out a group accident claim form:
01
Start by gathering all necessary information such as the policyholder's name, contact details, and policy number.
02
Provide details about the accident, including the date, time, and location.
03
Describe the nature of the accident and the injuries sustained by the claimant or claimants.
04
Include any witnesses who may have seen the accident occur.
05
Attach any supporting documentation such as medical reports, police reports, or photographs of the accident scene.
06
Fill out the section pertaining to the claimant's medical history and any pre-existing conditions that may be relevant to the claim.
07
Provide details about the healthcare provider who treated the claimant and any expenses incurred for medical treatment.
08
Indicate whether the claimant has filed a lawsuit or taken legal action in relation to the accident.
09
Review the form for accuracy and completeness before submitting it to the insurance company.
Who needs a group accident claim form?
01
Individuals who have been injured in an accident that occurred within a group setting, such as employees during work hours or participants in a sports team.
02
Policyholders who are seeking compensation from their insurance provider for injuries sustained by themselves or their group members.
03
Employers or group administrators who are responsible for managing and filing accident claims on behalf of their employees or group members.
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What is group accident claim form?
Group accident claim form is a document that allows a group of individuals who have been involved in an accident to file a claim together, instead of individually.
Who is required to file group accident claim form?
All individuals who were part of the accident and wish to make a claim for compensation are required to file the group accident claim form.
How to fill out group accident claim form?
To fill out the group accident claim form, individuals need to provide their personal information, details of the accident, any injuries sustained, and any other relevant information requested on the form.
What is the purpose of group accident claim form?
The purpose of the group accident claim form is to streamline the process of filing a claim for multiple individuals involved in the same accident.
What information must be reported on group accident claim form?
The group accident claim form must include personal information of all individuals involved, details of the accident, injuries sustained, medical treatment received, and any other relevant information requested.
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