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Purdue University Study Abroad Accident & Sickness Plan 1. Please fully complete this form 2. Attach itemized bills 3. Mail to: Health Special Risk, Inc. AXA Travel Assistance & Medical Emergency
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How to fill out accident amp sickness plan

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Obtain the accident and sickness plan documents from your insurance provider.
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Prepare all the necessary information such as personal details, medical history, and contact information.
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Fill out the application form as accurately as possible, providing all the required information.
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Provide details about the coverage you want, including the desired benefits and policy limits.
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Attach any additional documents requested by the insurance company, such as medical certificates or previous insurance records.
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Double-check the completed form for any errors or missing information.
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Submit the filled-out form along with any required payment to the insurance provider.
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Keep a copy of the filled-out application form and policy documents for your records.

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Accident and sickness plan is a type of insurance that provides coverage for medical expenses and lost income due to accidents or illnesses.
Employers are typically required to file accident and sickness plans for their employees.
Accident and sickness plans can be filled out by providing information about the employee, the type of coverage needed, and any relevant medical history.
The purpose of accident and sickness plan is to provide financial protection for individuals in case of unexpected medical emergencies.
Information such as the employee's name, contact information, medical history, coverage details, and beneficiary information must be reported on accident and sickness plans.
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