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Enrollment Form Group Personal Accident Policy Zurich American Insurance Company 1400 American Lane Schaumburg, Illinois 60196 POLICYHOLDER INFORMATION Name of Policyholder: State of Wisconsin Group
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How to fill out group personal accident policy

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How to fill out group personal accident policy

01
Read the policy document thoroughly to understand the terms and conditions.
02
Gather all the necessary information about the group members, such as their names, ages, and occupations.
03
Contact the insurance provider or agent to obtain the application form for the group personal accident policy.
04
Carefully fill out the application form, providing accurate information for each group member.
05
Make sure to include any additional coverage or riders required by the group.
06
Submit the completed application form along with the required documents, such as identification proofs and group details.
07
Pay the premium amount as specified by the insurance provider.
08
Review the policy proposal provided by the insurance provider and make any necessary changes or clarifications.
09
Once satisfied with the policy proposal, sign the agreement and make the payment.
10
Keep a copy of the filled application form, policy proposal, and payment receipt for future reference.

Who needs group personal accident policy?

01
Companies or organizations that have a group of employees, members, or participants.
02
Sports teams, clubs, or associations that engage in high-risk activities.
03
Educational institutions or schools with students involved in extracurricular activities.
04
Non-profit organizations or volunteer groups that organize events or provide services to the community.
05
Any group that wants to protect its members against financial losses or medical expenses resulting from accidents.
06
Employers looking to provide additional benefits for their employees.
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Group personal accident policy is an insurance policy that provides coverage for a group of individuals in the event of an accident causing injury or death.
Employers or organizations who wish to provide accident coverage for their employees or members are required to file a group personal accident policy.
To fill out a group personal accident policy, employers or organizations must provide information about the group to be covered, such as the number of individuals, coverage limits, and any specific requirements.
The purpose of a group personal accident policy is to provide financial protection to a group of individuals in case of accidental injury or death.
Information that must be reported on a group personal accident policy includes details about the insured group, coverage limits, beneficiaries, and any specific exclusions or conditions.
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illinois wisconsin yyyy gpa ssn cw insureds schaumburg xxstate designating enrolls policyholder contributory undersigned hereto authorizes designation dependents reliance beneficiaries herein enrollment xxx declares attachments approves contingent exceed

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