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APPLICATION FOR FLORIDA NO FAULT BENEFITS DATE OUR POLICYHOLDER DATE OF ACCIDENT FILE NUMBER TO ENABLE US TO DETERMINE IF YOU ARE ENTITLED TO BENEFITS UNDER THE FLORIDA PERSONAL INJURY PROTECTION
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Our policyholder is the individual or entity who holds an insurance policy with us.
Our policyholder is required to file the necessary information with us.
Our policyholder can fill out the necessary information online or by contacting our customer service.
The purpose of our policyholder is to provide important details for the insurance policy.
Our policyholder must report personal information such as name, address, and contact details.
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