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FCB BANKS GROUP HEALTH PLAN ACCIDENT QUESTIONNAIREPLEASE COMPLETE THIS FORM AND RETURN TO:MEMBER NAME:___MERCY BENEFIT ADMINISTRATORS PO BOX 14230 SPRINGFIELD, MO 65814MEMBER ID #:___CLAIMANT NAME:
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wwwlawinsidercomclausegroup-health-accident refers to a legal document or clause associated with health and accident insurance policies that outlines the terms, conditions, and coverage details.
Typically, insurers or organizations providing health and accident insurance are required to file this clause, as it pertains to the coverage they offer.
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The purpose of this document is to clearly define the scope of health and accident insurance coverage, ensuring all parties involved understand their rights and obligations under the policy.
Information required includes policyholder details, coverage types, exclusions, benefits, and relevant terms and conditions of the insurance policy.
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