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PERSONAL ACCIDENT CLAIM FORM PERMANENT TOTAL DISABILITY Serving Member / Police Staff / Retired Member* (*Delete as appropriate) To be completed by the Member for whom the benefit is being claimed

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How to fill out personal accident claim form

01

Obtain the personal accident claim form from your insurance provider or download it from their website.

02

Fill in your personal details such as name, address, contact information, and policy number.

03

Provide details of the accident including date, time, location, and description of what happened.

04

Include information on any witnesses to the accident if applicable.

05

Attach any supporting documents such as medical reports, police reports, and receipts for expenses incurred.

Who needs personal accident claim form?

01

Anyone who has been involved in an accident and is covered by a personal accident insurance policy may need to fill out a personal accident claim form.

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What is personal accident claim form?

The personal accident claim form is a document used to report an accident that resulted in personal injury.

Who is required to file personal accident claim form?

Individuals who have been involved in an accident and suffered personal injury are required to file a personal accident claim form.

How to fill out personal accident claim form?

To fill out a personal accident claim form, individuals must provide details about the accident, the injuries sustained, and any other relevant information requested on the form.

What is the purpose of personal accident claim form?

The purpose of the personal accident claim form is to document and report personal injury sustained as a result of an accident in order to seek compensation.

What information must be reported on personal accident claim form?

Information that must be reported on a personal accident claim form includes details about the accident, injuries sustained, medical treatment received, and any other relevant information requested on the form.

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