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Please include all dates of treatment and charges incurred due to the accident. 2 0 obj Aflac Worldwide Headquarters | Columbus, GA <> American Family Life Assurance Company of New York | Albany, NY %%EOF, qo&bs<9Pm9
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Once completed you can sign your fillable form or send for signing. File a Group Life Insurance or Accidental-Death and Dismemberment Insurance Rider Claim, File a Universal Life Insurance Claim underwritten by Trustmark Insurance Company Claim, File a Universal Life Insurance Claim underwritten by Trustmark Insurance Company, Do Not Sell or Share My Personal Information. 0000001020 00000 n 2"3sWA960?8;mmK#ZE2_=#C>QJ%q+@gg/`.\j'lY3GBQ_ecS2/`]F/b3$3maOCefRcJ`5!g@1,GaV\/9
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endobj endobj /I1 14 0 R /P0 15 0 R /P1 16 0 R /P2 17 0 R /Differences [ 1/a60/a73/a63/a77/a67/a68/a204] 0000043507 00000 n Our customer service representatives are here to assist you Monday through Friday 9 a.m. until 7 p.m. Eastern time. 3. @$)Lh&6Egt'qa=4JCbEhf.D@]'4gOBhAJ\j-2@i1Of6HUn&0Zg!2[-CMUcDL,99I`W(Mo=4ulk";_tepAHfJ;F[K'*>:ebQ]rrd/^N-lJT7#)95uN-MWu5OG
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5 0 obj 0000000212 00000 n endstream <>stream stream If you are filing for disability, please complete the Initial Disability Claim Form (S00224). >> Fill out Aflac Continuing Disability Form 2019 in several minutes by following the guidelines below: Select the template you need from our library of legal forms. 0000049332 00000 n endobj endobj m);lB2NZG/rMHahB@? Aflac is here to help. endstream a*7QP2nR!.R_;hRHWlnl#NqY`2;1A,B&CcHbipl%. rU4bL8-39(G
endobj stream >> 24 0 obj >> Payments can be used as needed - to help with medical bills, recovery expenses or even to help you pay for rent or groceries. c5lMh,QXUsVpDOgY[E488MHV?GK9DUk^qXiSo6?d"#T=f:;YTi0SU1_S\M2I.26bpPB\Xsl"fN>oQoH-
2&Tk-bp^c+fLgI$.,d5^! Follow our simple actions to get your Aflac Continuing Disability Form ready rapidly: Pick the template from the library. The Attending Physicians statement portion of the critical illness claim form is to be completed by the physician who first diagnosed your condition. -8KU)@AZCLegJ8ge%BBp0g(_Y&;BmiFJfS%>@Gu7. .8k,%=2e-? I)%]TcA`mWhX>Fb(1P"hjhfpCIF@eR>[8Uk8jb3JJCK>D0o*mhlN*%U(90mDYL0F##rb&>4GjbSZj8#'
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endobj For disability claims, we will need information from you, from your employer, and from your attending physician. Life claim forms for the state of Illinois must be obtained by contacting Aflac Worldwide Headquarters at 800.992.3522 to have the appropriate forms sent to you. Forms are available on our web site at aflac.com. A(lCW]h%VdMt:8Y)JTJc(@p\,K2F73Vt)lr]_VGs^b4MoT7ZmT:ZlP&6C?-PWabHK;JrCnJnrcc
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13827634d2d515810af3d192a27 Top Entertainment Law Firms Los Angeles,
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