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Accident Benefits

A person who is injured in an accident could be entitled to receive accident benefits while you are recovering. These can include Income Replacement Benefits, Caregiver Benefits, Medical Care Benefits, or Non-Earner Benefits.

Optional Accident Benefits

Optional Accident Benefits Confirmation Form

This week a friend of mine emailed me this document. The document is titled “Optional Accident Benefits Confirmation Form”....

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25%

Did you or a loved one sustain an injury as a result of*
Other Cause
How long ago did this accident occur?

Briefly describe your situation*

Name*
First Last
Email*
Phone*
How did you hear about us?
How did you hear about us?

Terms of Service*
- I have read and understand this disclaimer.
Comments
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