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Web supplemental claim form (continuing disability) (please have completed for support of continued disability) claim number: If this is a disability product with your policy number beginning with afl, please use the form below. Claims department • worldwide headquarters • 1932 wynnton road • columbus, ga 31999 failure to complete this form in its entirety may result in a delay.
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If this is a disability product with your policy number beginning with afl, please use the form below. *last name *first name *date of birth (mm/dd/yy) / / *sex: Female primary policyholder spouse initialdisabilitychecklist is disability due to a sickness? Web short term disability claim form instructions continental american insurance company post office box 84075 * columbus, ga. No yes.
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*last name *first name *date of birth (mm/dd/yy) / / *sex: You can also download it, export it or print it out. Web 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. Short term disability/long term disability claim form
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Claims Department • Worldwide Headquarters • 1932 Wynnton Road • Columbus, Ga 31999 Failure To Complete This Form In Its Entirety May Result In A Delay In Processing This Claim.
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