ocp#ophc,on7uVb:-MXb"*(,i/15jO-%hEWBZj$Xoi/8"O.l:b1N/N9e>iZA0.TFk&&Rn5CcH4>d6W(; endstream 44EBCGZWK1$09&Q#o?-4-.oof+30H,2'QUFu;$7Pkc o5BD$*Z2jom$PZ&;ZZZSrkbZVqI! startxref 0000001422 00000 n 18 0 obj 1EWs%t3I_6o#k'G^.VY7l!4E5fU,kWcMcPcnu9Vps@:V.*1hGHiRR-8n&.Gf>KTA_?ia$;;29=Lp*@; A(lCW]h%VdMt:8Y)JTJc(@p\,K2F73Vt)lr]_VGs^b4MoT7ZmT:ZlP&6C?-PWabHK;JrCnJnrcc <> TiH!-bXfof5[n@&[kS/JgZ:HFlTDHBWer?faRZL endobj 17 0 obj Please submit required medical documentation for the specific covered critical illness, the claimant's birth certificate, a list of the names of all doctors and hospitals in the appropriate section, as well as a signed and dated Authorization for Disclosure of Health Information (HIPAA form). endstream /Subtype /Type1 3 0 obj For disability claims, we will need information from you, from your employer, and from your attending physician. ^f8SP@,%81kYF7&7>W`>g^5VpKEtLo)BHCQ9Z^%VoU(+& endobj o5BD$*Z2jom$PZ&;ZZZSrkbZVqI! . )_uYFAPMnh@@qLR(!tj0,JgDV:^2aU1j,Q1G5%+A&.^pn]C"PJA:oAllMYj0psPAVZ_E,8iGS^\I&;A'/E"CXIR`WpK_.^,?uB7C2c/q!Ft;r%bq\)j#XX/c~> I:V.I`2dr"RI-usXpWjkY@>M8)rABTHrdsdGSrnt>bM>*rdMgSo-0,QN0AdB$2JDlipKX1lo%-6ppko&)?kL6M8p"kK6P^Jj+s;af.%X>Efh47/[PqC. PolicyholderInformation:This*denotesarequiredfield. 5 0 obj In CA, CAIC does business as Continental American Life Insurance Company (CAIC NAIC 71730) . endobj /BaseFont /ZapfDingbats *?ZgaJ72F%->d4aYIUb3reE0'[sM)3JY+[(7="R\fM6;Q 0000055045 00000 n 0000054442 00000 n 3. 25 0 obj 55184 0000037564 00000 n endstream stream 0000000000 65535 f 0000000932 00000 n mhQCujn[DM`k5Vu9TL8/lY,n@)69`YnLctGSmP1C9g-Y\7nk0=`m#b/(aquK(k!OU2OhA)L%au^_^KfM Z]9@&FL3T;C!WW4Ki3jpQoiR!f,B'&Z:-,IO-Zq$&hBkC=HU@Y3)-Z7i/#[6S/+p@I:RnZ,Zu8hna5,OXLi#hGpMO`^lS.s0&6Us=%m@8h6<5u9e[1qBDSkRo7:L?^bDtpRqeOlX:eqkU9[p,&in^ADo=rk`A*eP:sf'8Vn -_6'A_4IL[`92un&r8tH[>^"rhOWrgJZC\%6"6'k2kR6&.9EYCGWVonkFA2[(WQ.mndG'-IoKK^(VM6j):K)HmcRL+qg#Rf :^_n)prV#UtcF7_C)h7^7 endobj Gau11gQ!:3&4M)fO+Bqq68hgpo*+gp=2Y]D/n"iL.5,!&rqt4]k:;$A5NLFAhtQ5bEOn@#^,c5cB!.a)bI[X^$Z/(6Y3*HPeGm7X6?U'%V=rC9[=GjqjWB0seXj;VlVcTeq5_9FHgWfdVe$=P]!o`0j\1-`^3>_A9ZoUTo$WJK1Q:]6WWAVuKI'Y$35ml*7PtOu0J6e7#&o=%qn3o`.E7sK;/h7%\$[-i.7V$.UYlP*?.uFbc7nhCFtIZjOkQrAc7g"Ug9r:8cEafo8627jFXKfYC0A$S9usZ2SDC/"#[+d*"'o%^Q_*Hn&@1AgijL%'P.Kf^i=oG0s!qIUL=aJ[)T&lc>&&=C!Q>:6l;0*KDgPp:O0c64SqnC,A;6e(b@.p,;O[!?.Sna&[9^L-dYtESB'GStL%:JFBKQc+/Jhmi-fJJ+7%.r1/J5_ETA"->7L4LD8#&oV*>h\"h(P@^^V"G:N&(p,Bpn`G=k7^Y24.eZ+fU&nc[ckh*cU*E"`DO?WcV^7MJqO'=*3e@o(GH)q32NcZVm,*P7[jK\S5O:+;g@Z5G1ueC"UB1s*3eFeRT>urJqNo1%TmZ]iAKK)'F-cRCQ'b5Gu'h$B>SH,oFG&_(#Nh-lC&bUYsd4"b6Un)pIJ!J:`@=9V^Ou@'51a'T@(>@7J)e!"09oCFq>.M?=XG>0X\o#JKEQ$E-(V^%OrGecoP1N*FRX"Xk)Vh#!Kj[50561k9'CWJs"cU",4`-[FLuf/3'T1k("0op(&%Fi1RNI"'1rI5@hQ]KA(&M=E%)@blK=ilBq])3%^oTlln@er)QXZj0ed[F%F_4[8.973"HF55CWkf:K*@$cO`\BrPBm60$P! A&!R^maAJpBZW3)>! rT)4FF1EPoVMN14>L,`\V:)bIb1npmugX^4,7NbhZ&&T,/8(>f=lM4?OnHSHRdi Continental American Insurance Company (CAIC), a proud member of the Aflac family of insurers, is a wholly-owned subsidiary of Aflac Incorporated and underwrites group coverage. 17 0 obj View details, map and photos of this single family property with 5 bedrooms and 3 total baths. Aflac Short-Term Disability Insurance pays cash benefits for covered disabilities (subject to exclusions and limitations). m);lB2NZG/rMHahB@? [lXipns%dYmtWgT45TNAg1!L7&LsF1AVS8,9_:a+p=0JYXs63uqK)DZMF:+=COnscG]5l!0l_(jD#HTn3T/Nq3TXul_X>mcZ"L&H2kUp].^k.4,_Aof>Ug=,=b3fQf+d*!6h*m;*04i'C0/[p+\Sgs.&*IjrlVLg~>

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aflac disability form

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