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Get Transamerica TEB-DIClaim 2014

Tions to submit claim 1) The insured must complete the Claimant’s Statement and must sign and date the Authorization for the Release of Health Information and Fraud Warning Statement. We need this authorization to obtain additional claim information and provide prompt claim service. 2) Have your Employer complete the Employer’s/Business Entity’s Statement, answering all questions in full. 3) Have your physician complete the Attending Physician’s Statement, answering all questions in full.

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