Philadelphia American Life Insurance Company (PALIC) any additional information needed in connection with this claim. Start the process on filing a death claim for your loved one's Prudential Life Insurance policy with this online form. Why did my benefit payments stop? Monthly claim forms are required to certify the continuing total disability and must be completed by you and your medical provider. 0 0 8.9555 10.0954 re 79 0 obj <>/Filter/FlateDecode/ID[<8E72052C73710541B56C4D71CFFDEB09>]/Index[14 108]/Info 13 0 R/Length 145/Prev 81219/Root 15 0 R/Size 122/Type/XRef/W[1 3 1]>>stream \|@i{[/mdlmtl}R>O"[m:k=k>V=g{ivNvidg$-ZL^. It varies depending on how quickly CSO is in receipt of the authorization and how quickly the medical providers respond to CSOs request. 1 The American Journal of Medicine There are 4 parts that must be completed: (1) Loan Information - includes name and address of the lending institution and requires a copy of the monthly loan statement or payment coupon; (2) Insureds Statement - completed by you and includes your signature; (3) Employers Statement - must be completed by your employer (or you, if self-employed) and; (4) Attending Physicians Statement - must be completed by your medical provider. Do not include sensitive information in your email to us) healthinsurance@neweralife.com. These forms are completed by and obtained from the provider in which the treatment was sought. endstream endobj 24 0 obj <>/Subtype/Form/Type/XObject>>stream Please refer to your contract as it provides information about your rights and CSOs rights. Avram Noam Chomsky (born December 7, 1928) is an American public intellectual: a linguist . For Credit Unions Only to access ezLink, CLICK HERE. The Creditor Beneficiary is the irrevocable beneficiary meaning that it cannot be changed. A 1500 Health Insurance Claim Form is normally associated with clinic or physician visits. Continuing claim forms should be submitted no sooner than the date listed on your Explanation of Benefits (EOB) statement. This product is underwritten by Philadelphia American Life Insurance Company, a member of the New Era Family of Companies. I didnt realize I had the insurance until recently. Cleveland, OH 44181. Benefits are paid for Internal Cancer, Heart Attack, Stroke, End Stage Renal Failure, Major Organ Transplant, Coronary Artery Bypass and Angioplasty. Long Term CareCall Med America(877) 202-6043____________________________________________________________________, Life InsuranceCall Philadelphia American Life Insurance Company(800) 757-0736, Cancer, Disability, Accident Only, Hospital & Critical IllnessCall Philadelphia American Life Insurance Company(800) 554-0092, Agent ServicesCall Philadelphia American Life Insurance Company(800) 554-0092. Your waiting period is shown on your contract. 2.Sign and date the authorization on page two (2). New Era Life Insurance Companies offers a few products, which include life insurance, accident insurance, GAP insurance, critical illness, annuities, and Medicare supplements. %PDF-1.6 % The Uniform Transfers to Minors Act may allow the funds to be given to a custodian for the minor childs use and benefit, if no guardian is named. To speak with a representative call (888) 453-5125. To obtain license information, CLICK HERE. endstream endobj 30 0 obj <>/Subtype/Form/Type/XObject>>stream Unfortunately, it places a tremendous emotional strain on the family and many times accompanied by an overwhelming financial burden. Claim benefits are paid according to the dates you are actually totally disabled and after you have stopped working and your waiting period has been met. Customer Service: Email: Brighthouse Financial . This includes the Philadelphia American Medicare plans and other end-of-life insurance . :#}u[!L"I#-YCc]w8iGddsjGFd2$O6!mc;l1m`dy HWz0X'eB>h8mNa>rcY%Co2.eKx)dgFZ|.-KqKm~'=m'w}9F]Vby!`\,#heJNKBu{77LU,\E1#&[5$5?>^x|B]p&ea:y/}*k$2Xv New Era was incorporated in 1924 and is a family of companies that includes New Era Life Insurance Company of the Midwest and Philadelphia American Life Insurance Company. Choose an amount for your life insurance policy: $10,000 $15,000 $20,000 $25,000 outdoor chair cushion slipcovers The following review is an analysis of one of the most recognized players in its industry. CSO recommends you contact your lender in order to assure your account remains current. If a special You can use your benefit to help pay toward costly medicine, medical bills, co-pays or even travel and lodging associated with cancer treatment. For assistance by TTY: dial 711 and ask to be connected to 1-800-779-5433, Monday through Friday, 7:00 a.m. to 5:00 p.m. CST. Your financial security is most threatened when you are told by a physician that you have suffered a heart attack or stroke or that the tissue taken during a biopsy is, in fact malignant. CSO may also request an Authorization to Disclose Personal Information form be completed by the next of kin (if required). (Philadelphia Insurance Companies), COVER-PRO APPLICATION MARKETING CONSULTANT SUPPLEMENT rocess for cre (Philadelphia Insurance Companies), COVER-PRO APPLICATION MEDICAL BILLING SERVICE SUPPLEMENT Yes No (Philadelphia Insurance Companies), COVER-PRO APPLICATION MEDICAL TRANSCRIPTIONIST SERVICE SUPPLEMENT (Philadelphia Insurance Companies), APPLICATION COVER-PRO MORTGAGE BANKER AND BROKER SUPPLEMENT (Philadelphia Insurance Companies), COVER-PRO APPLICATION ORGANIC CERTIFYING ENTITIES (Philadelphia Insurance Companies), COVER-PRO APPLICATION PRINTER SUPPLEMENT nts 2. 0.749023 g Need help? Do not include sensitive information in your email to us. ]mLYa&}`qW03SXW d( g`-G)@ a" Obtaining affordable health care coverage is one of the top concerns for most people today. f For more information visit the Claim Center. PO Box 818005. Your agent or claim representative will let you know if you need to provide anything else. though he thought little of prominent New Left intellectuals Herbert Marcuse and Erich Fromm and preferred the company of activists to that . CSO recommends keeping the loan current until CSO has all the required information necessary to make a claim determination. This is not a secure email unless secured from the sender's email service. When you visit any website, it may store or retrieve information on your browser, mostly in the form of cookies. CSO recommends you continue to keep your loan current until CSO has all the required information necessary to make a claim determination. I was disabled while I was making my loan payments. Disclosure Information Form View AM Best's Rating Disclosure Form. Prompt notification on your part, which triggers a prompt response from us, works to reduce the expenses associated with most auto, property, and third party liability claims. All rights reserved. Allstate Digital Life Claims endstream endobj 15 0 obj /Filter<>/PubSec<>>>/Reference[<>/Type/SigRef>>]/SubFilter/adbe.pkcs7.detached/Type/Sig>>>>/Type/Catalog>> endobj 16 0 obj <>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/Tabs/R/Type/Page>> endobj 17 0 obj <>/Subtype/Form/Type/XObject>>stream Philadelphia American Life Insurance Company. Due to scheduled maintenance on Sunday, February 19, 2023 from 5:00 AM to 8:00 AM CST, our website will be unavailable. Yes, as long as the beneficiary and the funeral home have a signed contract. What are the Benefits of Health Insurance? The first claim form is considered the initial notice of the total disability. To learn more about which health plan is right for you call, This is not a secure email unless secured from the sender's email service. Our mission at Fill is simple: To be the easiest way to complete and sign PDF forms, for everyone. Administrative Office . Industry Forms; Purchasing (Vendors) Other DCI Websites. Or if you prefer, . To obtain a Disability Claim Form, CLICK HERE. This information may affect or compromise your benefits. /Tx BMC We help customers realize their hopes and dreams by providing the best products and services to protect them from life's uncertainties and prepare them for the future. In order to give you the most efficient service, we have provided links to allow our customers to change policy information, report claims, or make a payment directly to your insurance carrier. The Creditor Beneficiary is the irrevocable beneficiary, meaning that it cannot be changed. /Tx BMC Sending in the claim forms early can actually delay the claim benefit. . You can contact your Allstate agent at 1-800-366-3495 or fill out a claim notification formto begin the process. Philadelphia American Life Insurance Company PO Box 34952 Omaha, NE 68134-9832 CANCER SCREENING REIMBURSEMENT CLAIM FORM (C16) . *YO"fO>TQ63bEk:E Application - Solar Panel Supplemental36-9179. You may want to retain a copy for your . They are located in Houston, Texas. The loss of a loved one creates a ripple effect. Policyholders - Issued prior to 2011Call Philadelphia American Life Insurance CompanyPolicyholder Services: (800) 541-2363Agent Services: (800) 554-0092, To find a dentist through the DenteMax Network, CLICK HERE. Please state the (Philadelphia Insurance Companies), COVER-PRO APPLICATION TECHNICAL WRITER SUPPLEMENT % Professional % (Philadelphia Insurance Companies), COVER-PRO APPLICATION TELECOMMUNICATIONS CONSULTANT SUPPLEMENT ross annual revenue (Philadelphia Insurance Companies), COVER-PRO APPLICATION TICKET BROKER SUPPLEMENT 2. /Tx BMC If incomplete information is provided at the onset of the claim, it can cause delays in the claim handling. All insurance and/or securities transactions require signed agreements between New Era Life Insurance Companies and its customers, and the terms of those agreements are . Less worry. hbbd```b``z "d% dv``r d\ D6A@vd^Xw1XM$ $y30],8L_ $Zw Feel like you are wasting time editing, filling or sending Free fillable Philadelphia Insurance Companies PDF forms PDF forms? Gain peace of mind today. The faster Philadelphia Insurance Companies receives your new notice of loss, the quicker we can assist in managing the necessary claim recovery services, to expedite the claim settlement process. Houston, TX 77210-4884. Fill has a huge library of thousands of forms all set up to be filled in easily and signed. EMC No other representation, whether made in person, on-line, electronically, If the loan was paid off prior to the Scheduled Expiration Date of the Insurance and benefits are still due for the period of total disability prior to date the loan was paid off, then payments will be made directly to you. endstream endobj 25 0 obj <>/Subtype/Form/Type/XObject>>stream Full name (Philadelphia Insurance Companies), APPLICATION COVER-PRO FINANCIAL PLANNERCONSULTANTADVISER SUPPLEMENT (Philadelphia Insurance Companies), COVER-PRO APPLICATION FUNDRAISING CONSULTANT SUPPLEMENT r ual re (Philadelphia Insurance Companies), COVER-PRO APPLICATION GRANT COORDINATOR WRITER SUPPLEMENT oss (Philadelphia Insurance Companies), COVER-PRO APPLICATION HANDWRITING DOCUMENT ANALYST SUPPLEMENT n (Philadelphia Insurance Companies), COVER-PRO APPLICATION HOTEL MOTEL MANAGER SUPPLEMENT t (Philadelphia Insurance Companies), COVER-PRO APPLICATION INTERIOR DESIGNER DECORATOR SUPPLEMENT 2. Please complete a separate claim form for each family member. Youll need the following information to begin your claim. To learn more about which health plan is right for you call 800-552-7879 or email healthinsurance@neweralife.com. rAL,-r`|B+ File a Claim Form Directory Go Paperless AN Mobile Insurance keyboard_arrow_down. BOSTON MUTUAL LIFE INSURANCE COMPANY . To speak with a representative, call (833) 522-4874, ___________________________________________________________________________. Annuity/Group Annuity policies generally start with "CAC": 800-304-3454. %%EOF U.S. Customers filing an INITIAL INVOLUNTARY UNEMPLOYMENT INSURANCE (IUI) Claim, please file and upload your documents here. PO Box 4884. Box 25160 Oklahoma City, OK 73125 Fax: 800-818-3453. 0 0 8.9555 10.0954 re OurHealth Saver Indemnity Plan can help provide families with peace of mind by providing health insurance benefits they can afford. For Bank DCC Programs -To access ezDCC, CLICK HERE. 0 If CSO is in receipt of conflicting information, CSO may request additional documentation of your loss, or to determine if your loss is impacted by a pre-existing condition, or to validate your eligibility for coverage. To review Frequently Asked Questions, CLICK HERE. Please return a copy to us along with the completed claim form. /Tx BMC Form Preview Example. My loan payment is due on the 15th. Your contract specifies under the Proof of Loss provision that written proof of loss must be furnished no later than 15 months (18 months in Hawaii) after the date of loss, unless you are legally incapacitated. Credit disability insurance provides a benefit designed to pay the scheduled loan payment, or a portion of it, in the event of your total disability due to a covered sickness or injury. 2023 New Era Life Insurance. Please (Philadelphia Insurance Companies), COVER-PRO APPLICATION GA, SD, WV CLAIMS ADJUSTER SUPPLEMENT (Philadelphia Insurance Companies), COVER-PRO APPLICATION CLAIMS ADJUSTER SUPPLEMENT (Philadelphia Insurance Companies), COVER-PRO APPLICATION GA, SD, WV COURT REPORTER SUPPLEMENT (Philadelphia Insurance Companies), COVER-PRO APPLICATION COURT REPORTER SUPPLEMENT 2. The American-Amicable Group of Companies is headquartered in the historic ALICO Building in Downtown . EMC Is the (Philadelphia Insurance Companies), COVER-PRO APPLICATION TRANSLATOR, INTERPRETER SUPPLEMENT Translation services: % (Philadelphia Insurance Companies), COVER-PRO APPLICATION TRAVEL AGENT SUPPLEMENT cent twelve (12) (Philadelphia Insurance Companies), COVER-PRO APPLICATION TRAVEL AGENT SUPPLEMENT ) months gross (Philadelphia Insurance Companies), COVER-PRO APPLICATION TUTOR SUPPLEMENT 2. Topics for Consumers within the Missouri Department of Insurance, Financial Institutions & Professional Registration. Supplement - Special Events-Liquor Liability Supplement36-9388. ConsumersTo sign your CSO electronic application, CLICK HERE.To obtain a free online Medicare Supplement Quote, CLICK HERE. With more than 90 years of emergency services experience, Provident has dedicated and caring claims staff who remain committed to timeliness and accuracy while processing your claim. To find out more information about Philadelphia American Medigap plans, contact a Philadelphia American Medicare Supplement representative today or use our quote form below. Find company research, competitor information, contact details & financial data for Philadelphia American Life Insurance Company Inc of Houston, TX. Please refer to your contract as it provides information about your rights and CSOs rights. The Creditor Beneficiary is the name of the lender to whom loan payments are made. If youre working with an agent, theyll also be sent the same packet. More life. The fields of these forms can be completed online but must be printed and signed prior to being returned to our office. endstream endobj 24 0 obj <> endobj 25 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB]/XObject<>>>/Rotate 0/Type/Page>> endobj 26 0 obj <>stream FNL Policyholders (Effective July 1, 2021) CSO became administrator of the credit insurance policies underwritten by First National Life Insurance Company of the USA. HOME OFFICE: 120 Royall Street Canton, MA 02021 ADMINISTERED BY: PHILADELPHIA AMERICAN LIFE INSURANCE COMPANY . University: 1945-1955 . Critical Illness Insurance is designed to ease the financial pressure by providing a lump sum cash benefit paid directly to you upon the diagnosis of a covered illness. Please call us at (855) 201-8880 to speak to a claim representative with any questions. 77210-4884 Philadelphia American Life provides a variety of Critical Illness options to help protect your financial resources. oklahoma loyal american life insurance company, loyal american insurance duncan ok, oklahoma loyal claim, loyal american life form: 1 2. A Report of Disability claim form and the Authorization to Disclose Personal Information must to be completed after you have been continuously totally disabled beyond your waiting period. Term/UL/Deferred Annuities/Payout Annuities: 866-880-3112. Choose the document or form you need to continue: Application - Salon And Day Spa GL And Property36-11786, Application- Amusement- Parks36-12131 - Amusement Park Application, Application - Builders%27s Risk Ground Up Construction36-8478, Application - Adult Day Care Supplemental36-12813, Application - Human Services - Basic36-9276, Application - Human Services - Comprehensive36-9277, Application - Human Services Renewal36-9278, Application - Human Services Renewal - CA ONLY36-9279, Application - Non Profit Non-Social Service Application36-9280, Application - Residential Care Supplemental36-15854, Application - Sleep Centers And Laboratories36-9281, Application - Trade Association Application36-9282, Supplement - Abuse And Molestation Supplement36-9382, Application - Adoption And Foster Care36-16136, CACommunityService36-8480 CALIFORNIA Race, National Origin and Gender Endorsement, Supplement - Camp Supplement36-9384 - CAMP SUPPLEMENTAL APPLICATION, Supplement - HIV AIDS Personal Care-Residential Questionnaire36-9386 - Application - HIV and AIDS Personal Care Residential Questionnaire, Application Massachusetts Residential Property Liability Liquid Fuel Spill Supplemental36 8481 (Philadelphia Insurance Companies), Application - Medical Professional36-9341, Oklahoma Fire Application Addendum36-8482 - Oklahoma Fire Application Addendum, Social Service Claims Made Supplement36 9387 (Philadelphia Insurance Companies), Application - Solar Panel Supplemental36-9179, Supplement - Special Events-Liquor Liability Supplement36-9388, Non-Profit Special Events Questionnaire36-8437 - SPECIAL EVENTS QUESTIONNAIRE, Water Slide36 9389 (Philadelphia Insurance Companies), Supplemental - Winter Weather Freeze-up36-8483, Event Cancellation - Non-Appearance Application36-9489 - EC - Non-Appearance 7.2016, Application - Child Care Accident Insurance36-10803, Application - Amateur Sports - Accident Application36-9983, Application - Camp Accident Application36-10549, Application - Student Underwriting Questionnaire36-9470, Application - Student Underwriting Questionnaire36-11308, Application - Student Medical Underwriting Questionnaire36-16104, Business Travel Accident Application36-9395, Outbound-Inbound Travel Application36-11989, Formularia De Reclamo Por Accidente36-11007, Business Travel Accident Application36-10802, Outbound-Inbound Travel Application36-10804, Student Medical Underwriting Questionnaire36-10806, Form - Add - Delete - Auto Daily Rental36-11744 - Rental quote template- SCHED PCPM (03-2012), Form - Monthly Premium Reporting - Gross Receipts36-8837 Monthly Premium Reporting Form - Gross Reciepts, Application - Automobile Filing Questionnaire36-8959, Application - Chauffeured Transportation36-10633, Application - Motorcycle Dealerships36-9616, Application - Common Carrier Supplement36-9895, Application - Interim Liability And Physical Damage36-8958 - Application - Interim Liability and Physical Damage, Application - Lessors Contingent And Excess36-11264, Application - Garage Employee Supplemental36-10227 - Application - Garage Employee Supplemental, Application - School Bus Contractor36-11554, Business Income Worksheet For Schools36-11160, Application - Colleges And Universities Supplement36-11161, Application - Educators Professional Select PIIC - Countrywide36-11162, Application - Educators Professional Select PIIC - FL36-10728, Application - Educators Professional Select PIIC - ID36-10241, Application - Educators Professional Select PIIC - KS36-11163, Application - Educators Professional Select PIIC - MA36-11164, Application - Educators Professional Select PIIC - ME36-10838, Application - Educators Professional Select Renewal Countrywide36-11165, Application - Educators Professional Select Renewal PIIC - FL36-10925, Application - Educators Professional Select Renewal PIIC - ID36-11166, Application - Educators Professional Select Renewal PIIC - KS36-9517, Application - Educators Professional Select Renewal PIIC - MA36-11167, Application - Educators Professional Select Renewal PIIC - ME36-10712, Application - Educators Professional Select TMSIC36-10571, Application - Educators Professional Select Renewal TMSIC36-11168, Application - Educational Institutions Security Supplement36-8721, Flexi Plus Give New App - KS%2C MA%2C NY36-10104, Application - Student Housing Supplement36-10786, Application - Vocational Schools Supplemental36-11171 Vocational Schools Supplemental Application, Application - Family Entertainment Centers %28FEC%2936-11594, Application - Paintball Supplemental36-11495, Application - Zipline Supplemental36-11559, Application - Animal Tracks36-8901 - Application - Animal Tracks, Application - Convention Center Supplemental36-14256 - Performing Arts Supplemental Application, Application - Audio Visual Companies36-11009, Application - Boat Dealers New Business Supplemental36-8609, Application - Boat Dealers Renewal Supplemental36-8610 - Application - Boat Dealers Renewal Supplement, Application - Bowling Center Supplemental36-11687, Application - Camp Operators Renewal36-10469, Application - Fireworks - Pyrotechnics36-10470 - Application - Fireworks - Pyrotechnics, Application - Go Kart Supplemental36-10471 - Application - Go Kart Supplemental Application, Application - Water Trampoline Supplemental36-9238, Application - Waterslide-Water Park Supplemental36-10472 - 47FE2EC8, Application - Craft Brewery And Distillery Supplemental36-8438, Application - Craft Brewery And Distillery Renewal36-16355, Application - Fairs And Fairgrounds Supplemental Application36-11027, Application - Audio Visual Companies36-9968, Application - Film Production36-9969 Application - Fairs and Fairgounds Supplemental Application, Application - Photographers - Videographers36-9971, Application - Film Production Short Term36-9972 Application - Fairs and Fairgounds Supplemental Application, Application - Golf - Country Clubs36-8544, Application - Golf Ranges And Miniature Golf Supplemental36-11596, ApplicationGolfPremisesEnvironmentalCoverage36-10840 - Application - Golf Premises Environmental Coverage _PEC_, Application - Golf Liquor Liability Supplemental36-8523 - Golf - Liquor Liability Supplemental Application -FINAL FR, Business Income Worksheet36-10564 - Golf BI Worksheet, Water Slide Supplemental Application (Philadelphia Insurance Companies), Application - Museums And Cultural Institutions Supplemental36-9571, Application Public Library Supplemental36-15841 - Application - Public Library Supplemental - Public Entities, Application - Paintball Supplemental36-10268, Application - Dance Competition Supplemental36-10112, Application - Performing Arts Facilities And Venues Supplemental36-11202 - Performing Arts Supplemental Application, Performing Arts - Troupes Traveling Performers Supplemental Application (Philadelphia Insurance Companies), FacilityTenantUsersLiabilityInsuranceProtectionApplication36-9990 - Facility Tenant Users Liability Insurance Protection Application, Tenant Users Liability Insurance Protection Supplemental Application (Philadelphia Insurance Companies), Application - Tenant Users Liability Reporting Form36-10170, Application - Affordable Housing36-9569 - Application - Affordable Housing, New Business Application - Condo - HOA Association36-9540 - Application - Condominium-Homeowner Association - DO Flex Prot plus, Application - HOA And Condo Renewal36-8477, Application - Homeowners Association %28PUD%29 Supplement - FULL Amenities36-10557, Application - Homeowners %28PUD%29 Supplement With LIMITED Amenities36-9467, Application - Renewal Supplement - Lake Questionnaire36-9634 Renewal Application - Lake Questionnaire, Application - Mobile Home Park Renewal36-10451, Application - Healthcare Auto Supplemental36-9042 (Philadelphia Insurance Companies), LODGE & RESORT APPLICATION (Philadelphia Insurance Companies), MARINA OPERATORS LEGAL LIABILITY APPLICATION (Philadelphia Insurance Companies), BACKPACKING AND HIKING SUPPLEMENTAL APPLICATION (Philadelphia Insurance Companies), CLIMBING WALL SUPPLEMENTAL APPLICATION* (Philadelphia Insurance Companies), CONCERT SUPPLEMENTAL APPLICATION* (Philadelphia Insurance Companies), CROSS COUNTRY SKIING SUPPLEMENTAL APPLICATION (Philadelphia Insurance Companies), FITNESS CENTER OR SPA SUPPLEMENTAL APPLICATION* (Philadelphia Insurance Companies), GOLF COURSE SUPPLEMENTAL APPLICATION* (Philadelphia Insurance Companies), ICE SKATING SUPPLEMENTAL APPLICATION* (Philadelphia Insurance Companies), IN-LINE SKATINGSKATEBOARDING SUPPLEMENTAL APPLICATION (Philadelphia Insurance Companies), LIQUOR LIABILITY SUPPLEMENTAL APPLICATION (Philadelphia Insurance Companies), PAINTBALL SUPPLEMENTAL APPLICATION* (Philadelphia Insurance Companies), ROPESCHALLENGE COURSE SUPPLEMENTAL APPLICATION* (Philadelphia Insurance Companies), SNOW SLEDDING SUPPLEMENTAL APPLICATION (Philadelphia Insurance Companies), WAGON OR SLEIGH SUPPLEMENTAL APPLICATION (Philadelphia Insurance Companies), HEALTH AND FITNESS CLUB SUPPLEMENTAL APPLICATION (Philadelphia Insurance Companies), HEALTH & FITNESS CLUB RENEWAL SUPPLEMENTAL APPLICATION (Philadelphia Insurance Companies), HIGH INTENSITY FUNCTIONAL FITNESS APPLICATION AND RISK SURVEY (Philadelphia Insurance Companies), HEALTH CLUB CHILD CARE SUPPLEMENTAL APPLICATION (Philadelphia Insurance Companies), HEALTH & FITNESS CLUB Climbing Wall Supplemental Application (Philadelphia Insurance Companies), WATER SLIDE SUPPLEMENTAL APPLICATION (Philadelphia Insurance Companies), FITNESS STUDIO GENERAL LIABILITY AND PROPERTY APPLICATION (Philadelphia Insurance Companies), MARTIAL ARTS STUDIO GENERAL LIABILITY AND PROPERTY APPLICATION (Philadelphia Insurance Companies), SALON AND DAY SPA RENEWAL APPLICATION If any (Philadelphia Insurance Companies), YOGA STUDIO GENERAL LIABILITY AND PROPERTY APPLICATION (Philadelphia Insurance Companies), FEEDLOT SUPPLEMENTAL (Philadelphia Insurance Companies), FRUIT AND VEGETABLE GROWERS PACKERS SHIPPERS SUPPLEMENTAL (Philadelphia Insurance Companies), FRUIT AND VEGETABLE GROWERS - 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