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Arkansas and North Dakota (Use for employeemember and dependent injury claims)

Arkansas and North Dakota (Use for employeemember and dependent injury claims) 2025

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The document outlines the procedures and requirements for filing a group insurance claim with The Prudential Insurance Company of America. It includes sections for claimant information, employee details, insurance coverages, payment options, and an authorization for the release of medical information. Additionally, it describes the Alliance Account settlement option for beneficiaries receiving life insurance payments, detailing how funds are managed and accessed. The document also contains important legal warnings regarding fraudulent claims and state-specific regulations.

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