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The document is a Long Term Care Claim Form provided by Unum Group, detailing the process for policyholders to file claims for long-term care benefits. It outlines the necessary information and documentation required, including personal details, medical conditions, assistance with Activities of Daily Living (ADLs), and supervision needs due to cognitive impairments. The form emphasizes the importance of accurate information to prevent fraud and includes sections for both the claimant and attending physician to complete.

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Versions	Form popularity	Fillable & printable
2021	4.9 Satisfied (58 Votes)
2020	4.8 Satisfied (45 Votes)
2015	4.3 Satisfied (91 Votes)
2014	4 Satisfied (23 Votes)

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