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2023 HSR Accident & Sickness Claim Form

(Only for incidents that occurred in 2023) Claim form for Health Special Risk (HSR) insurance policy for incidents occurring in the calendar year 2023. Use this form to process a claim in the event of an accident or other applicable incident within 90 days. This form is only needed in the event of a claim. Fill out the form and process it directly through HSR, the third-party insurance company through which Cascade Pacific Council has purchased unit accident insurance for each Scouting unit.

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