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HOSPITAL CONFINEMENT INDEMNITY (GAP) CLAIM FORM
WebFidelity National Financial, Inc. ("FNF") (NYSE:FNF) is a leading provider of title insurance and transaction services to the real estate and mortgage industries. Webthe information disclosed pursuant to this Authorization to administer the above referenced individual's health insurance coverage. I authorize Fidelity Security Life Insurance Company or its reinsurers to make a brief report of my protected health information to MIB. A photographic copy of this Authorization shall be as valid as the original. hairstyles for women over 60 for 2023
Fidelity Security Health Insurance Company
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