Click the tabs below to see forms related to each chapter of Division 69L (Workers' Compensation) of the Florida Administrative Code. Please complete the following forms included in this Accident Benefits Claim Packet.Refer to your group insurance certificate for covered benefits. 1. Please use the checklist below to indicate the operation in the QBE Pacific Islands region to which you will be submitting your proposal. MARKET. This insurance company is licensed to issue insurance policies in Florida. Accident insurance from UnitedHealthcare is designed to help cover deductible gaps and daily living expenses with a cash benefit for unexpected injuries. Forms for members enrolled in individual, family and employer plans with Florida Blue.