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Insurance Claim Notice
INSURANCE CLAIM NOTICE
[Date]
[Mr/Mrs/Ms/Dr] [First Name of receipient] [Last Name of receipient]
[Title of receipient]
[Company of receipient]
[Address of receipient]
[City of receipient], [State of recipient] [Zip Code of receipient]
Dear [Mr/Mrs/Ms/Dr] [Last Name of recipient]:
You are hereby notified that we have incurred a loss covered by insurance you underwrite. The claim information is as follows:
1. Type of Loss or Claim: [Type of Loss or Claim]
2. Date and Time Incurred: [Date and Time Incurred]
3. Location: [Location]
4. Estimated Loss or Casualty: [Estimated Loss or Casualty]
Please forward a claim form or have an adjuster call me at the below telephone number.
Very truly,
Signature Date
Policy Number [Policy Number]
Name [Name of Sender]
Address [Address of Sender]
Telephone No. [Work Telephone No. of Sender]
Telephone No. [Home Telephone No. of Sender]