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Letter Notifying Insurance Company of a Claim

Notice of Insurance Claim on the Policy of Another due to Motor Vehicle Accident. This is a form notice to the insurance carrier of a person involved in a motor vehicle accident.
Format: Word | Rich Text
$14.95
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Notice of Insurance Claim on the Policy of Another due to Motor Vehicle Accident

_______________________
(Date)
_________________________________
(Name of Insurance Company or Agent)                                                                          
___________________________________________________
(P. O Box or Street Address, City, State, Zip Code)
 Re: ___________________; Policy Number ___________________
  (Name of Insured)

To Whom It May Concern:
 Please be advised that the undersigned ____________________ (Name) received injuries and sustained property damage in an accident on ________________ (date), at the following location:

etc.

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Letter Notifying Insurance Company of a Claim
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