INSURANCE CLAIM NOTICE
INSURANCE CLAIM NOTICE
Date :
To _______________
_______________
_______________
Dear _______________
You are hereby notified that I have incurred a loss which I believe is covered by my insurance policy detailed below. Details of the loss are as follows:
1. Type of loss or claim: _______________
2. Date and time incurred: _______________ _______________
3. Location: _______________
4. Estimated loss: _______________
Please forward a claim form to me as soon a possible.
Yours sincerely
Home Phone _______________
Work Phone _______________
Policy Number _______________