HomeMy WebLinkAboutClaim of Loss MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108-1904
16171 723-3800 Ma Only 18001392.6108,FAX(8001 851.8424
8/8/2018
• Form of Notice of Casualty Loss to Building
Under Mass,Gen.Laws,Ch.139,Sec.3B
YARMOUTH BUILDING DEPT
1146 ROUTE 28
SOUTH YARMOUTH MA 02664
Re: Insured: KATHARINE CLEARY AND MICHAEL RHINES
Property Address: 300 BUCK ISLAND ROAD UNIT 9C,WEST YARMOUTH.MA 02673
Policy Number: 1404416
Type Loss: Water Damage:All Other Water Damage
Date of Loss: 08/05/2018
Claim Number: 431137
Claim has been made involving loss,damage or destruction of the above captioned property,which may either
exceed$1000.00 or cause Massachusetts General Laws Chapter 143,section 6 to be applicable. If any
notice under Massachusetts General Laws,Chapter 139,Section 38 is appropriate,please direct it to the
attention of the writer and include a reference to the captioned insured,location,policy number,date of loss
and claim or file number.
MPIUA Claims Division
cMA00021
AUG 132018I
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