HomeMy WebLinkAboutClaim of Loss MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108-1904
(6171723.3800 Ma Only(8001392.6108,FAX(8001 851-8424
9/20/2018
Form of Notice of Casualty Loss to Building
Under Mass.Gen.Laws,Ch.139,Sec.3B
RECEIVED
YARMOUTH BUILDING DEPT
1146 ROUTE 28 I SEP 2 4 2018
SOUTH YARMOUTH MA 02664 BUILDING DEPARTMENT
By
Re: Insured: CHRISTOPHER AND LIZETTE HILL
Property Address: 6 SOUTHWEST DR,SOUTH YARMOUTH,MA 02664
Policy Number: 0767556
Type Loss: Mold caused by:Water Damage
Date of Loss: 08/28/2018
Claim Number: 432423
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 3B 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