HomeMy WebLinkAboutClaim of Loss MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108-1904
(617)723-3800 Ma Only(800)392-6108,FAX(800)851-8424
12/12/2018
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: FRANCISAWHITE
Property Address: 3 CAPTAIN PERCIVAL ROAD,SOUTH YARMOUTH, MA 02664
Policy Number: 1125099
Type Loss: Water Damage:All Other Water Damage
Date of Loss: 04/1212018
Claim Number: 434477
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 isnppro'priate,please'd?iict 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.
MPLUA Claims Division
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