HomeMy WebLinkAboutInsurance Claim MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108-1904
(617)723-3800 Ma Only(800)392-610.., FPO;;800)851-8424
9/5/2019
Form of Notice of Casualty Loss Su': "rig
Under Mass.Gen.Laws,Ch.139,
YARMOUTH BUILDING DEPT
1146 ROUTE 28
SOUTH YARMOUTH MA 02664
Re: Insured: FREDERICK CONNELLY
Property Address: 88 MASSACHUSETTS AVE,WEST YARMOUTH,MA 02673
Policy Number: 0775392
Type Loss: Windstorm Other than Hurricane or Ton
Date of Loss: 08/22/2019
Claim Number: 442179
Claim has been made involving loss,damage or destruction of the above captiory property,which may either
exceed$1000.00 or cause Massachusetts General Laws,Chapter 143,se(: an 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