HomeMy WebLinkAboutNotice of Loss 2/23/26 Hanover
Insurance Group
PO Box 15147
Worcester, MA 01615-0147
Telephone: 800-628-0250 Ext. 5796745
Fax Number: 508-926-5660
February 25, 2026
Town Clerk of Yarmouth 2Q26
1146 Route 28 �
South Yarmouth, MA 02664
Re: Our Insured: Kathleen Farley
Claim Number: 85-00922182
Date of Loss: 02/23/2026
Claimant:
Policy Number: HVN H351869
Property Address: 114 SULLIVAN RD,WEST YARMOUTH MA 02673
Dear Town Clerk of Yarmouth:
Claim has been made involving loss, damage or destruction of the above captioned property,
which may either exceed $1,000.00 or cause Mass. General Laws, Ch. 143, Sec. 6 to be
applicable. If any notice under Mass. General Laws, Ch. 139, Sec. 3B is appropriate, please direct
it to the attention of the undersigned and include a reference to the captioned insured, location,
policy number, date of loss, and claim number.
On this date, I caused copies of this notice to be sent to the persons named above at the
addresses indicated above by first class mail.
Sincerely,
?ajn-ai�a �/c�9��Glm
Tamara Brown
Associate Adjuster- Property
Massachusetts Bay Insurance Company
tabrown@hanover.com
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Fraud Warning Statement for all States (except as individually listed below):
Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance containing any
materially false information or conceals,for the purpose of misleading,information concerning any fact material thereto commits a fraudulent
insurance act,which is a crime and subjects that person to criminal and civil penalties(In Oregon,the aforementioned actions may constitute a
fraudulent insurance act which may be a crime and may subject the person to penalties).(In New York,the civil penalty is not to exceed five
thousand dollars($5,000)and the stated value of the claim for each such violation).(Not applicable in AL,AR,AZ,CA,CO,DC,FL,KS,LA,ME,MD,
MN,NM,OK,PR,RI,TN,VA,VT,WA and WV).
APPLICABLE IN AL, AR, DC, LA, MD, NM, RI, TX (Workers' Compensation Only), and WV:
Any person who knowingly(or willfully in MD)presents a false or fraudulent claim for payment of a loss or benefit or who knowingly(or willfully
in MD)presents false information in an application for insurance is guilty of a crime and may be subject to fines or confinement in prison.
APPLICABLE IN ARIZONA: For your protection Arizona law requires the following
statement to appear on this form. Any person who knowingly presents a false or
fraudulent claim for payment of a loss is subject to criminal and civil penalties.
APPLICABLE IN CALIFORNIA: For your protection California law requires the following to appear on this form.
Any person who knowingly presents false or fraudulent information to obtain or amend insurance coverage or to
make a claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state
prison.
APPLICABLE IN COLORADO: It is unlawful to knowingly provide false, incomplete, or misleading facts or
information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties
may include imprisonment, fines, denial Of insurance and civil damages. Any insurance company or agent of an
insurance company who knowingly provides false, incomplete, or misleading facts or information to a policyholder or
claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to a
settlement or award payable from insurance proceeds shall be reported to the Colorado Division of Insurance within
the department of regulatory agencies.
APPLICABLE IN DELAWARE, FLORIDA and OKLAHOMA: Warning: Any person who knowingly, and with intent
to injure, defraud or deceive any insurer, makes any claim for the proceeds of an insurance policy containing any
false, incomplete or misleading information is guilty of a felony (In FL, a person is guilty of a felony of the third
degree).
APPLICABLE IN KANSAS: Any person who, knowingly and with intent to defraud, presents, causes to be presented
or prepares with knowledge or belief that it will be presented to or by an insurer, purported insurer, broker or any
agent thereof, any written statement as part of, or in support of, an application for the issuance of, or the rating of
an insurance policy for personal or commercial insurance, or a claim for payment or other benefit pursuant to an
insurance policy for commercial or personal insurance which such person knows to contain materially false
information concerning any fact material thereto; or conceals, for the purpose of misleading, information concerning
any fact material thereto commits a fraudulent insurance act.
APPLICABLE IN MAINE, TENNESSEE, VIRGINIA, WASHINGTON AND NORTH CAROLINA:It is a crime to
knowingly provide false, incomplete or misleading information to an insurance company for the purpose of
defrauding the company. Penalties may include imprisonment, fines or a denial of insurance benefits.
APPLICABLE IN INDIANA: A person who knowingly and with intent to defraud an insurer files a statement of
claim containing any false, incomplete, or misleading information commits a felony.
APPLICABLE IN KENTUCKY: Any person who knowingly and with intent to defraud any insurance company or
other person files a statement of claim containing any materially false information or conceals, for the purpose of
misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime.
APPLICABLE IN NEW HAMPSHIRE: Any person who with a purpose to injure, defraud or deceive any insurance
company, files a statement of claim containing false, incomplete or misleading information is subject to prosecution
and punishment for insurance fraud, as provided in RSA 638:20.
APPLICABLE IN MINNESOTA: A person who files a claim with intent to defraud or helps commit a fraud against
an insurer is guilty of a crime. MN Workers' Compensation Only: Any person who with intent to defraud,
receives workers compensation benefits to which the person is not entitled by knowingly misrepresenting,
misstating, or failing to disclose any material fact is guilty of theft and shall be sentenced pursuant to section
609.52, subdivision 3.
PENNSYLVANIA Motor Vehicle Only: Any person who knowingly and with intent to injure or defraud any insurer
files an application or claim containing any false, incomplete or misleading information shall, upon conviction, be
subject to imprisonment for up to seven years and payment of a fine of up to $15,000.
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