Notice of Insurance Claim
Name of insured:
To Whom It May Concern:
Please be advised that an accident occurred on at the following location: .
|property damage only||
|personal injury only||As a result of this accident I received injuries.|
|property damage and injury||
The person named above (Name of Insured) was involved in the incident. Please confirm in writing to the address below your liability coverage of the insured identified above. Please also advise whether your insured contends that anyone other than your insured may be in whole or in part legally responsible for accidents on or near the accident site or premises, or for this accident.
If necessary, I may be reached by telephone at the number below. Thank you for your prompt attention to this matter.
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