Claim ID: 16513
Submitted: Nov-16-2018
Requested Processing: Photos required
Name: Evasax
Email: jbueme@probbox.com
Company: google
Phone: 85981695743
Their Claim No.:
Insured:
Policy No.:
Date of Loss: 1975-10-10
Insured Address: New York
Insured Telephone: 83876515741
Claimant Address: New York
Claimant Telephone: 84952245723
Loss Location
USA
Local Authorities:
Loss Description: ventolin hfa inhaler
Handling Instructions: ventolin hfa inhaler