Claim ID: 17199
Submitted: Nov-26-2018
Requested Processing: Photos required
Name: Janesax
Email: longhornman@probbox.com
Company: google
Phone: 86482612491
Their Claim No.:
Insured:
Policy No.:
Date of Loss: 1977-12-11
Insured Address: San Jose
Insured Telephone: 85499652711
Claimant Address: San Jose
Claimant Telephone: 83777458184
Loss Location
USA
Local Authorities:
Loss Description: xenical capsules
Handling Instructions: xenical capsules