Claim ID: 17497
Submitted: Dec-01-2018
Requested Processing: Photos required
Name: Janesax
Email: jbschreib@probbox.com
Company: google
Phone: 89199123272
Their Claim No.:
Insured:
Policy No.:
Date of Loss: 1979-11-12
Insured Address: San Jose
Insured Telephone: 89242211565
Claimant Address: San Jose
Claimant Telephone: 87579232978
Loss Location
USA
Local Authorities:
Loss Description: xenical pills
Handling Instructions: xenical pills