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We are pleased to inform you that the following claims have been approved.
Regards,
Noted by:
____________________________________________________________________________________________
We regret to inform you that the remaining amount of the following claims have been denied by our provider due to
the following reasons:
Pre-existing illness and are still within the one year contestability period.
NO. CODE NAMES OF STATUS DATE DATE OF NO OF DAYS BRANCH CAUSE OF DEATH
INSURED ENROLLED DEATH
1 221.19 DATUIN, DENIED 03/08/2019 05/04/2019 56 ROXAS CARDIOVASCULAR
JEFFERSON O REMAINING ARREST