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  • Claims Department (Transmittal)

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    ARlapuz
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    This document is a transmittal from an insurance agency to an insurance claims department providing documents related to an insurance claim. It includes the date, addresses of both parties, and a list of documents being transmitted for a specific policy owner and their claim, including claimant statements, medical records, test results, receipts, and identification documents.

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    This document is a transmittal from an insurance agency to an insurance claims department providing documents related to an insurance claim. It includes the date, addresses of both parties, and a list of documents being transmitted for a specific policy owner and their claim, including claimant statements, medical records, test results, receipts, and identification documents.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    13 views1 page

    Claims Department (Transmittal)

    Uploaded by

    ARlapuz
    This document is a transmittal from an insurance agency to an insurance claims department providing documents related to an insurance claim. It includes the date, addresses of both parties, and a list of documents being transmitted for a specific policy owner and their claim, including claimant statements, medical records, test results, receipts, and identification documents.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    of 1

    TRANSMITTAL

    DATE: AUG 05, 2022

    TO: CLAIMS DEPARTMENT


    6F UPTOWN PLACE TOWER 1, 1 EAST 11TH DRIVE, UPTOWN BONIFACIO
    1634 TAGUIG CITY, METRO MANILA, PHILIPPINES

    FORM: DTE INSURANCE AGENCY


    2ND FLOOR UNIT 10 KESTER BLDG. MAHARLIKA HI-WAY, BRGY. ILAYANG IYAM
    LUCENA CITY, QUEZON, PHILIPPINES.

    RE: DOCUMENTS

    CLAIMS POLICY OWNER DOCUMENTS


    AMR,DHI DEMIN,MARIA PN15108461-CLAIMANT STATEMENT,APS,PDP,CLINICAL/DISCHARGE
    LUISA VILLAS SUMMARY,RECORD OF OPERATION,HEMATOLOGY,URINALYSIS,BLOOD
    BANK,ROENTGENOLOGICAL REPORT,RAPID ANTIGEN TEST,PHYSICIAN
    ID,MEDICAL CERT,BIRTH CERT,PLI ID, PO IDs,INCIDENT REPORT,OFFICIAL
    RECEIPTS,SOA,PRESCRIPTION,XRAY

    PREPARED BY: ARIEL LAPUZ

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