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Pca
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_SETUP.1
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ROR.BLD
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Text File
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1997-07-22
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2KB
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68 lines
#100
@001 Enter the name of the INSURED:
~Enter the name of the insured under the policy.
@003 Enter the nature of the investigated incident:
~Briefly explain the type of claim which is being investigated.
~For example: robbery.
|004 Enter the date of the incident:
~Enter the date of the incident which is being investigated.
@010 Enter the address of the insured:
~Enter the street address of the insured.
@020 Enter the city of the insured:
~Enter the city where the insured resides.
@030 Enter the state of the insured:
~Enter the where the insured resides.
@040 Enter the zip code of the insured:
~Enter the zip code of the insured.
@090 Enter the title of signatory:
~Enter the title held by the person sending the reservation of
~rights under the policy. For example: Claims Manager/
@100 Enter the name of the INSURANCE COMPANY:
~Enter the name of the insurance company.
@005 Enter the policy number:
~Enter the policy number.
#end control section
#100
To:
@001
@010
@020 @030 @040
Policy number: @005
Date of incident: @004
We have received a report concerning @003, on @004. Please be
advised that we will continue to investigate this incident.
However, we are investigating this matter solely under a
reservation of all rights, including the right to disclaim
coverage under this policy. None of our actions in this regard
are to be construed as a waiver of any of the rights of our
company.
We will advise you as soon as possible concerning our company's
decision as to whether or not our policy provides coverage for
this incident.
Dated: _____________________________
For @100:
________________________________________
Title: @090