Preliminary Advice of Loss Form
Preliminary Advice of Loss Form
Dear Sir/Madam
We regret to advise of an accident/loss reported to us and a probable claim, the particulars of which
are as follows:
2. Policyholder : __________________________________________________
Policy No : _________________
Completed Notice of Claim is attached / will be sent to you with further particulars in due course.
Thank you.
Yours faithfully
______________________________________________
Name : ________________________________________________________________
Address : ________________________________________________________________
________________________________________________________________
PAL 14122015