HomeMy WebLinkAboutInsurance Letter - Correspondence - 86 UNION STREET 12/23/2022 er
tnsurance GrolupO
P10, Box 15,145
Worcester MA 0,1615-0145
Telephone',,, 8010-6,28-02,50 Ext: 8,555400
Fax Number: 508-19126-56,601
January 26,, 2023,
TOWN CLERK
120 MAIN ST
NORTH ANDOVER MA 018451
R,e Our Insured: 'Edward Snell
Polilcy Number,-.1, HPN 7376092
Claim Numbet": 85-002925571001
Date of Loss-,, 12/23/2022
Propert'y Addriess-NI, 816 UNION ST NORTH ANDOVER MA
To whom it may coricern:1,
Yf
Claim,, has, been, made involving loss, damage or destruction of the above captioned propert
w h I c h m a y' e i th e r, ex�,ce ed 1,0 01 0-0 0 o r ca U1s e M"a s s, G e n e ra I LgLAs Sec., 6 to be
applicable, If any, notice under- Mass. General Lam5 3,--Ch. 1, 3B ils appropriate, please
eno he 'i,nred,
d"rect it to the, attention of the undersigned and include a refier- ce t t , captioned s u
lociatioln,, policy number, date, oflosS, and claibi number.
On this date,, I callsed copilies of this notice to, be sent, to thile persons, Anamed above at the
addressies indicatied above by, first class mail.
Sincerely,
Aimanda Braidley
Associate, Adjuster
The Citizens Insurance Company, of America
Page I of I
Fraud Warning Statement for all States(except as individually listed below):
Any person who knowing[- and with intent to defraud any insurance company or other person files an application for insurance
containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material
thereto commits a fraudulent insurance act, which is a crime and subjects that person to criminal and civil penalties In Oregon, the
aforementioned actions rimy constitute a fraudulent insurance act which may-be a crime and may subject the person to penalties). (In
NewYork,the civil penalty is not to exceed fire'thousand dollars( 5, 00)and the Stated value of the claim,for each such violation).(Not
applicable In AL,AR,AZ, CA,CO, DC, FL, KS, LA, ME, M D, MN, NM,OK, PR, R1,TN,VA,VT,VIA and w).
APPLICABLE IN AL, AR, DC, LA. MD, NM, Ri, T (Workers" Compensation Only), and V; Any person
who knowingly r willfully in MD presents .a false or fraudulent claim for payment of a loss or benefit or who
knowingly wingly(or willfully in MD) presents false inf rmation in an application for insurance is guilty of a crime and may be sub-
ject to fines or confinement in prison.
APPLICABLE IN AF I NA: For your protection Arizona laver requires the following statement t
appear on this form.. Any person who knowingly presents a false or fraudulent claim for payment of
loss is subject to criminal and civil penalties.
APPLICABLE IN CALIF F NIIA: For your protecti n California l aw requires the following to appear on this form.Any person who l n ow-
1 n gly presents false or fraudulent information to obtain or amend insurance c verage or to male a claim for the payment of a loss is guilty
of a crime and may be subject to fines and confinement in state prison.
APPLICABLE IN COLORADO: It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance
company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of
insurance and civil damages.Any insurance company or a ent;of an insurance company who Knowingly provides false, incomplete, or
misleading facts or information to a policyholder or claimant for the purpose of defrauding or attempting to defraud the policyholder or
claimant with regard to a settlement or award payable from insurarnce proceeds shall be reported to the Colorado Division of insurance
within the department of regulatory agencies.
APPLICABLE IN DELAWARE,FLORIDA and KLAH MA:Any person who knowingly and with intent to injure,defraud,or deceive any
insurer files a statement of claim or an application containing any false,incomplete,or misleading information is guilty of a felony(In FL,
a person is guilty of a felony of the third degree).
APPLICABLE IN KANSAS.Any person who, knowingly and with intent to defraud, presents, causes to be presented or prepares with
knowledge or belief that it will be presented to or by an insurer, purported insurer, broker or any agent thereof, any written statement
as part of,or in support of,an application for the issuance of,or the rating of an insurance.policy for personal or commercial insurance,
or a claim far payment er other benefit pursuant to an insurance policy for co merdaI or personal insurance which such person knows
to contain materiaily false information concerning any fact material thereto; or conceals, for the purpose of misleading, information
concerning any'fact material thereto commits a fraudulent insurance act.
APPLICABLE K MAIN E, TEN ES EE, VIR INIA, I ASHIN TON AND NORTH TH AR LI : it is a crime to knowingly provide fare,
incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties may include
impriisonrnent,fines or a denial of insurance benefits.
APPLICABLE i N iNDIAI A:A person who l no vingl y and with 'intent to defraud an insurer files a statement of claim containing any false,
incomplete,or misleading information commits a felony.
APPLICABLE IN i EI TU KY: Any person who knowingly and with intent to defraud any insurance company or other person files a
statement of claim containing any materially false information or conceals, for the purpose of misleading, information concerning any
fact material thereto commits a fraudulent insurance act,which is a crime.
APPLICABLE IN NEW H MPSHI E: Any person who with a purpose to injure, defraud or deceive any insurance company, files a
statement of claim containing false, incomplete or misleading information is subject to prosecution and punishment for insurance fraud,
as provided in RSA : 0.
APPLICABLE IN MINI E TA: A►person who files a claim with intent to defraud or helps commit a fraud against an insurer is guilty of
a crime. MN porkers' Compensation Only:Any person who with intent to defraud, receives workers compensation benefits to which
the person is not entitled by knovwringly misrepresenting, rn1sstating, or failing to disclose any material fact is guilty of theft anti shall be `
sentenced pursuant to s 609.52,subdivision I
PENNSYLV NIA Motor Vehicle Only: Any person who knowingly and with intent to injure or defraud any insurer files an application
or claim containing airy false, incomplete or rnisl ading information shall, upon conviction,be subject to imprisonment far up to sever
years and payment of a fine of up to 15,000.