| Insured Name | Policy No | Payment Status | Claim No | Transaction No | In Payment Of | Payee Name | Summary Amount |
|---|---|---|---|---|---|---|---|
| MENGLY J. QUACH EDUCATION PLC. | PA/PPI/C-48471 |
Full Payment | CL/PA/PPI/3967 | CL/PA/PPI/3967-01 |
ACCIDENTAL MEDICAL EXPENSE | Mengly J. Quach Education PLC | 22.80 |