| Insured Name | Policy No | Payment Status | Claim No | Transaction No | In Payment Of | Payee Name | Summary Amount |
|---|---|---|---|---|---|---|---|
| KG (CAMBODIA) RESORTS CO., LTD | PA/PPI/C-48514 |
Full Payment | CL/PA/PPI/3974 | CL/PA/PPI/3974-01 |
ACCIDENTAL MEDICAL EXPENSE | Vanna Dary/Mao Ravuth | 82.06 |