Claim Payment Vouchers

Record ID

CPV No

Created By

Settle Date

Paid Amount

Payment For

Claims No (Transaction)

Amount in Words USD Thirty Six and Twenty Five Cents Only

Insured Name	Policy No	Payment Status	Claim No	Transaction No	In Payment Of	Payee Name	Summary Amount
UM TOCH	`PA/PPI/C-48823`	Full Payment	CL/PA/PPI/3963	`CL/PA/PPI/3963-01`	ACCIDENTAL MEDICAL EXPENSE	LEY LEN	36.25

Payment Mode

Bank Selection

Account Code	Account Name	Debit	Credit
`111006`	Claim Paid - PA	36.25	0.00
`660020`	Amount due from/(TO)Reinsuranc	10.88	0.00
`115506`	Claim Rec.Cam.Re- P.A	0.00	10.88
`114006`	Claim Rec.Q.T Share- P.A	0.00	0.00
`660215`	FTB-Claims Acc.	0.00	36.25