| Insured Name | Policy No | Payment Status | Claim No | Transaction No | In Payment Of | Payee Name | Summary Amount |
|---|---|---|---|---|---|---|---|
| POLYBUILDING (S) PTE. LTD. | PA/PPI/C-48822 |
Full Payment | CL/PA/PPI/3969 | CL/PA/PPI/3969-01 |
ACCIDENTAL MEDICAL EXPENSE | BORMEY SOR | 119.00 |