Claim Payment Vouchers

Record ID

CPV No

Created By

Settle Date

Paid Amount

Payment For

Claims No (Transaction)

Amount in Words USD One Hundred Twenty Two and Eighty Eight Cents Only

Insured Name	Policy No	Payment Status	Claim No	Transaction No	In Payment Of	Payee Name	Summary Amount
NEOCOMISP LIMITED	`PA/PPI/C-48881`	Full Payment	CL/PA/PPI/4000	`CL/PA/PPI/4000-01`	ACCIDENTAL MEDICAL EXPENSE	SOKNA KONG	122.88

Payment Mode

Bank Selection

Account Code	Account Name	Debit	Credit
`111006`	Claim Paid - PA	122.88	0.00
`660020`	Amount due from/(TO)Reinsuranc	49.16	0.00
`115506`	Claim Rec.Cam.Re- P.A	0.00	24.58
`114006`	Claim Rec.Q.T Share- P.A	0.00	24.58
`660216`	ABA - Collection Acct	0.00	122.88