HomeMy WebLinkAbout03. A) Claim - Allan Gustavus, Jr. Statewide Services, Inc,
Claim Division 1241 John Q.Hammons Dr.
P.O.Box 5555
Madison,WI 53705-0555
577-209-971.2
July 10, 2013
City of Oshkosh
PO Box 1130
Oshkosh, WI. 54902
Attention: Pam Ubrig
RE: Insured: City of Oshkosh
Claimant Name: Allen Gustavus Jr.
Claim Number: WM000702660645
Date of Loss: 5/29/2013
Statewide Services, Inc., is the third-party administrator for the League of Wisconsin
Municipalities Mutual Insurance liability and auto program We received notice of the
above-referenced claim, and want to assure you that we are in the process of reviewing it.
This claim has been assigned to:
Adjuster/claim handler name: Ginger Kimpton
Title: Claim Adjuster
Phone: 855-828-5515
Fax: 866-828-6613
Email Address: gkimpton @statewidesvcs.com
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Feel free to call or email the claim handler above. (,i L-
Sincerely, jUC 10 2013
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Statewide Services Claim Department -.. ` ' i
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Cc: Tim Nickels
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