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* 1. Your Contact Details

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* 2. How much was your insurance premium in;

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* 3. Have you had a claim against you in the past five years?

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* 4. Please elaborate on what the claim was for

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* 5. Did you settle your claim

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* 6. What was the claim amount?

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* 7. If you have any other comments or thoughts on this issue, please feel free to share

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