| Claimant | Status | Accident Date | Insured Name | Benefit State | Claim Number | Reserved |
|---|---|---|---|---|---|---|
| {{ result.CLAIMANTNAME }} | {{ result.STATUS }} | {{ result.ACCIDENTDATE }} | {{ result.INSUREDNAME }} | {{ result.BENEFITSTATE }} | {{ result.PRODUCTTYPE }} {{ result.CLAIMNUMBER }} | {{ result.TOTALAMOUNT | formatMoney }} |
| Insured Name | Occurrence Number | Occurrence Status | Occurrence Date | State | Reserved |
|---|---|---|---|---|---|
| {{ result.INSUREDNAME }} | {{ result.PRODUCTSHORTNAME }} {{ result.OCCURRENCENUMBER }} | {{ result.STATUS }} | {{ result.OCCURRENCEDATE }} | {{ result.STATE }} | {{ result.TOTALAMOUNT | formatMoney }} |