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North Carolina's Department of Insurance
Investigation File: Shenandoah Life
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4Policy
Information
4Kimble
File
4Payment
of Benefits
PDF
4Policy
Information
North Carolina.
Department of Insurance
INVESTIGATIONS DIVISION
Insurance Policy
Information
Theodore Mead Kimble and Patricia Gail Blakley Kimble
Insured Patricia Gail
Blakley
Insurer: Shenandoah Life
Policy # 030004500
Beneficiary: Sheila E. Blakley (mother of Patricia Gail Blakley)
Policy data: Life insurance policy issued through Patricia Blakley's
employer. Claim # 0224981 paid to beneficiary on 10/01/96 in the
amount of $25,980.82 (face amount plus interest on delayed
settlement).
4Kimble
File
Kimble File
Insurer Shenandoah Life
Insured
Patricia Blakley Life policy issued through employment.
Information
Claim paid 10/1/96 to Sheila Blakley (Mother) in amount of
$25,980.82
4Payment
of Benefits
SHENANDOAH LIFE
INSURANCE COMPANY
OCTOBER 01, 1996
PRESIDENT
CINNAMON RIDGE APARTME
18 SAILS WAY DRIVE
GREENSBORO NC 27406
INSURED: PATRICIA GAIL BLAKLEY
GROUP POLICY: 030004500
CLAIM NUMBER: 0224981
CHECK NUMBER: 7000003
PROCEEDS OF THIS POLICY ARE PAYABLE
AS FOLLOWS:
FACE AMOUNT OF INSURANCE $25,000.00
TAXABLE INTEREST ON DELAYED SETTLEMENT 980.82
AMOUNT OF CHECK *25,980.82
ENCLOSED IS OUR CHECK IN PAYMENT OF
BENEFITS DUE:
SHEILA E BLAKLEY
595 WOODOAK TRAIL
RANDLEMAN NC 27317
----------------------------------------------
SHENANDOAH LIFE
INSURANCE COMPANY
7000003 10-01-96
DEATH PROCEEDS-CERT NO. 241354789
89001
25,980.82
POLICY #: 030004500
AGENT/AGENCY #:
FORWARD TO DP/DSK 89001
PLEASE DETACH THIS VOUCHER FROM CHECK
BEFORE PRESENTING FOR PAYMENT
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