C.L.U.E Reports and
your insurance
C.L.U.E.® Auto Claims Report
in Compliance with FACT Act. This report has a
whole lot to do with your car insurance rates.
Incidents on this report are added to any moving
violations that you might have. DMV points +
C.L.U.E.(Insurance points) = your points total.
| Date Ordered: 10 / 11 / 2015 | Expires On: 11/11/2015 |
C.L.U.E. AUTO CLAIMS REPORT
| Reference #: | 10531111940410 | Date of Order: | 010/ 11 / 2012 |
| Account: | 113272 | Date of Receipt: | 11 / 11 / 2012 |
| Recap: | SUBJECT 1 CLAIM (S) REPORTED | ||
| POSSIBLE RELATED CLAIMS 0 CLAIM (S) REPORTED |
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SEARCH REQUEST |
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| Subject Name: |
JOHNNY DOE | ||
| Date of Birth: | 01 / XX / 19XX | ||
| SSN: | XXX-XX-XXXX | ||
| Sex: | U | ||
| Address: | 1111111 ON MAIN ST Anytown, NJ 08000 |
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REPORTED CLAIM HISTORY |
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| The 7-year loss history below is associated with the subject and information listed in the Search Request section of this report. Additional loss history information may be available if additional search information is provided. |
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| CLAIM 1 | |||
| Claim Date/Age: | 01 / 01 / 2008 | CLUE File #: | 1234567890123456 |
| Company: | PROGRESSIVE INSURANCE | Claim #: | 1234567 |
| Policy #: | ABCD1234567890 | Policy Type: | PERSONAL AUTO INSURANCE |
| Policy Holder: | DOE , JOHNNY W | Vehicle Operator: | DOE , MSJANE |
| Date of Birth: | 11 / XX / 19XX | ||
| SSN: | XXX-XX-XXXX | ||
| Sex: | M | ||
| Address: | 1111111 ON MAIN ST Anytown, NJ 08000 |
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| Drivers License #: |
12345XXXX NJ | ||
| Vehicle: | MY CAR TYPE | ||
| VIN: | 1A2B3C4D5E6F7G8H9 | Disposition: | N/A |
| PAYMENTS BY CLAIM TYPE |
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| Amount | Type | Status | |
| $0 | COLLISION | CLOSED | |
| $710 | PHYSICAL/PROPERTY DAMAGE | CLOSED | |
| $0 | RENTAL REIMBURSEMENT | CLOSED | |
| Additional Info: |
N/A | ||
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POSSIBLE RELATED CLAIMS |
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| Claims listed below are based on a match of the subjects last name and the address(es) listed in the Search Request section of this report. |
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| CLAIM 1 | |||
| Claim Date/Age: | 06 / 05 / 2015 | CLUE File #: | 1234567890123456 |
| Company: | PROGRESSIVE INSURANCE | Claim #: | 111199191954321 |
| Policy #: | ABCD1234567890 | Policy Type: | PERSONAL AUTO INSURANCE |
| Policy Holder: | DOE , JAMES W | Vehicle Operator: | DOE , MSJANE |
| Date of Birth: | 01 / XX / 19XX | ||
| SSN: | XXX-XX-XXXX | ||
| Sex: | M | ||
| Address: | 1111111 ON MAIN ST Anytown, NJ 08000 |
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| Drivers License #: |
12345XXXX GA | ||
| Vehicle: | JEEP LBRTYSPFRD | ||
| VIN: | 1c2B933D5E6F7G9H1 | Disposition: | N/A |
| PAYMENTS BY CLAIM TYPE |
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| Amount | Type | Status | |
| $18,000 | COLLISION | CLOSED | |
| $50 | RENTAL REIMBURSEMENT | CLOSED | |
| Additional Info: |
N/A | ||
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INQUIRY HISTORY |
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| Date: | 11 / 22 / 2014 | Requestor: | FACTACT/CHOICEPOINT |
| Date: | 04 / 01 / 2015 | Requestor: | FACTACT/CHOICEPOINT |
| Prepared by: | COMPREHENSIVE LOSS UNDERWRITING EXCHANGE C.L.U.E. Inc., Atlanta, GA. |
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| C.L.U.E. is a registered trademark of LexisNexis Risk Solutions Inc. |
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