| Claim Details |
| District Name | West Godavari |
| Mandal Name | Gopalapuram |
| Claim Code | 24051500141 |
| Policy No | G0000178 |
| Lic / India First ID | 1000 |
| Appno No. | 01050504004010102207 |
| Policy Holder Name | Nagamani pulapalli |
| Father/Husband Name | siluvayya pulapalli |
| Loan Amount | 18182 |
| Incident Date | 01/08/2014 |
| Incident Place | Gangolu |
| Cause | Fever |
| Status | Cheque/DD issued to Nominee |