7 MAJESTIC WAY 10-14-23 CLAIM Providing Insurance and Financial Services RECEIVED AStateFarm®
Home Office, Bloomington, IL
NOV 2 7 2023
CITY OF SALEM
November 14, 2023 BOARD OF HEALTH
Salem Board of Health State Farm Claims
98 Washington St PO Box 106169
Salem, MA 01970 Atlanta GA 30348-6169
CERTIFIED MAIL: RETURN RECEIPT REQUESTED
RE: Claim Number: 21-59DO-40L
Our Insured: Tizita Mitiku
Date of Loss: October 14, 2023
Loss Location: 7 Majestic Way, Salem, MA 01970-6829
Tax Block: **TAX BLOCK**
Tax Lot: **TAX LOT**
To whom it may concern:
State Farm Fire & Casualty Insurance Company writes to provide notice as required by
Massachusetts law in connection with the matter referenced above. State Farm® received notice
of loss or damage in excess of$1,000 at 7 Majestic Way, Salem, MA.
We hereby notify your office pursuant to General Laws c. 139, §3B that State Farm
intends to make a payment of$1,000 or more in connection with the above referenced
insurance claim.
Further, the applicable amendatory Policy Endorsement informs the insured of the
Massachusetts requirement by stating the following:
"We are required by Massachusetts law that we must notify the local inspector of
buildings or Board of Health at least 10 days before we make a payment of$1,000 or
more for loss to a building or structure.
We must also give notice if there is damage which makes a building a health or safety
hazard or dangerous or unsafe for occupancy regardless of the amount of our payment.
If, prior to payment, we receive official notice of a pending or existing lien against your
premises, we must delay payment until the matter is settled. If we are required to pay all
or part of the amount of the lien, we will not be obligated to pay that amount to you.
If you have questions or need assistance, call us at (972) 929-3423