Pool_1

>> Patriot <<

PatriotAlliance Unity Health

as reviewer and designee AM Inc.

Insurer memo To: Insured Re: Dalwin Hawkins Insured : John-Boford Hawkins 183-899745-AU-4682-QI79A6 Inst: 4567-AYEWIU ref: 12-76-907B

Claim: 87493736.8364 as entry JSYEGFDI83

As above referenced, limited to but not exclusively from art. YY-667, said limits and terms exclude but do not solicit as transactions as defined in YY-667 and YQ-31. Therefore right leg below knee prosthesis is denied. Review is unnecessary and predenied under terms of ERISA applicability and limitations.

Reviewer.