| Party Type | Name | Address Line 1 | Address Line 2 | City | State | Zip Code | Phone | Fax |
| Claimant | Thomas Klemenz | | | | | | | |
| . . . Claimant's Rep | . . . Gillis & Gillis, P.C. | One Century Tower | 265 Church Street, Suite 203 | New Haven | CT | 06510- | (203) 562-5104 | (203) 495-6476 |
| Employer | City of New Haven | 200 Orange Street | Suite 401 | New Haven | CT | 06510- | (203) 946-8357 | |
| . . . Insurer Contact | . . . PMA Customer Service Center | ATTN: Hearing Notice Desk | PO Box 5231 | Janesville | WI | 53547-5231 | (888) 476-2669 | (800) 432-9762 |
| . . . . . . Insurer's Rep | . . . . . . Strunk, Dodge, Aiken & Zovas | 200 Corporate Place, Suite 100 | | Rocky Hill | CT | 06067- | (860) 785-4500 | (860) 436-9630 |
| Misc Int Party | Anthem Blue Cross and Blue Shield | P.O. Box 533 | | North Haven | CT | 06473-4201 | (203) 239-4911 | |
| . . . MIP Agent | . . . Carelon Subrogation | P.O. Box 659940 | | San Antonio | TX | 78265-9939 | (262) 523-8096 | |