PNX-UDENNA INSURANCE BROKERS, INC.

We Care! We Protect! We Secure!

Claims Requirement

Motorcar Claim

- Police Report/ Incident Report
- OR & CR of the Insured Unit
- Driver's License
- Stencils
- Estimate/ Quote of the Repair
- Pictures of the Damaged Part
* AND OTHER CLAIM DOCUMENTS REQUIRED BY THE INSURANCE COMPANY

Property/ Fire Claim

- Fire Investigation Report
- Sworn Statement of Fire Claim
- Affidavit of Loss
- Non-Waiver Agreement
- Copy of Business Permit (if applicable)
- Copy of Articles of Incorporation (if applicable)
- Pictures of the Damaged Property
- Other related documents that may be required
* AND OTHER CLAIM DOCUMENTS REQUIRED BY THE INSURANCE COMPANY

Marine Cargo Claim

- Incident Report
- Bill of Lading/ Waybill
- Sales Invoice/ delivery Invoice/ Packing List
- Inventory of the Damaged Items
- Pictures of the Damaged items
*AND OTHER CLAIM DOCUMENTS REQUIRED BY THE INSURANCE COMPANY

Suretyship Claim

- Written Notice with details of the amount and incident details
- Minutes of the meeting between the Obligee and Principal
- Audit Report of the Obligee on the monthly/annual transactions with the Principal
- Receipts/Invoices acknowledging the payments received
- Any other documentation that may be required
*AND OTHER CLAIM DOCUMENTS REQUIRED BY THE INSURANCE COMPANY

Engineering Claim

- Duly accomplished Sworn Statement of Claim (to be supplied by adjuster)
- Duly accomplished Non-Waiver Agreement (to be supplied by adjuster)
- Incident Report
- Weather and rainfall report from the nearest weather station officially issued by the PAGASA (if applicable/required)
- Copy of Contract Agreement with Bid Estimates
- Copy of Notice of Award
- Copy of Notice of Commence
- Copies of Business Registration, permit, etc.
- Survey of damages based on standard engineering practices (Plans, survey data, PERT CPM, etc.)
- Projected Cash Flow of the project
- Detailed computation of loss and damages in order to bring back the damaged portions to its original condition before the loss
- Certified copies of recent and previous monthly accomplishment/progress report including its back up computation
- Certified copies of recent and previous billing reports
- Documents in support to the actual cost of repair/replacement of the affected properties such as invoices, receipts, etc.
- Clear and properly annotated panoramic pictures immediately taken after the loss
*AND OTHER CLAIM DOCUMENTS REQUIRED BY THE INSURANCE COMPANY

Casualty Claim

1. Third Party Bodily Injury
• Police Report/Incident Report
• Medical Certificate
• Certificate of Attending Physician
• Doctor’s Prescription
• Original Receipts of the claimable items
• Affidavit of Desistance

2. Third Party Property Damage
• Police Report/Incident Report
• OR & CR of the involved Units (for motorcar only)
• Driver’s License (for motorcar only)
• Stencils (for motorcar only)
• Estimate/Quote of the Repair
• Pictures showing the damages
*AND OTHER CLAIM DOCUMENTS REQUIRED BY THE INSURANCE COMPANY

Personal Accident Claim

- Incident Report
- Notice of Loss Form
- Certificate of Attending Physician
- Medical Certificate
- Original Receipts of the claimable items
- Doctor’s Prescription
- Certified True Copy of Death Certificate (Death claim only)
- Certified True Copy of Birth Certificate of the Deceased (Death claim only)
- Certified True Copy of Marriage
- Contract/CENOMAR (Death claim only)
- Certificate of Employment of the Deceased
- Certificate of Claimants Beneficiaries (Death claim only, form to be provided)
- Certified True Copy/ies of Birth Certificate/s of the Beneficiary/ies
*AND OTHER CLAIM DOCUMENTS REQUIRED BY THE INSURANCE COMPANY