CLAIMS

 

Detailed here are a list of steps and the resulting requirements needed in order to facilitate various kinds of insurance claims. Rest assured that we
will do everything we can to facilitate your claim in the simplest, most efficient
way possible.

Should you find yourself having to undergo any of these claims processes,
you’ll find that with us, you’re in good hands.

Report A Claim

GENERAL INSURANCE CLAIMS

MOTOR CLAIMS

In the unfortunate event you are involved in an accident, here are a few reminders that will save you from future inconveniences:

1. Report the accident immediately to our Motor Car Claims Department or to your Account Manager so that we can properly advise and assist you in the matter.

2. In case the accident involves a third party, do not immediately admit liability or make any payment or commitment without the approval of the insurance company.

3. Do not authorize any repair on your vehicle unless the insurance company has given its approval.

Please note that failure to follow 2 & 3 may prejudice your policy rights and make it difficult or even impossible to process your claim. Listed below are the common reasons for denial of motor car claims:

1. Late filling (as stated in the policy, the insured shall, as soon as possible, give notice thereof to the Company the full particulars)

2. Discrepancy of details (particularly on registered owner, serial number, motor number, and other particulars stated in the policy)

3. Unauthorized repair

4. Unpaid premiums

The quick and client processing of your motor car claim is very much dependent on the completeness of the documents submitted. Basically, the following are the required claim documents for the various kinds of motor car claims.

Own Damage Claim

a. Police report or a notarized a davit of the driver stating the facts of the accident

b. Photocopy of the Certificate of Registration with the official receipt

c. Photocopy of the driver´s license with the official receipt

d. Pictures of the damaged portion(s) of the insured unit, with at least one showing the plate number

e. Repair estimate

f. Stencil of motor and chassis numbers.

Third Party Liability – Property Damage Claim

a. Police report or a notarized affidavit of the driver stating the facts of the accident

b. Photocopy of the Certificate of Registration with the official receipt (both parties)

c. Photocopy of the driver´s license with the official receipt (both parties)

d. Pictures of the adverse vehicle showing the car´s plate number and the damaged portion(s)

e. Repair estimate

f. Stencil of motor and chassis numbers

g. Certificate of No Claim issued by the adverse party´s insurer supplies bought, doctor´s fee, and burial expenses

Third Party Liability – Bodily Injury Claim

a. Original copy of the medical certificate, death certificate, or autopsy report

b. Original copies of the official receipt covering hospital bills, medicines and/or supplies

c. Certified true copy of birth certificate if the victim is a minor, or proof of a liation of claimant to the victim

d. Relevant pictures

e. Police report

f. Photocopy of the certificate of Registration with the official receipt

g. Photocopy of the driver´s license with the official receipt

h. Affidavit of Desistance or Release of claim duly signed by the BI claimant

Carnap Claim

a. Police report

b. Certificate of Registration with the official receipt

c. Photocopy of the driver´s license with the official receipt

d. Copy of Complaint Sheet led with the Anti - Carnapping Unit

e. Alarm Sheet from CHPG and Police Unit (can be obtained from the PNP Anti - Carnapping unit at Camp Crame).

f. Certificate of Non - Recovery issued by the Anti - Carnapping Unit (can be secured 90 days after the issuance of an Alarm Sheet)

g. Ignition key or spare key (to be surrendered in exchange of the settlement check)

h. Release of Chattel Mortgage, if any

Theft Claim

a. Police report

b. Photocopy of the Certificate of Registration with the official receipt

c. Photocopy of the driver´s license with the official receipt

d. Pictures of the unit showing plate number and the place where the stolen accessories were before they were stolen

e. Stereo manual for stolen stereo, or estimate of stolen accessories, etc.

f. Copy of Complaint Sheet led with the Anti - Carnapping Unit

g. Alarm Sheet from CHPG and Police Unit (can be obtained from the PNP Anti - Carnapping unit at Camp Crame)

h. Certificate of Non - Recovery issued by the Anti - Carnapping Unit (can be secured 90 days after the issuance of an Alarm Sheet)

i. Ignition key or spare key (to be surrendered in exchange of the settlement check)

j. Release of Chattel Mortgage, if any

NON-MOTOR CLAIMS

1. All non - motor claims led must be immediately submitted/reported to TRINITY INSURANCE BROKERS, INC. The following information should be immediately reported:

•Policy number

•Brief narration of the incident

•Extent of loss (whether partial or total)

•Contact person and telephone number

2. The assured must take all reasonable steps to preserve the debris and traces of damages caused by the unfortunate event for inspection purposes, and must protect the property from further damage.

3. Premium payment/remittance for the insurance policy subject to claim shall be verified. If the premium has not been paid, the policy cannot respond and is therefore considered ineffective.

4. Upon receipt of notice of loss, TRINITY INSURANCE BROKERS, INC . will report to the insurance provider and will request to assign an accredited adjuster who shall arrange ocular inspection and investigation of the incident/loss.

5. The validity and authenticity of the claim shall be established through ocular inspection and investigation to be conducted by the adjuster and by verifying the consistency of information gathered and stated in the documents submitted vis - à -vis the declarations in the policy.

6. All claim documents must be complete, clear, and readable. TRINITY INSURANCE BROKERS, INC. may request for additional indispensable documents, which may be found necessary in the course of the evaluation of a claim.

7. The liability of the insurance provider shall be subject to valuation and shall be limited to the actual loss, subject to the applicable conditions and warranties of the insurance policy and in no case shall exceed the insurance policy coverage.

8. The Salvage Value of the retrievable items and insurance policy deductible (if any) shall be deductible from the computed amount of loss to determine the net liability.

9. TRINITY INSURANCE BROKERS, INC. shall verify and coordinate with co - insurers (if any) covering the same property involved in the loss. The co - insurers shall proportionately share the amount of loss.

10. The AVERAGE CLAUSE shall be applied in case the property covered is underinsured. The assured shall be considered as co - insurer for the uninsured portion of the sound value of the property and shall bear a ratable proportion of the loss.

11. Upon completion of evaluation and acceptance of offer from the assured, TRINITY INSURANCE BROKERS, INC. shall facilitate in the early release of the settlement check from the insurance provider.

12. The settlement check will be sent by TRINITY INSURANCE BROKERS, INC . to the assured, once it is received from the insurance provider.

The quick and client processing of your claim is very much dependent on the completeness of the documents submitted. Basically, the following are the required claim documents for the various kinds of non - motor car claims.

PROPERTY/FIRE CLAIMS

General Requirements

1. Original or copy of the policy including warranties and clauses attached to it

2. Pictures of the damaged properties

3. Inventory list of the insured property/ies damaged with the corresponding valuation of repair or replacement, liens and encumbrances, if any, and estimated value of salvage

4. A brief written report on the events that lead to the loss, including the name of witness/es, if available, the location/nature of ownership of the property/ies insured, and the year the building was constructed as well as the original construction cost (for building loss)

5. Arson Investigation Report or Fire Certification

6. PAG-ASA Report (for lightning, typhoon, and other weather disturbance losses)

7. Other documents that may be required by the adjuster

For Building Claim

1. Item No. 1 to 6 of the General Requirements

2. A civil engineer or architect’s detailed estimate (obtained at the expense of the insured) in order to place the building in the same state of repair as before the accident

NOTE: No contemplated improvements may be included in the estimate, and/or proper allowance for age and depreciation, etc. may be allowed.

3. Appraisal report, if any

4. Copy of the building plan, complete with dimensions and design specifications

5. Lease contract or agreement, if assured is not the lot owner

6. Certified true copy of building permit, Transfer Certificate of Title and Declaration of Real Property

7. Other documents that may be required by the adjuster

For Goods and Merchandise Claim

1. Item No. 1 to 6 of the General Requirements

2. Detailed inventory of the articles damaged, showing the cost price of each, extent of damage and salvage value, if any, and if the risk sustained partial or water damage

3. Proof of damage (technical report/laboratory analysis)

4. Inventory of the whole goods and merchandise in the building (for partial loss)

5. Latest inventory report, for total loss, led with the Bureau of Internal Revenue or any other government entity, prior to the loss

6. Movement reports/documents in between the last inventory report submitted and the date of loss (for total loss)

7. Production and movement report for loss in the manufacturing area

8. Certified true copies of the Income Tax Return Form together with the financial statements of the last three (3) years

9. Accounts and Purchases Books, sales invoices, and all other business records (to be made available for the adjuster ’s review)

10. Location of other store/s or warehouse and amount of insurance on stocks contained therein, if any

11. Other documents that may be required by the adjuster.

For Robbery/Burglary Claim

1. Copy of the policy with warranties and clauses attached to it

2. Insured’s report on the circumstances of the loss

3. Police investigation report

4. Affidavit or statements of witnesses (if any)

5. Inventory list of the insured property/ies with the corresponding valuation of replacement, liens and encumbrances, if any

6. Pictures showing damaged, stolen properties

7. Other documents that may be required by the adjuster

For Machinery and Equipment / FF Claim

1. Item No. 1 to 6 of the General Requirements

2. Detailed inventory of the articles damaged or destroyed, showing the cost price of each, and the date acquired

3. Records, invoices, and receipts, if any (to be made available for the adjuster ’s review)

4. Building contents layout

5. Other documents that may be required by the adjuster

For Pier Impact Claim

1. Copy of the policy with warranties and clauses attached to it

2. Comprehensive loss report indicating circumstances of loss

3. Marine Protest (to be led with the Philippine Coast Guard within 24 hours from the date of loss)

4. Formal claim against the vessel owner (to be led within 30 days from the date of loss)

5. Under water survey

6. Photographs of the damaged property

7. Complete plans and design specification of the affected property

8. Detailed estimate, including bid proposals, if any

9. Technical report

10. Other documents that may be required by the adjuster

For Spontaneous Combustion Claim

1. Copy of the policy with warranties and clauses attached to it

2. Insured’s report on the circumstances of the loss

3. Laboratory analysis of the burnt product for adjustment of volume

4. Weigh scale/ticket card indicating the volume of the burnt product

5. Daily inventory/production records prior to the incident

6. Shipping/delivery records

7. Pictures of the burnt product

8. Other documents that may be required by the adjuster

For Robbery/Burglary Claim

1. Copy of the policy with warranties and clauses attached to it

2. Insured’s report on the circumstances of the loss

3. Police investigation report

4. Affidavit or statements of witnesses (if any)

5. Inventory list of the insured property/ies with the corresponding valuation of replacement, liens and encumbrances, if any

6. Pictures showing damaged, stolen properties

7. Other documents that may be required by the adjuster

MARINE & CARGO HULL CLAIMS

Marine Cargo Claim Requirements

1. Copy of the insurance policy with warranties and clauses attached

2. Formal advise from the insured to insurer regarding the claim

3. The following are to be submitted:

a. Marine Risk Note and endorsement, if any

b.Commercial invoice

c. Bill of lading

d. Packing lists

e. Copies of the formal claim against the following:

• Arrastre operator/contractor

• Vessel's owner/agent

• Therbailees, such as the customs broker, etc. and their respective replies

f. Copy of delivery receipts

g. For claims involving shipments in Bad Order condition:

• Bad order issued by the arrastre contractor

• Copy of the turn-over survey of the bad order on board cargoes issued by the arrastre contractor as attested by the vessel´s representative

• Original laboratory or quality control analysis report

• Original invoice for repair/ reconditioning of the bad order or damaged items

h. For claims involving short- landed shipment/ spillage/ leakage

• Bad order certificate issued by the arrastre contractor

• Turn-over survey on bad order cargoes

i. For claims involving short delivered shipments:

• Short delivery or short landing certificate issued by the arrastre contractor certifying the non-discharge of packages or tally sheet of discharge

EMPLOYEE BENEFITS/ PERSONAL LINES CLAIMS

HMO/MEDICAL CLAIMS

HMO / Medical Insurance Reimbursement Checklist

In-Patient Clients

Requirements

a. Duly- accomplished Notification of Claim form (NOC)

b. Original official receipt(s) of all payments made

c. Admitting medical history (includes detailed history of present illness, as well as family, personal, and past medical history

d. Discharge summary reports (includes patient’s course in wards, diagnosis test requested, and medications given)

e. Statement of account (summarized and itemized)

Supporting charge slips in cases wherein the hospital has no itemized statement of account Copy of the results of the laboratory, x-ray, and other diagnostic exams and therapeutic services

If Surgical Procedure Was Done

Copy of the Operative Report (includes detailed description of the surgical procedure done) or Histopathology Report (includes information on the nature, extent, and stage of illness which may not be seen in other documents submitted)

For Injury as a Result of an Accident

a. Basic requirements for in-patient claims
b. Copy of the police report

In the Event of the Death of the Insured

a. Copy of the registered death certificate, and if applicable:

b. Basic requirements for in-patient claims

c. Copy of the police report

TRAVEL INSURANCE CLAIMS

Medical and Emergency Benefit

For Out-Patient Treatment

a. Completely filled out attending physician’s statement for the out-patient treatment

b. Original official receipts with payment details

c. If with a surgical operation, photocopy of the operative report

d. Photocopy of the doctor ’s presentation of medication required for treatment

e. Photocopy of the doctor ’s request for laboratory procedure

f. Photocopy of the laboratory results

g. If accident related, original police report/accident report

For In-Patient Treatment

a. Original and full medical report (per training to the confinement) from the hospital or attending physician/s (e. g. clinical abstract/admitting history, discharge summary, etc. )

b. Original official receipts with payment details

c. If with surgical operation, photocopy of the operative report

d. Photocopy of the doctor ’s prescription for home medication

e. If accident related, original police report/accident report

f. Photocopy of the laboratory results

g. Photocopy of the doctor ’s prescription for home medication

h. Completely filled out attending physician’s statement for in-patient treatment

i. Personal Accident Benefit

i. Doctor ’s official and original written diagnosis

ii. Full medical report establishing the loss of limb or loss of sight or total and permanent disability

iii. In case of a death, photocopy of the death certificate and the relevant coroner ’s report

iv. If the accident was reported to the police authorities, original police report/accident report

v. Completely filled out attending physician’s statement for in-patient treatment

Baggage Loss or Damage Benefit

a. Original baggage irregularity report issued by the airline/carrier in case the loss or damage occurred while such baggage was under their custody

b. Certification from the carrier, hotel, or any other party, or any proof satisfactory to the Company that the loss or damage to the baggage was not indemnified, or if settlement was made, a certification specifying the amount settled

c. For other circumstances, an original police report for such loss or damage

d. Original official receipts for the purchase of the lost or damaged bag. If the original official receipts are not available, submit an affidavit of a lost official receipt. Details of the official receipts such as date of purchase, brand, model, and type of lost or damage bag should be specified in the affidavit.

e. Or, if already repaired, original official receipt for the cost repair with corresponding details

f. Original official receipt for the purchase of the lost or damaged articles within the baggage (e. g. clothing, prescribed medicines, bag)

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