CLAIMS

Personal Accident Insurance Claim

CLAIMS INSTRUCTIONS

  1. Acquire an Accident Insurance Claim Report.
    You may download one here. (File Specs: PDF file, 88 kb)
  2. Accomplish Accident Claim Report Fully
  3. Attach necessary documents (See checklist)
  4. Forward the accomplished accident claim report form together with all the necessary documents


Please submit the following documents in case of:

  1. Death Claim

    1. Police Investigation Report or Statement of Witness/es
      (if not available, affidavit or incident report)
    2. Newspaper Clippings, if any
    3. Attending Physician's Medical Certificate
    4. Birth Certificate
    5. Death Certificate (Certified True Copy)
    6. Autopsy Report
    7. Marriage Contract
    8. Burial Receipts
    9. Pictures (if any)
    10. Others

  2. Medical Reimbursement for Bodily Injuries or Disability Claim

    1. Police Investigation Report or Statement of Witness/es
    2. Attending Physician's Medical Certificate
    3. Doctor's Prescription
    4. Hospital Statement of Account
    5. Medical Bills and Receipts (original)
    6. Others

The Company reserves the right to request for additional documents as the need arises. Also, this communication should not be construed as an admission of the Company's liability nor waiver of its rights and privileges under the said policy. Thank you.


PGA Sompo Japan Insurance Inc.:

Audi:

AUDI ALABANG WESTGATE:
Filinvest corner Commerce Ave.,
Westgate Center, Filinvest Corporate City
Alabang, Muntinlupa City

AUDI GREENHILLS:
201 EDSA, Mandaluyong City
1554 Philippines

AUDI GLOBAL:
PGA Cars Centre, 11th Ave., corner 28th St,
Bonifacio Global City, Taguig


Porsche:

PORSCHE GREENHILLS:
201 EDSA, Mandaluyong City
1554 Philippines


Lamborghini:

PGA Cars Centre, 11th Ave.
Bonifacio Global City
1634 Philippines


Hyundai:

Hyundai North EDSA:
Part of the PGA Cars, Inc. Group
1174 EDSA, Balintawak, Quezon City


1st Life:

R. Coyiuto Securities, Inc.:

Member: Philippine Stock Exchange
5th Floor Corinthian Plaza
121 Paseo de Roxas St.
Legaspi Village, Makati City


Pioneer Tours:

290-292 Dasmarinas corner Marquina St.
Binondo, Manila


Coyiuto Foundation:

COYIUTO HOUSE, 119 C. Palanca St.
Legaspi Village, Makati City