Form

File a Claim


Personal Details


Claim Details


Required Documents
Note: Max. file size of 2MB


Property Documents Reference

General Requirements

  1. Photocopy of policy
  2. Sworn statement of formal claim
  3. Non-Waiver Agreement
  4. Interview sheet (whenever applicable)
  5. Proof of premium payment
  6. Fire Certification/Fire Investigation Report
  7. Sworn statement of witnesses, if any
  8. Affidavit of loss stating
    • Date and time of loss
    • Location of insured property
    • Extent of damage and salvage value, if any
    • Liens and encumbrances
    • Nature of ownership on the property insured
    • Any information relative to the loss; and
  9. Registration papers
    • For Partnership and Corporation
      • Certificate of Registration issued by the Securities and Exchange Commission
      • Articles of Incorporation
    • For Single Proprietorship
      • Certificate of Registration of Business Name issued by the Bureau of Domestic Trade, Department of Trade and Industry
      • A Civil Engineer’s or Architect’s detailed estimate (obtained at the expense of the assured) to place the damaged building in the same state of repair as before the accident. (No contemplated improvements may be included in the estimate and proper allowance for age and depreciation etc., may be allowed)
      • Business permits and license
  10. Other documents (as the adjuster may require)

For Building

  1. A Civil Engineer’s or Architect’s detailed estimate (obtained at the expense of the assured) to place the damaged building in the same state of repair as before the accident. (No contemplated improvements may be included in the estimate and proper allowance for age and depreciation etc. may be allowed)
  2. Certified copy of Building Permit
  3. Certified copy of Declaration of Real Property
  4. Copy of plan of the building or sketch prepared by engineer/architect
  5. Lease Contract or Agreement if the assured is not the owner
  6. Transfer Certificate of Title
  7. Year the building was constructed and original construction cost. State also the details of renovations/improvements, if any
  8. Other documents (as the adjuster may require)

For Machinery & Equipment, Furniture, Fixtures and Fittings

  1. Detailed estimate (breakdown of materials, labor and other costs pertaining to the damaged equipment)
  2. Detailed list of the damaged and undamaged equipment, their respective unit cost and date of acquisition
  3. Records, invoices, receipts and/or property records, if any
  4. Latest appraisal report and/or property records, if any
  5. Other documents (as the adjuster may require)

For Stocks

  1. Detailed inventory of the articles damaged or destroyed, showing the cost price of each, extent of damage and salvage value
  2. Proof costing (i.e. invoices, importation papers, etc.)
  3. Latest inventory of merchandise filed with the Bureau of Internal Revenue or any government entity prior to the loss
  4. Other documents (as the adjuster may require)

For Leasehold Improvements

  1. A Civil Engineer’s or Architect’s detailed estimate (obtained at the expense of the assured) to place the damaged building in the same state of repair as before the accident. (No contemplated improvements may be included in the estimate and proper allowance for age and depreciation etc. may be allowed)
  2. Copy of Plan of the building or sketch prepared by Engineer/Architect
  3. Lease Contract or Agreement, if the assured is not the lot owner
  4. Other documents (as the adjuster may require)
Engineering Documents Reference

For Constructive/Erection All Risk Claim

  1. Photocopy of policy and proof of premium payment
  2. Assured’s report on the circumstances of the loss
  3. Drawing plans and design specifications
  4. Building Permit (for building losses)
  5. Detailed repair estimate or replacement proposal
  6. List of bid items and quantities and any additional offers made stating dimensions and standard prices
  7. Inspection Report, if possible
  8. Original and/or revised PERT/CPM
  9. Expert’s report on the ground and soil conditions, etc.
  10. Technical report from the supplier on the damaged property
  11. Other documents (as the adjuster may require)

For IAR/Machinery Breakdown Claim

  1. Photocopy of policy and proof of premium payment
  2. Assured’s report on the circumstances of the loss
  3. Pictures of the damaged property(ies)
  4. Technical/Engineering Report Analysis and detailed repair estimate
  5. Quotations, catalogs from the manufacturers/suppliers
  6. Copy of Contract Order/Agreement between the assured and the contractor
  7. Temperature reading prior to the loss
  8. For pressure vessels, boilers and the like, ensure that all recent maintenance testing/records are made available
  9. Other documents (as the adjuster may require)

For Business Interruption Claim

  1. Manufacturing
    • Profit and Loss Statement for fiscal year immediately preceding the loss
    • Monthly Sales Report
    • Monthly/Quarterly Production Schedules
    • Photocopy of policy and proof of premium payment
    • Other documents (as the adjuster may require)
  2. Non-Manufacturing
    • Annual Financial` Statement for 2 fiscal years ended prior to the loss
    • Monthly/Quarterly Operating Statement
    • Monthly/Quarterly Inventories
    • Daily/Hourly production in units or sales value
    • Photocopy of policy and proof of premium payment
    • Other documents (as the adjuster may require)

For Electronic Equipment

  1. Photocopy of policy and proof of premium payment
  2. Duly accomplished Notice of Loss or Damage for Electronic Equipment Insurance
  3. Incident Report
  4. Picture of the damaged equipment
  5. Detailed repair estimate
  6. Technical report/analysis
  7. Records, invoices, receipt, if any
  8. Detailed inventory of article(s) damaged or destroyed showing cost/price of each and the date acquired
  9. Other documents (as the adjuster may require)
Marine Cargo Documents Reference

General Requirements

  1. Original Policy/Certificate of Insurance/Risk Note and proof of premium payment;
  2. Original/certified copy of Commercial Invoice;
  3. Original Bill of Lading and/or other contract of carriage;
  4. Copy of Import Entry Declaration;
  5. Survey Report of an independent marine surveyor;
  6. Copy of Packing List;
  7. Original copies of formal claim filed against the following:
    • Arrastre Operator/Conductor
    • Vessel Owner/Agent
    • Other bailees like Customs Broker, etc., and their respective replies;
  8. Copy of Delivery Receipts;
  9. Duplicate copy of the Warehouse Receipt; and
  10. For claim involving shipment in bad order condition:
    • Bad order certificate issued by the Arrastre Contractor
    • Copy of Turn-over Survey of Bad Order on board cargoes
    • Original Laboratory or Quality Control
    • Analysis of damaged items
    • Interchange Equipment Receipt
  11. Other documents (as the adjuster may require)
Marine Hull Documents Reference

General Requirements

  1. Original Marine Hull Policy and proof of premium payment
  2. Copy of vessel’s Certificate of Philippine Register
  3. Copy of vessel’s Certificate of Ownership
  4. Copy of vessel’s Coastwise License
  5. Copy of vessel’s Departure Clearance
  6. Copy of vessel’s Certificate of inspection
  7. Master’s Note of Protest
  8. Repair estimates of the damaged vessel
  9. Deck logbooks/extracts covering the repair period
  10. A Statement of the Cost & Expense of towing together with the additional costs and expenses of putting the vessel in a tow worthy condition
  11. Survey reports and bills
  12. Statement of Fees and Expenses incurred in attending casualty and diving survey
  13. Other documents (as the adjuster may require)
Personal Accident Documents Reference

General Requirements

  1. Photocopy of policy and proof of premium payment
  2. Claim Forms, duly accomplished (original)
  3. Detailed Incident Letter/Report (original)
  4. Police/Investigation Report or Affidavit of Witnesses (original)
  5. Medical/Doctor’s Certificate (original)
  6. Employment Certificate or Copy of Company ID; Copy of School ID for Student PA.

Other claim documents for each benefit

  1. Death Claim
    • Certified true copy of Death Certificate (original)
    • Birth Certificate of the insured
    • Funeral Parlor bill with receipt
    • Proof of beneficiary(ies)’ identity (Original Birth Certificate, Marriage Certificate, etc.)
    • Copy of valid ID’s of the beneficiary(ies)’
    • Other documents may be required as deemed necessary
  2. Medical Expenses
    • Itemized Hospital Statement of Account/billing/charge slips
    • Official receipts of hospital bills/professional fees (original)
    • Official receipts of medicines and medical prescription (original)
    • Clear copy of valid Driver’s License if victim was driving the vehicle at the time of the loss
    • Clear copy of the CR and valid OR registration of the driven motorcycle at the time of the loss
    • Clear copy of the animal bite vaccination card schedule
    • Other documents may be required as deemed necessary
  3. Dismemberment or Permanent Disability
    • Physician/Surgeons Certificate and other Medical Records to accurately display where the insured's body member was actually severed. (original)
    • Photograph showing the actual severity of the dismembered body part.
    • Other documents may be required as deemed necessary.

Reminder: This communication should not be construed as an admission of liability or a waiver of any provision and term of the policy or our rights and defenses that we reserve for future determination. We have the right to request for additional documents if found warranted during the course of our evaluation.
Travel Documents Reference

Basic Requirements

  1. Copy of policy and proof of premium payment
  2. Request Letter for Reimbursement or Detailed Incident Report
  3. Original Official Receipt(s) of all payments made
  4. Copy of complete Flight Itinerary and Boarding Passes
  5. Copy of Passport (pages with biographic data and immigration stamp dates for entries and departures)
  6. Birth Certificate (if claimant is minor)

Medical Reimbursement

  1. Completed NOC Form
  2. Police Investigation Report or Affidavit of Witnesses (if due to accident)
  3. Copy of driver's license if victim was driving the vehicle at the time of loss
  4. Admitting Medical history with diagnosis (includes detailed history of present illness; family, personal and past medical history)
  5. Discharge summary report with diagnosis (includes patient’s course in wards, diagnostic tests requested and medications given)
  6. Original official receipt of the medical expenses incurred
  7. Medical Prescription from the Attending Physician
  8. Clinical Test/Laboratory Test Results
  9. Copy of (+)RT-PCR test for COVID-19**
  10. X-ray Result or any other diagnostic examinations results
  11. Itemized Hospital Statement of Account with date and time of confinement and discharge
  12. Supporting charge slips of statement of account in cases where hospital has no itemized SOA
  13. If surgical procedure was done:
    • Copy of Operative Report (includes detailed description of surgical procedure done)
    • Histopathology Report (includes information on the nature, extent and stage of illness which may not be seen in other documents submitted)
  14. Other documents may be required as deemed necessary

Death Claim

  1. Completed NOC Form
  2. Police Investigation Report or Affidavit of Witnesses (if due to accident)
  3. Copy of driver's license if victim was driving the vehicle at the time of loss
  4. Medical Records
  5. Birth Certificate
  6. Death Certificate
  7. Marriage Contract, if married
  8. Burial Receipt
  9. Other documents may be required as deemed necessary

Trip Cancellation

  1. Original medical report and/or Death Certificate of the Insured Person or the immediate family member. Documents must reflect the date of occurrence admission to hospital, death, accident, the diagnosis, the clinical background and treatment prescribed.
  2. Proof of occurrence of covered incident such as Police Report, Bureau of Fire and Protection Certificate/Report.
  3. Proof of Filiation (Birth Certificate, Marriage Certificate, etc.)
  4. Original receipts for the non-refundable portion of the travel accommodation expenses paid in advanced, including flight rebooking fees (if any)Other documents may be required as deemed necessary

Trip Termination or Curtailment

  1. Original medical report and/or Death Certificate of the Insured Person or the immediate family member. Documents must reflect the date of occurrence admission to hospital, death, accident, the diagnosis, the clinical background and treatment prescribed.
  2. Proof of occurrence of covered incident such as Police Report, Bureau of Fire and Protection Certificate/Report.
  3. Proof of Filiation (Birth Certificate, Marriage Certificate, etc.)
  4. Original receipts for the proportional part (non-refundable) of the value of the journey forfeited, including flight rebooking fees (if any)
  5. Other documents may be required as deemed necessary

Delayed Departure

  1. Original Airline Certification stating the cause or reason of the flight delay
  2. Copy of the actual flight itinerary and boarding passes
  3. Compensation Certificate/Letter from the Airline company
  4. Original official receipt of the additional expenses incurred due to the flight delay (food and/or accommodation)
  5. Other documents may be required as deemed necessary

Baggage Delay

  1. Original Property Irregularity Report (PIR) or Airline Certificate with length of delay of the checked-in baggage
  2. Baggage Delivery Receipt with date and time of delivery and receipt of the baggage
  3. Original certification of settlement of the compensation payment by the airline company
  4. Original official receipt of the additional expenses incurred in purchase of necessary clothing and toiletries
  5. Other documents may be required as deemed necessary

Loss or Damage of Checked-in Baggage

  1. Original formal complaint before the police at the place where the incident occurred duly listing the contents of the luggage and their economic value.
  2. Written complaint before the airline company, within the time limits established.
  3. Certificate of the said complaint Property Irregularity Report (PIR) from the airline.
  4. Official receipt in purchase of the lost or damage baggage
  5. List of the contents of the luggage with estimated price and date of purchase of each item.
  6. Photograph of the damaged item and the original receipt
  7. Original certification of settlement of the compensation payment by the airline company.
  8. Other documents may be required as deemed necessary

Hijack

  1. Certification from the airlines regarding the incident and stating how long the hijack lasted
  2. Other documents may be required as deemed necessary

Disclaimer: Kindly note that the submission of the above-mentioned documents does not guarantee approval of your claim. Your claim will be reviewed and evaluated based on available documents submitted and subject to the limits and the terms and conditions of your existing Agreement. Mercantile reserves the right to request for additional documents as deemed necessary.
Motor Documents Reference

For Own Damage Claim

  1. Photos of the unit showing damages & plate number/CS number
  2. Picture covering the scene of the accident
  3. Repair Estimate
  4. Police Report / Notarized Affidavit
  5. Clear & readable copy of CR with latest OR
  6. Clear & readable copy of driver’s license with OR (make sure that the date below the photo is readable)
  7. Company ID (if applicable)
  8. Authorization Letter executed by the policyholder (authorizing the driver to drive the unit at the time of the accident)
  9. Valid ID of the policyholder/insured
  10. Policy
  11. Other documents (as the adjuster may require)

For Property Damage Claim

  1. Photos of the unit showing damages & plate number/CS number
  2. Repair Estimate
  3. Clear & readable copy of CR with latest OR
  4. Clear & readable copy of driver’s license with OR
  5. Certificate of No Claim
  6. Other documents (as the adjuster may require)

By continuing you agree to our Data Privacy Notice.