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The Softbroom Capital of the North, and Premier Highland Vegetable Producer, & Adventure Tourism Paradise of La Union

Application for Claim Indemnity Report

The Philippine Crop Insurance is entitled for the payment of Crop, fisheries and livestock losses arising from natural calamities, diseases and pest infestations. This also provides protection against non-crop agricultural asset losses due to perils for which the asset has been insured against. Not just for agricultural produce, but for insurance of life and limbs of farmer.

Office or Division:

Agriculture Office

Classification:

Complex

Type of Transaction:

G2C, G2G

Who may avail:

All Farmers

CHECKLIST OF REQUIREMENTS

WHERE TO SECURE

For Livestock Claim

 

Notice of Loss Duly Accomplished Form

Municipal Agriculture Office

Loss Report Form – Duly accomplished (1 original, 2 Photo copy)

Municipal Agriculture Office

Clear Photo of the Dead Animal  (showing the Sex  male/female)

 

Self Provide

Barangay Certification

Barangay Hall

Municipal Agriculturist Certification

Municipal Agriculture Office

Veterinary Report

Municipal Agriculture Office

Police Blotter Report (If due to Accident)

Municipal Police Station

Notice of two disinterested person

Mayor’s Office

For Crop Insurance

 

Claim Indemnity Report Form

Municipal Agriculture Office

Picture of Damaged Crop

Self Provide

Technician’s Report

Municipal Agriculture Office

For Life Insurance Claim

 

Loss Report

Municipal Agriculture Office

Death Certificate

Municipal Civil Registrar Office

Birth Certificate of Claimant (as proof for the relationship of the claimant and the insured, if the claimant is parents, siblings or child)

 

Municipal Civil Registrar Office

Marriage Certificate (if the claimant is spouse)

 

Municipal Civil Registrar Office

Medical certificate

Attending Physician/Municipal Health Station

Government Issued Identification card (1 photo Copy)  both the insured and the claimant

B.I.R Post Office DFA PSA SSS GSIS Pag-IBIG Philhealth COMELEC

Police Blotter Report (if the cause of death is accident)

 

Municipal Police Station

CLIENT STEPS

AGENCY ACTIONS

FEES TO BE PAID

PROCESSING TIME

PERSON RESPONSIBLE

1. Sign in the client log book in the office

1. Give the log book to the client

None

1 minute

Agricultural Technologists

Agriculture Office

Or

Government Internship Program

Agriculture Office

2. Tell your purpose to file for claim indemnity regarding the loss you experience

 

2. Talk to the client and check their records if it is still covered by the Insurance Period, If yes,  Issue loss report form, Notice of loss , Claim indemnity report form and assist the farmer in filling up the forms

 

2.1 Prepare the Certification and veterinary report

None

20 minutes

 Agricultural Technologists
Agriculture Office
Or
Municipal Agriculturist Agriculture Office

Livestock Inspector

Agricultural Technologist

Agriculture Office

Or

Municipal Agriculturist

Agriculture Office

3. Secure additional requirements from other offices

3. Give the list of additional necessary requirements and advise them to secure it from the office in charge

 

 

 

Municipal Civil Registrar Office

Municipal Police Station

Municipal Health Station

Municipal Mayor

San Gabriel, La Union

* Except for the Medical Certificate Secure it from the Hospital Attended by the Insured for Life Insurance Claim

4. Pay the corresponding fee for other requirements

4. Receive the payment of farmer base on the requirements needed

 

*Birth Certificate and Marriage Certificate are not necessary new, personal copy can be reproduced as requirement.

Police Report Fee-30.00 pesos

 

Affidavit of Two Disinterested person fee- 66.00 pesos

 

Death Certificate

Birth Certificate- 150.00 pesos

 

Marriage Certificate- 150.00 pesos

 

20 minutes

Administrative Aide IV

Municipal Treasury

 

5. Photo Copy the duly accomplished forms and requirement form (2 copies each page)

 

 

5. Advise them to reproduce all the requirements before submitting it for personal copy.

 

1.00 -2.00 pesos each page depending on the size (long or short)

10 minutes

Photo copy Centers

Near San Gabriel Municipal Hall

 

 

 

6. Return to the Municipal Agriculture office and submit duly accomplished application forms (Photo copied)  together with the requirements

6. Accepts the forms and  requirements then check for completeness

 

 

 

None

3 minutes

Agricultural Technologists

Agriculture Office

                         Or      

Municipal Agriculturist

Agriculture Office

7. Receive the personal copy and kept it for future references

 

 

7. Issue one of the photocopied duly accomplished application forms for personal references

 

7.1 File the remaining 1 photo copy for references

 

7.2 If None of the Municipal Agriculture Staff can travel and submit the application forms/ documents within 7 days the farmer itself is required to submit personally their application form to the Philippine Crop Insurance extension office

None

3 minutes

Agricultural Technologists

Agriculture Office

                         Or      

Municipal Agriculturist

Agriculture Office

8. Submit the Application forms and requirements to the Philippine Crop Insurance Extension Office (If none of the Municipal Agriculture Staff can Travel within 7 Days)

8. Accepts the Documents and verify for completeness

 

 

 

3 hours

Philippine Crop Insurance Staff

PCIC Extension Office

Barangay Biday, San Fernando city, La Union

9. Review and make sure that the transmittal being issued was signed by the authorized personnel or staff

9. Sign the transmittal and issue together with the official receipt (If applicable)

 

None

2 minutes

Philippine Crop Insurance Staff

PCIC Extension Office

Barangay Biday, San Fernando city, La Union

10. Furnished Copy of the transmittal to the Municipal Agriculture Office for their reference

10. Accept the transmittal and kept for future reference

None

5 minutes

Agricultural Technologists

Agriculture Office

                         Or      

Municipal Agriculturist

Agriculture Office

11. wait for the confirmation of PCIC office on the status  of their insurance via text messages

11. Turn-Over the duly accomplished application form (original copy) with transmittal to the Philippine Crop Insurance Corporation office *make sure that the transmittal will be signed by the person receives the documents submitted

* file the transmittal copy for future reference

None

7 days

Agricultural Technologists

Agriculture Office

                         Or      

Municipal Agriculturist

Agriculture Office

Philippine Crop Insurance Staff

PCIC extension Office

Brgy. Biday, San Fernando City, La Union

 

 

10. follow up or inquire in the Municipal Agriculture Office if no confirmation received

10. Follow up to PCIC Office regarding farmers application (as per farmer request) via phone call

None

1 Hour

Agricultural Technologists

Agriculture Office

                         Or      

Municipal Agriculturist

Agriculture Office

to

Philippine Crop Insurance Staff

PCIC extension Office

Brgy. Biday, San Fernando City, La Union

 

Official Website of the Municipality of San Gabriel