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 |
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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 |
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Claim Indemnity Report Form | Municipal Agriculture Office | ||||
Picture of Damaged Crop | Self Provide | ||||
Technician’s Report | Municipal Agriculture Office | ||||
For Life Insurance Claim |
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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 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
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| 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
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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
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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
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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
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| 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
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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
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