Stronghold Insurance Company Inc.

INSURANCE QUOTE

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To receive a free consultation session from our professional staff, simply fill out the form below and provide us with basic information about your desired non-life insurance product. Our professional team will contact you shortly after submitting your inquiry.

Report A Claim

FULL NAME OF ASSURED / INSURED

Salutation:

Last Name:

First Name:

Middle Name:

MAILING ADDRESS

No. / Building / Street :

Municipality / City :

Village / Subdivision :

Province:

Zipcode:

HOME / OFFICE ADDRESS

No. / Building / Street :

Municipality / City :

Village / Subdivision :

Province:

Zipcode:

CONTACT INFORMATION

Please indicate atleast one contact number.

Residence Tel. No.:

Office Tel. No.:

Fax No.:

Mobile No.:

Email Address:

Age:

Coverage Period:

Policy No.:

Requirements

The following must be submitted in order to facilitate the evaluation/processing of claim and/or issuance of our Letter of Authority to Repair (LOA).

OWN DAMAGE (Damage to your vehicle)

- Police report
- Driver’s statement/affidavit
- Xerox copy of driver’s license with official receipt
- Xerox copy of registration certificate with official receipt
- Picture of damage portion
- Xerox copy of policy
- Xerox copy of official receipt of premium payment
- Stencil of motor & chassis number
- Repair estimate

THIRD PARTY PROPERTY DAMAGE

- Police report
- Affidavit/statement of both drivers
- Driver’s license with official receipt of both drivers
- Xerox copy of registration certificate with OR both vehicles
- Picture of damaged portion of both vehicles
- Xerox copy of the policy of the inured with official receipt
- Stencil of motor & chassis number of both vehicles
- Repair estimate
- Certificate of No Claim from the insurer of the adverse party

THIRD PARTY BODILY INJURY

- Police report
- Driver’s statement/affidavit
- Driver’s license with official receipt
- Registration certificate with official receipt
- Xerox copy of OR of premium payment
- Xerox copy of certificate of cover or policy
- Original medical certificate
- Original medical receipt
- Stencil of motor and serial number
- Hospital statement of account
- Original prescription receipt

DEATH CLAIM

- Police report
- Driver’s statement/affidavit
- Driver’s license with OR
- Registration certificate with OR
- Xerox copy of certificate of cover
- Xerox copy of OR premium payment
- Death certificate of victim
- Birth certificate of victim
- Marriage license of parents of victim
- Original funeral receipts

Inquiries

INSURANCE QUOTE

Request A Quote

Report A Claim

FULL NAME OF ASSURED / INSURED

MAILING ADDRESS

HOME / OFFICE ADDRESS

CONTACT INFORMATION

Please indicate atleast one contact number.

Requirements

The following must be submitted in order to facilitate the evaluation/processing of claim and/or issuance of our Letter of Authority to Repair (LOA).

OWN DAMAGE (Damage to your vehicle)

THIRD PARTY PROPERTY DAMAGE

THIRD PARTY BODILY INJURY

DEATH CLAIM

Get In Touch

Head Office

Inquiries

INSURANCE QUOTE

Request A Quote

Report A Claim

FULL NAME OF ASSURED / INSURED

MAILING ADDRESS

HOME / OFFICE ADDRESS

CONTACT INFORMATION

Please indicate atleast one contact number.

Requirements

The following must be submitted in order to facilitate the evaluation/processing of claim and/or issuance of our Letter of Authority to Repair (LOA).

OWN DAMAGE (Damage to your vehicle)

THIRD PARTY PROPERTY DAMAGE

THIRD PARTY BODILY INJURY

DEATH CLAIM

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Get In Touch

Head Office