File a claim online

Online Claim Notification

Welcome to the Online Claim Notification of Standard Insurance! Please complete the form below to facilitate the notification of your claim. Our Claims Representative will immediately get in touch with you regarding this claim. Thank you.

Fields with (*) asterisks are mandatory

I. Policy holder Details

*Policy Number: - - (ATQ-ARC-123456789)
Are you a CompanyIndividual
Type of Policy with Standard Insurance:

*Policy Holder Name:

MrMrs

Last Name :
First Name :
Middle Initial :

* Address:

No. / Building / Street :
Village/ Subdivision :
Municipality/City :
Province :

* Contact Details ( Kindly provide an email address and at least one contact number so that we can get back to you regarding your claim.)

*Residence Number :
*Mobile Number :
Office Number :
Fax :
Email Address :

II. Details of Claim/Loss

*Date of Loss
*Estimated Time of Loss
*Place of Loss
*Brief Description of the Circumstances of Loss

III. Claim Notified By:

*Policy holderRepresentative of Policy holder

If other than the Policyholder, please specify name and relation to Policyholder

*Name
*Relation to Policyholder
*Contact Details:

Telephone
Mobile
Email
Fax

Upload Claim Documents :

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click here for the list of claim requirements