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Claim Forms

We make certain transactions easy for you by making transactional forms available online. If you need to make a change on your insurance application or existing policy, or to facilitate continuous billing through credit card, or decided to switch funds for your unit-linked policy, or even file a claim, then such transactional forms are listed below for you to click, print, and accomplish anytime, anywhere.

Attending Physician’s Statement for Death Claim Download Form (.PDF)
Attending Physician’s Statement for Living Benefits Download Form (.PDF)
Statement of Claimant for Death Benefit Download Form (.PDF)
Statement of Claimant Dismemberment/Hospitalization/Accidental Medical Reimbursement Download Form (.PDF)
Statement of Claimant for Disability Download Form (.PDF)



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Contact Us

9th Floor, Allied Bank Center, 6754 Ayala Avenue corner Legaspi Street,
Makati City, Philippines

Trunkline: 818-LIFE (5433)
Fax : 818-2701
Domestic Toll Free Number: 1-800-10-818-5433

MAKATI CENTRAL OFFICE P.O. BOX 3191

Email: [email protected]
Service hours: 9:00am to 6:00pm

Copyright 2017 | All Rights Reserved | Allianz PNB Life Insurance Inc.