info@onealliancepr.com
+1 787 622 3333
Instagram
Facebook-f
Twitter
Linkedin-in
Home
About Us
Services
Personal Lines
Commercial Lines
Informative 480
Contact
Home/Roadside Assistance
Home
About Us
Services
Personal Lines
Commercial Lines
Informative 480
Contact
Home/Roadside Assistance
Home
About Us
Services
Personal Lines
Commercial Lines
Informative 480
Contact
Home
About Us
Services
Personal Lines
Commercial Lines
Informative 480
Contact
Roadside Assistance
Assurena Insurance Agency is an independent insurance brokerage agency that carries some of the best coverage options in the entire New USA.
Our Contacts
88 Centre Street North,
Toronto L4W 1C9
advisor@assurena.com admin@assurena.com
+1 (419)-507-0468
+1 (213)-345-0468
Working Hours
Monday
9.00 - 5.00
Tuesday
8.00 - 5.00
Wednesday
8.00 - 5.00
Thursday
8.00 - 5.00
Friday
8.00 - 4.00
Satureday
Closed
Sunday
Closed
Twitter
Facebook
Linkedin-in
Skype
Catastrophe Incident Report
Catastrophe Incident Report
Insured's name
E-mail address
Insured's phone number
Mailing Address
Policy number
Date of incident
Type of incident
Hurricane or storm
Earthquake or tempering
Floods
Others
Location
Road
Kilometer
Neighborhood
Municipality
No. of vehicles involved
Age
Sex
Male
Female
License number
State issuing the license if other than P.R.
Last 4 social security numbers
Town
Zip Code
Work phone
Name of the insurance company covering you
Driver's name
Driver's last name
Age
Sex
Male
Female
License number
State issuing the license if other than P.R.
Last 4 social security numbers
Address
Town
Zip Code
Residence phone number
Work phone
Date of payment
Expiration date
Brand
Model
Year
Color
Tablet number
Mileage
Engine or serial number (VIN)
Registration number
Write the accident and damage sustained by Vehicle 1, and include other comments.
Owner's name
Owner's last name
Age
Sex
Male
Female
E-mail address
License number
State issuing the license if other than P.R.
Last 4 social security numbers
Address
Town
Zip Code
Residence phone number
Work phone
Name of the insurance company covering you
Date of payment
Expiration date
Brand
Model
Year
Color
Tablet number
Mileage
Engine or serial number (VIN)
Registration number
Write the accident and damage sustained by Vehicle 1, and include other comments.
The content of this report does not imply recognition of responsibility of the parties involved in the accident, but a correct compilation of information that will facilitate the processing of claims that may be made as a result of this accident. LAW #18 ARTICLE 27.320 "Any person who knowingly and with intent to defraud files false information in an application for insurance, or who presents, assists or causes to be presented a fraudulent claim for the payment of a loss and other benefit; or presents more than one claim for the same damage or loss, shall incur a felony and, upon conviction thereof, shall be sanctioned for each loss, shall incur a felony and, upon conviction thereof, shall be sanctioned for each violation with a fine of not less than five thousand ($5,000) dollars, nor more than ($10,000) dollars or imprisonment for a fixed term of three (3) years, or both penalties. If there are aggravating circumstances, the fixed penalty established may be increased up to a maximum of five (5) years; if there are extenuating circumstances, it may be reduced to a minimum of two (2) years."
I accept
Send
Need help?
Contact us
Call an agent
