HISCOR Insurance Services Corp.
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Request a Quote

Please complete the form below. ( * Fields Are Required )

Basic Information

Name or Company:*
Address:*
Telephone Number:* Fax Number:
Cell Number:* Contact Person:
Email Address:*
How would you prefer your quote delivered?



   

Requirement Information

Service of Interest:
 
Vehicle Insurance
Private Vehicle
Vehicle's Year Model:
Vehicle's Make:
Vehicle's Value:
Expiration Date:
Commercial Vehicle
Vehicle's Year Model:
Vehicle's Make:
Vehicle's Value:
Expiration Date:
Marine Insurance
Value of Cargo:
Expiration Date:
Frequency:
Engineering Insurance
Value of Contract Expiration Date:
Value Amount: Expiration Date:
Type of Equipment:
Value of Equipment: Expiration Date:
Value of Equipment Expiration Date:
Casualty and Liability Insurance
Region:
Philippines
USA & Canada
Asia & Europe
Value of Coverage:
Expiration Date:
Amount of Coverage: Expiration Date:
Amount of Coverage: Expiration Date:
Amount of Coverage: Expiration Date:
Amount of Coverage: Number of People:
Service Type: Expiration Date:

Fire & Allied Perils

Type of Perils
Fire / Lightning
Earthquake / Shock
Typhoon / Flood
Riot, Strike & Malicious Damage
Broad Water Damage
Extended Cover
Business Interruption
Sum Insured:
Expiration Date:
 

 

Bonds
Value amount of contract: Performance Bond
Surety Bond
Supersedeas Bond
Contractual All Risk Bonds

Other

Please specify your insurance requirements:

Health Care Insurance Services (HMO)

Please specify your insurance requirements:

Aviation Insurance

Please specify your insurance requirements:

 

The key is communication.

We will be calling you for details and for a more personalized service.
For more information, you may call us at 899-3075 / 897-1135 / 897-7205
Date of availability


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