Data Collection Notice
Submission Successful!
Thank you for submitting your car details. We’ll process your request shortly.
Please allow us to validate the information you submitted. We will get in touch with you in two (2) working days.
Insurance Computation
Selected Car Details
Edit Coverage
Insured Up To:
i This is the maximum limit to be paid to the policy owner. In case of a total loss claim, the amount to be paid will be based on the fair market value (FMV) of the vehicle at the time of loss.REGISTERED OWNER'S INFORMATION
Present Address
Vehicle Details
Application Summary
Selected Car
Brand:
Model:
Variant:
Year:
Fair Market Value:
Owner Info
Full Name:
Email:
Phone:
Sex at Birth:
Civil Status:
Birthdate:
Address:
Vehicle Details
Plate/Conduction Number:
MV File Number:
OR/CR Registration Date:
OR/CR Expiration Date*
Insurance Coverage
Provider:
Fair Market Value:
BI Coverage: ()
PD Coverage: ()
Acts of Nature: ()
Uploaded Documents & Images
Referral Code (Optional)
Submission Successful!
Thank you for your interest in purchasing a Motorcar coverage from us!
Please allow us to review the information you submitted. We will get in touch with you in two (2) working days.
You may also directly reach us from Mondays to Fridays, 8:00AM to 5:00PM, through:
Mobile: (+63931) 127-9348
E-mail: admin@powerwealth.ph