"Name of Insured" - name of policy holder as appears on your insurance Policy Schedule.
"Email Address" - If form is being filled out online, we will need your email address to contact you.
"Address" - the address as appears on your insurance Policy Schedule.
"Date of Loss" - the date when the hurricane struck.
"Location of Loss" - complete if the locaton of loss is other than your address above. If similar insert "same as above."
"Policy Number" - as located on your policy - e.g. 0104A0000M1
"Contact Numbers" - provide us with your cellular, land line number, email, etc. so we could reach you.
"Agent" - if you had purchased your insurance through one of our agents, please provide name of agent. If policy was bought from our main office, leave blank.
Insert name of hurricane.
Provide us with your preliminary estimate for repair whilst you obtain a repair quotation from local contractor/repairman.
RF&G Insurance Company Ltd.
Gordon House
1 Coney Drive
Belize City, Belize C.A.