Specialty Coffee Plantation Crop Insurance Claim
Policy Number
Date of Claim
Insured Name
Contact Number
Address of Plantation
Crop Variety
Total Area Insured (hectares)
Area Affected (hectares)
Estimated Loss (%)
Date of Loss
Cause of Loss
Drought
Excess Rainfall
Pests/Diseases
Frost
Fire
Other
Description of Loss
Upload Supporting Documents
Signature
Date