%20(43)%20copy.png)
Please read these terms and conditions carefully before using the policy.
• 24/7, 365 days inside or outside work premises during the policy period
• Worldwide
• While travelling in a public or private conveyance used for land and sea travel and while traveling as a passenger in any commercial airline flights.
• Age Limit - 18 to 65 yrs old
Provides a lump sum benefit to the designated beneficiary in the unfortunate event of your Kasambahay’s death due to accident and permanent disability.
Reimbursement for all the necessary medical expenses incurred for the treatment of bodily injuries resulting from an accident up to the limit specified.
Offers coverage in the unfortunate event of death or injury due to unprovoked murder and assault.
Reimburse medical costs if your kasambahay is injured by a pet bite.
Provides financial assistance for burial expenses in the event of death.
BODILY INJURY caused by violent, accidental external and visible means which injury shall solely and independently of any other cause result in:
A. Death occurring within twelve calendar months of bodily injury as aforesaid.
B. Permanent Disablement occurring within twelve (12) calendar months of bodily injury aforesaid and not followed within twelve calendar months of the said bodily injury by the death of the insured: the percentages in Table of Benefits.
C. 1. Total Disablement temporarily from engaging in or giving attention to profession or occupation: Weekly Compensation for such disablement at the rate of xxx.
C. 2. Partial Disablement temporarily from engaging in or giving attention to profession or occupation: Weekly Compensation for such disablement at the rate of one-third of benefit – C.1.
D. Medical and Surgical treatment for such injury: Indemnity for the expenses of such treatment incurred by the Insured subject to a Limit in respect of Any One Accident.
Compensation under benefits C.1 and C.2 either separately or together shall not be payable for a longer period than one hundred (100) weeks in respect of any one injury calculated from the date the Insured was first examined by a duly qualified Medical practitioner. The Insured shall for the purpose of this Policy be considered partially disabled under benefit C.2 when able to attend to some extent to his profession or occupation but unable to attend to a substantial part thereof.
The loss of the first joint of the thumb or any other finger or of any toe shall be considered as equal to the loss of one half (1/2) of the thumb or finger or toe and the benefit shall be one-half (1/2) of the benefit specified in the table above for the loss of the thumb or finger or toe.
The loss of more than one (1) phalange of the thumb or any other finger or of any toe shall be treated as a loss of the entire thumb or finger or toe.
Where, however, there is loss of two (2) or more parts of the hand, the percentage payable shall not be more than the loss of the whole hand.
Where the injury is not specified the Company will adopt a percentage of disablement which in its opinion is not inconsistent with the provision in this table.
The Aggregate of all percentages payable in respect of any one accident shall not exceed one hundred percent (100%).
Written notice shall be given to the Company without unnecessary delay but in any event within three (3) weeks of the occurrence of the injury in respect of which a claim is to be made. In event of accidental death, immediate notice thereof must be given to the Company.
All certificates, information and evidence required by the Company shall be furnished at the expense of the insured or his legal personal representative and shall be in such form and of such nature as the Company may prescribe. The Insured as often as required shall submit to medical examination on behalf of the Company at its own expense in respect of any alleged bodily injury. The Company shall in case of the death of the Insured be entitled to have a post mortem examination at its own expense. The Insured shall as soon as possible after the occurrence of any injury obtain and follow the advice of a duly qualified medical practitioner and the Company shall not be liable for any consequence arising by reason of the Insured’s failure to obtain or follow such advice and used such medical devices or remedies as may be prescribed.
The Insured shall give immediate notice in writing to the Company of any change in his address or in his profession or occupation or of the effecting of other insurances except certificates against accident disease or sickness and on tendering any premium for the renewal of this policy shall give notice in writing to the Company of any disease, sickness, physical defect or infirmity with which he has become affected or of which he has become aware since the payment of the preceding premium.
This policy may be renewed from term to term, subject to the consent of the Company, by issue of the renewal certificate by the Company and by payment of the premium in advance at the Company’s premium rate in force at time of renewal. The policy shall be renewable after the end of the period of insurance which the Principal Insured attains the age of seventy five (75) years. The Company may at any time give notice to the Insured to terminate this Policy forthwith without prejudice to the rights of the Insured in respect to prior injury provided that the Company return to the Insured the last premium paid by him less a pro-rata part thereof for the period of the year for which the Policy has been in force. Notice to be given to the Company may be given personally to the Insured in writing or send by registered mail to him at his last address known to the Company. By like notice to the Company the Insured may at any time terminate and cancel this Policy in which case the Company will retain the customary short period rate for the time the Policy has been enforced.
No assignment of the benefits of this Policy shall be binding upon the Company unless and until the originals or a duplicate thereof is filed with the Company. The Company does not assume any responsibility for the validity of any assignment. No change of Beneficiary under this policy shall guarantee the Company unless consent thereto is formally endorsed hereon by the Company.
“In the event of any controversy or claim arising out of or relating to this contract, or a breach thereof, the parties hereto agree first to try and settle the dispute by mediation, administered by the Insurance Commission or any recognized mediation institution under its Mediation Rules, before resorting to arbitration, litigation or some other dispute resolution procedure.”
or;
“In the event of any controversy or claim arising out of or relating to this contract, or a breach thereof, the parties hereto agree first to try and settle the dispute by mediation, administered by the (provide the name of the mediation center) under its Mediation Rules. If settlement is not reached within sixty [60 days] after service of a written demand for mediation, any unresolved controversy or claim arising out of or relating to this contract shall be settled by arbitration in accordance with the (name of the mediation body or center).”
IT IS HEREBY DECLARED AND AGREED that the provision of Article 1250 of the Civil Code of the Philippines (Republic Act No. 386) which reads: 'In case an extraordinary inflation or deflation of the currency stipulated should supervene the value of the currency at the time of the establishment of the obligation shall be the basis of payment'… shall not apply in determining the extent of liability under the provisions of this Policy. It is hereby further understood and agreed that in the event of a claim, an Insured, who is covered by two or more policies with the Company shall not recover nor the Company, make payment for more than what would have been recoverable if all the benefits in the different policies have been covered under one policy.
Unless the Company at least forty five (45) days in advance of the end of the Policy mails or delivers to the Assured at the address shown in the Policy notice of its intention not to renew the Policy or to condition its renewal upon reduction of limits or elimination of coverage, the Assured shall be entitled to renew the Policy upon payment of the premium due on the date of renewal.
No alteration to this Policy will be held valid unless the same is countersigned by the insured in accordance with Section 50 of the Insurance Code or initiated by an Authorized Officer of the Company.
This following scale of rates shall apply to policies issued or renewed for less than one (1) year and shall also be used in calculating return premium on policies cancelled and not replaced.
This contract shall terminate only in the event of accidental death as provided herein or upon expiry.
In any policy year, the total benefits payable under this contract in respect of any one accident resulting in loss(es) within one hundred eighty (180) days from date of accident(s) shall be the principal sum (e.g. loss of life, loss of both hands and feet, loss of sight of both eyes and either hand or foot).
In any policy year, the aggregate benefits payable under the Dismemberment/ Disability Benefit of this Contract in respect of one or more accident(s) resulting in any loss, the amount(s) payable under the Dismemberment/ Disability Benefit shall be the principal sum less the amount(s) paid for previous loss(es). However, the payment of all benefits under the Dismemberment/ Disability that equal the principal sum shall terminate such benefits except with respect to death coverage.
In any policy year, the amount of benefit payable for loss of life, arising from independent/ unrelated accident/event shall always be the principal sum.
Any partial benefit already paid for any loss (es) shall not be carried over in the subsequent policy year, (i.e. The amount of benefits to be paid in the succeeding policy year shall not be reduced by any amount paid in the proceeding policy year.)
This Policy shall not extend to cover:
(A) Death or disablement occasioned by or happening through:
i. War, Invasion, Acts of Foreign Enemy, Hostilities (whether war be declared or not), Civil War, Rebellion, Revolution, Insurrection, Mutiny, Military or Usurped power, martial law or state of siege or any of the events or causes which determine the proclamation or maintenance of martial law or stage of siege. Violence occurring in any Assembly or Demonstration, Civil Commotion, Riots, Strike, Military or Popular Rising.
ii. Suicide or Attempted Suicide (sane or insane), Hernia, Alcoholism, Venereal Disease or Insanity.
iii. Earthquake, Volcanic Eruption or Tidal Wave.
iv. Any weapon or instrument employing atomic fission or radioactive force, whether in time of peace or war.
(B) Death or disablement caused by murder, assault or homicide or any attempt thereat.
(C) Death or disablement occurring while the Insured is traveling in an aircraft other than one licensed for public passenger service and operated by a regular Air Line on a published schedule flight over a regular air route between two definitely established airports and in which the insured is traveling as a ticket-holding passenger.
(D) Death or disablement consequent upon the Insured engaging, whether for sports or otherwise, in hunting, racing of all kinds, steeple-chasing, polo playing, motor cycling (including pillion riding and/or driving a motorcycle, motor scooter, motor bicycle or any other two-wheeled motor vehicle having one or more riding saddlers), mountaineering, winter sports, ice hockey, football, or yachting or using woodworking machinery driven by mechanical power.
(E) Death or disablement occasioned by or happening through pregnancy or childbirth with respect to women.
(F) Death or disablement caused while the Insured is performing or attempting the performance of an unlawful act.
Compensation shall be payable only when the entire amount of the claim shall have been ascertained and proved to the satisfaction of the Company.
In the event of death of the Insured all sums of money payable under this Policy shall be paid to the legal personal representative of the Insured except that compensation for death under Benefit A of Table of Benefits shall be paid to the beneficiary(ies) designated in the Schedule thereto whose receipt for such compensation for death shall be final and full discharge of the liability of the Company therefore.
Accidental death and dismemberment benefits shall be payable even if the loss occurs one hundred eighty (180) days from the date of the accident.
All accident and Health Insurance policy with an annual coverage shall contain a free-look period of not less than five (5) days and a provision on return of full premium. A free-look period refers to the period of time in which a new health insurance policy owner can terminate or cancel the insurance policy. A free look period allows the policyholder to decide whether or not to continue with the contract, and if he or she decides to cancel it for whatever reason/s, the policyholder can demand the cancellation thereof.
It is hereby understood that upon the issuance of the policy, no Documentary Stamp Tax will be refunded as a result of the cancellation or endorsement of the policy or reduction in the premium due for whatever reason outside of the month of the issuance of the policy.
• Attending Physician Statement or Medical Certificate (original or Certified True Copy/CTC)
• Police Investigation Report and Statement of Witnesses (original or CTC)
• Birth Certificate (original or CTC) – insured/victim
• Death Certificate (NSO certified) – insured/victim
• Autopsy Report – if available (original or CTC)
• Marriage Contract (original or NSO certified)
• Two (2) Government Issued IDs
• Personal Accident Claim Report Form – duly accomplished and signed
• Attending Physician Statement or Medical Certificate (original or CTC)
• Police Investigation Report and State of Witnesses (original or CTC)
• Birth Certificate (original or CTC)
• Official Receipts – for additional medical expenses (original copy)
• Hospital Records – for amputation and operation performed by attending physician
• Picture of Amputated/Affected Body Part/s of the Victim:
- Whole Body picture
- Close shot of the affected body parts
• Two (2) Government Issued IDs