CLAIMS PROCEDURE

CLAIMS PROCEDURE

Hospitalization

Any policy holder who is confined in a hospital for at least 18 hours as a resident patient may apply for a hospitalization claim benefit, subject to the company’s approval upon submission of the following and other pertinent documents:

  • Duly accomplished claim form:
  • Original copy of Record or details of consultations and treatments in the past.
  • Itemized Hospital Statement of Account showing the time and date of admission and discharge.
  • Original or true copy of Hospital Admitting History and Discharge Summary or Medical Abstract which you can obtain from the Records Section of the hospital.
  • Record or details of operation (if surgical operation was performed).
  • Results of laboratory procedures and diagnostic examinations.
  • Photocopy of 2 valid IDs of the insured (e.g. passport, SSS, TIN, Comelec, etc.).
  • Any other additional documents as the company may require later.

Death

The following documents must be submitted when filing an application for death claims:

  • Original copy of Claimant’s Statement (click to download the form) duly accomplished by every beneficiary of legal age.
  • Original copy of Claimant’s Authorization (click to download the form).
  • Original Identification of the Deceased (click to download the form).
  • Original copy of the Certificate of Attending Physician (click to download the form).
  • Original or true copy of death certificate issued by the Local Civil Registrar of the place of death, bearing his signature and seal of office
  • Original policy contract or if lost or could not be found Affidavit of Loss executed by the beneficiary/ies.
  • Birth or Baptismal certificate of the deceased.
  • Birth or Baptismal certificate of the beneficiary / ies.
  • Marriage contract of the spouse-beneficiary.
  • Original copy of Affidavit of surviving heirs if the beneficiary is already deceased.
  • Any other additional papers as the company may require later.

Education

  1. To file a claim for the Semestral Benefit:
    • Submit a copy of birth certificate on or before the schedule of the first semestral benefit.
    • Subsequent semestral benefit will automatically be issued and delivered to the policyholder as scheduled.
    • Semestral benefit checks will be available every May and October.
  2. To file a claim for the Graduation Gift:
    • Submit the original policy contract (Affidavit of loss, if lost) on or before attaining the insurance age of 21 years old.
  3. To file a claim for the Contingent Benefit:
    • Beneficiary should submit the death claim requirements stated above if the policyholder is deceased.
    • If the policyholder is permanently and totally disabled, submit the medical records or certification showing such condition.

Maturity Benefits (MPP, TMS, MSP, TMP)

Policyholder must submit the following requirements:

  • Original policy contract (Affidavit of loss, if lost)
  • Copy of 2 valid IDs
  • Copy of Birth Certificate or Baptismal Certificate
Note:

Once completed, forward all the requirements to the Head Office or any PLGIC branch.

Benefit checks of all approved claim applications shall be available within 10 to 15 business days (for pick-up or courier delivery) from the receipt date of the complete requirements.