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What are the requirements to file a claim? Requirements are different for each type of claim.
A. Death claim
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Standard requirements
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One (1) Claimant Statement Form per beneficiary
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Death certificate of the Life Insured
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One (1) valid government-issued photo ID of the beneficiary
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Other conditional requirements (as applicable)
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For claims for policies that have been active or reactivated/reinstated within two years:
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Attending Physician’s Statement
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Complete medical records or health history of the deceased (may be requested from hospitals or clinics that attended to the deceased)
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Admission and discharge summary
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Consultation record of present and past illness, if any
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Clinical abstract, if any
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Diagnostic procedure results (e.g. ECG, biopsy, blood test, ultrasound, MRI, any endoscopy procedure, x-ray), if any
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Hospital Confinement records of present and past illness, if any
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HMO utilization report, if any
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For minor beneficiary (less than 18 years old):
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Birth certificate of the minor beneficiary
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Affidavit of legal guardianship for claim proceeds less than PHP 500,000 or USD 10,000 (The form for Affidavit of legal guardianship is provided by us once claim is approved)
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Guardianship bond for claim proceeds more than PHP 500,000 or USD 10,000
For the guardianship bond, to seek legal assistance to submit the following requirements:- Petition for the approval of a guardian’s bond;
- Court order approving the issuance of a bond; and
- A guardian’s bond.
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If death is by external causes (e.g., accident, homicide, suicide, murder):
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Certified true copy of the Final Investigation report of police authorities or National Bureau of Investigation
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Driver’s license and vehicle registration if the Deceased was driving a vehicle at the time of death
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Certified true copy of Medico-Legal Report or Autopsy Report, if any
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Police report/Incident report if death is due to accident
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If the policy has been assigned:
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If the related loan has no outstanding balance at the time of death, duly signed Release of Assignment from the Assignee
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If the related loan has an outstanding balance, certification of outstanding indebtedness (signed by the Assignee) of the Deceased at the time of death. The assignee must also submit the Claimant Statement and a valid government-issued photo ID.
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For Group Yearly Renewable Term or Group Personal Accident
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Employer’s Certification
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For Mortgage Redemption Insurance (MRI)
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Certificate of Coverage of Group Creditor Life Insurance
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Certificate of Outstanding Loan from Creditor on the amount of loan outstanding at the time of death
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For Field Trip Coverage
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Field trip certificate from school
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Incident or police report
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B. Medical claim
B. Medical claim (for accident or hospital income claims)
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Additional mandatory requirements based on type of claim
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For Daily Hospital Income/Intensive Care Unit
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Hospital Statement of Account with admission and discharge date
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Clinical Abstract
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For Accidental Medical Reimbursement
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Incident Report/Police Report describing the accident
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Official receipts related to the treatment of the injury and within 30 days from date of accident
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Prescription of the medicines used during treatment
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For Surgical Expense Benefit
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Record of Operation
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Original official receipts for surgeon’s fee, anesthesiologist’s fee, operating room fee, and recovery room fee
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Standard requirements
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Hospitalization and Reimbursement Claim form
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Attending Physician’s Statement
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One (1) valid government-issued photo ID of the claimant
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Other conditional requirements
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For Dengue
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Any of the following confirmatory laboratory test results on Dengue:
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Dengue Virus Antigen Detection (NS1); or
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Dengue IgM (MAC-ELISA); or
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Thrombocyte count less than 100,000/mm², with hospital confinement as shown by:
- admission summary and discharge clinical abstract summary, and
- duly certified statement of account of hospitalization
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For Typhoid
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The diagnosis must be confirmed by the Life Insured’s attending physician, accompanied by any of the following confirmatory tests for Typhoid and Paratyphoid Fever:
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Widal test for S typhi O values of more than or equal to 1/200;
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Stool, Urine, Blood or Bone Marrow culture to detect Salmonella enterica serotype Typhi (S. typhi), or value> 7 from the results of the tubex test; or
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Typhidot test
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admission summary and discharge clinical abstract summary, and
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duly certified statement of account of hospitalization
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For Measles
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The diagnosis must be confirmed by the Life Insured’s attending physician, accompanied by the following confirmatory test for Measles:
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The diagnosis must be confirmed by the Life Insured’s attending physician, accompanied by the following confirmatory test for Measles:
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Measles (Rubeola) IgM antibody
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For Malaria
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The diagnosis must be confirmed by the Life Insured’s attending physician, accompanied by the following confirmatory test for Malaria:
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Peripheral smear for Malaria parasites (MP test)
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If the claimant is or the event happened outside the Philippines
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All forms and proofs of claim obtained outside the Philippines must be in English and apostilled or duly authenticated by the Philippine Embassy or Consul of the country where the event happened.
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Medical records from a hospital located abroad do not require authentication by the Philippine Embassy located in the foreign country. Apostille mark or stamp for medical records is accepted.
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If the claimant is a legal entity
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Secretary’s Certificate confirming the board resolution authorizing the company representative
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General Information Sheet
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One (1) valid government-issued photo ID of the representative
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C. Critical Illness claim
C. Critical Illness claim (for major disease claims)
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Standard requirements
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Claimant Statement
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One (1) valid government-issued photo ID of the claimant
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Complete Medical Records supporting the critical illness diagnosis (duly certified by the issuing hospital/institution):
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Admission and Discharge Summary;
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Clinical Summary and Abstract;
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Diagnostic procedure results supporting the diagnosis (e.g. ECG, biopsy, blood test, ultrasound, MRI, any endoscopy procedure, x-ray, etc..)
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History Sheet: Contains the chief complaint, personal and family history (past and present)
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Additional requirements based on type of illness
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For cancer
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Attending Physician’s Statement – Crisis Cover (Cancer, Terminal, or Other Illnesses)
Download Attending Physician’s Statement – Crisis Cover Cancer Terminal or Other Illnesses
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Biopsy and/or histopathology results
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If leukemia, bone marrow diagnostic result
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For stroke
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Attending Physician’s Statement – Crisis Cover (Stroke)
Download Attending Physician’s Statement – Crisis Cover Stroke
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CT scan or MRI result/s
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For heart attack
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Attending Physician’s Statement – Crisis Cover (Heart Attack)
Download Attending Physician’s Statement – Crisis Cover Heart Attack
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All ECG Results and interpretations – Series
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Cardiac enzyme – Troponin / CK-MB
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Coronary angiogram result
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Echocardiogram, if any
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For brain tumor
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Attending Physician’s Statement – Crisis Cover (Cancer, Terminal, or Other Illnesses)
Download Attending Physician’s Statement – Crisis Cover Cancer Terminal or Other Illnesses
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All CT scan/s
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Biopsy result, if any
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MRI result/s
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Record of operation, if any
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For renal failure
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Attending Physician’s Statement – Crisis Cover (Renal Failure)
Download Attending Physician’s Statement – Crisis Cover Renal Failure
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BUN
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Creatinine
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Dialysis record (Certified True Copy)
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Glomerular Filtration Rate (GFR)
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Urinary Creatinine Clearance
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Urinary Protein Determination
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D. Total Permanent Disability and Accidental Disablement (TPD)
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Standard requirements
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Claimant Statement
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Attending Physician’s Statement
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One (1) valid government-issued photo ID of the claimant
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Activities of Daily Living
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Complete Medical Records supporting the Disability (duly certified by the issuing hospital/institution):
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Neurological Examination
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Clinical Abstract for Confinement, if any
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Certified True Copy of Record of Operation, if any
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Employer’s Certification
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SSS Certification on Total and Permanent Disability, if any
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FAQs
Who can file a claim?
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For living benefit, the life insured or policyowner can file a claim.
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For death benefit, a beneficiary of legal age or a minor beneficiary’s guardian can file a claim.
Where can I file a claim?
- Via online
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Start your claim by submitting to makeaclaim@prulifeuk.com.ph
Purpose Subject line New claim Claims_New Request_Policy Number Requirement submission Claims_Requirement_Ticket Number or Policy Number Inquiry Claims Inquiry_Ticket Number or Policy Number -
- Via your agent
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Your agent can help hand in your form and manage the process, so you don’t have to.
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- Via customer center
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Drop your completed forms and relevant documents at a customer service center.
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How do I file a claim?
- Step 1: Start your claim
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Complete the claims request form to let us know you're making a claim.
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- Step 2: Prepare your documents
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Prepare the necessary forms and documents while you wait for our acknowledgement.
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- Step 3: Submit your documents
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Submit your documents via email to makeaclaim@prulifeuk.com.ph.
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- Step 4: Receive your claim
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Once approved, we'll send your claim to you via fund transfer or Gcash.
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