17/09/2017
What is a Personal Accident Insurance?
Personal Accident insurance or PA insurance is an annual policy which provides
compensation in the event of injuries, disability or death caused solely by violent,
accidental, external and visible events.
What
are
the schedules of benefits available?
Coverage
OPTION 1
OPTION 2
OPTION 3
OPTION 4
Accidental Death, Dismemberment
&/or Disablement
PHP 100,000.00
PHP 60,000.00
PHP 40,000.00
PHP 100,000.00
Burial Assistance (Due to Accidental
Death)
PHP 10,000.00
PHP 6,000.00
PHP 4,000.00
PHP 10,000.00
Period of Cover
1 year
1 year
1 year
6 months
-
For Options 1
–
3: Insurance coverage* is effective for one (1) year upon issuance of E
-
COC.
-
For Option 4: Insurance
coverage* is effective for six (6) months upon issuance of E
-
COC.
What
is an E
-
COC?
E
-
COC stands for Electronic Certificate of Coverage. It is a document issued by the Insurance
Company
thru GPRS as an accredited partner that describes a covered person’s
coverage
benefits,
limitations and
exclusions.
What
are the definitions of
benefits or coverage?
1.
Accidental Death
,
Permanent Disablement
/ Dismemberment
Pays the whole principal sum for loss of life in case of supervening death directly and necessarily
resulting from one and the same bodily injury for:
-
Loss of life within six (6) months from date of accident for short term policy
cover.
-
Loss of life with
in twelve (12) months from date of accident for annual
policy cover.
2.
Burial Assistance (following accidental death)
Provides financial assistance for burial expenses in the event of death due to accident of insured.
When is the
effectivity of
the insuran
ce coverage?
The insurance coverage shall be effective one (1) day after the date of purchase.
Who are eligible to avail the said Personal Accident Insurance?
Customers
with 18
-
64 years
of age
can avail the said PA insurance. However,
i
nsured’s
coverage
immediately terminates upon expiry of the insurance coverage,
or once insured
attains the age of
65
, should
a customer
age reaches
65
during policy period, coverage will
continue until it reaches expiration date.
Who are eligible to become my beneficiary
?
Insured person can nominate his or her preferred beneficiary. But it is always
recommended to nominate immediate family members.
Who are eligible to claim for the covered benefits?
Only the insured person or its beneficiary can request to claim covered benefits.
How can I claim for the covered benefits?
In the event of a claim, the claimant shall submit the complete claims requirements to
any
Malayan Insurance Company (MICO) branch nationwide.
How long can my claim request be processed?
MICO claims department shall facilitate and settle all valid claims within seven (7) working
days from receipt of the complete and accurate claim documen
ts from the insured.
What will be the form of payment
?
MICO shall release the claims payment check to the claimant
(beneficiary)
upon
presentation of a valid ID & signing of the quit claims form.
What are the requirements of claiming?
In the event of a
claim, the claimant shall submit the following requirements to nearest MICO
branch:
1.
General Requirements
a.
Claims forms (to be provided by MICO)
b.
Original Confirmation of Cover (COC)
c.
Duly notarized affidavit, police report or incident report
d.
Government
issued ID of Assured / Beneficiary
2.
For
Accidental Death
/ Burial Assistance
a.
Original or Certified True Copy of Death Certificate with seal and issued
by the Local Civil Registrar
b.
Original or Certified True Copy of Birth Certificate of the insured
c.
Post Mort
em Examination
d.
Autopsy Report, if any
e.
Identification of beneficiary:
For spouse: Marriage Contract
For parents/children/siblings: Birth Certificate
3.
For Accidental Dismemberment/Permanent Total Disability:
a.
Medical Certificate from attending physician
b.
Picture
, showing the injury
s there any exclusion in claiming said benefits?
The insurance policy shall not cover, and in no claims shall be settled for expense incurred in connection
with:
Loss caused directly or indirectly, wholly or partly, or occasioned
by:
-
Murder & assault or any attempt threat;
-
Bacterial infections, disease or sickness; pregnancy or miscarriage; congenital
anomalies or Acquired Immune Deficiency Syndrome (AIDS);
-
Su***de or any attempt threat (sane or insane), insanity or alcoholism
-
Terr
orism, war, invasion, act of foreign enemy, hostilities or warlike operations
(whether war be declared or not), civil war, rebellion, revolution, insurrection,
mutiny, military or usurped power, riot, civil commotion, strikes, military or
popular rising, o
r the use of a weapon or instrument employing atomic fission
or radioactive force, whether in time of peace or war;
-
Landslide or cave
-
in or mines, earthquake, tidal waves, typhoons/floods or
volcanic eruption;
-
Any bodily injury which shall result in hernia
-
Ionizing radiations or contamination by radioactivity
Loss while engaging in hunting, mountaineering, winter sports, ice hockey, football,
scuba diving, ice or water skiing, yachting, racing of any kind, steeple chasing, polo
playing (
PA’s does not inclu
de coverage for injuries resulting from any
hazardous/professional sports
)
Loss while participating in a brawl, committing a crime, or making an arrest or a
raid as an officer of the law;
Loss while under orders for warlike operations or for restoration
of public order,
while the insured is serving the armed forces of any country or international
authority, whether in peace of war
While operating, learning to operate or serving as a crew member of an aircraft or
vessel;
Any of the following persons:
-
Pe
rsons who are under the age of eighteen (18) years and over sixty
-
five (65)
years of age or mentally incompetent or physically impaired
-
Acrobats, asylum attendants, aviators, boiler men, detectives, divers, explosive
makers, firemen, fishermen, national journalists/news reporters, politicians and
other known celebrities/personalities, loggers, miners policemen, sailors,
sawmill workers, s
ecret service personnel, woodworking machinists,
underground workers and window cleaners, while performing their tasks as
such.
Documentary Stamp tax is not refundable in case of cancelation of deletion of
coverage
