| BENEFITS | COVERAGE | ||
|---|---|---|---|
| DEATH INDEMNITY (including burial and funeral expenses) |
₱20,000.00 | ||
| BODILY INJURIES AND FRACTURES | Hospital Rooms | Maximum of 45 days per accident | ₱500.00/day |
| Laboratory examination fees, X-rays | ₱2,000.00 | ||
| Surgical Expenses | Major Operation | ₱7,500.00 | |
| Medium Operation | ₱5,000.00 | ||
| Minor Operation | ₱1,500.00 | ||
| Anesthesiologist’s Fees | Major Operation | ₱2,500.00 | |
| Medium Operation | ₱2,000.00 | ||
| Minor Operation | ₱500.00 | ||
| Operating Room | Major Operation | ₱1,500.00 | |
| Medium Operation | ₱1,000.00 | ||
| Minor Operation | ₱500.00 | ||
| Medical Expenses | For daily visits of Practitioner or Specialist | ₱400.00/day | |
| The total amount of medical expenses must not exceed (For a single period of confinement) | ₱5,000.00 | ||
| Drugs and Medicine | Actual value of drugs and medicine used but not to exceed | ₱20,000.00 | |
| Ambulance | Actual amount charged for ambulance transport but not to exceed | ₱1,500.00 | |
| PERMANENT DISABLEMENT | Up to ₱50,000.00 (subject to schedule) |
||
| INCIDENTAL EXPENSES | Up to ₱10,000.00 (subject to schedule) |
||
TERMS and CONDITIONS
SECTION I - LIABILITY TO THE PUBLIC
- The Company will pay all sums necessary to discharge liability of the Insured, arising from all expenses and damages directly resulting from any bodily injury and/or death to any THIRD PARTY (excluding all moral, exemplary and other incidental damages, expenses and loss of income) in an accident caused by the use of the Scheduled Vehicle, provided that the Insured’s liability shall have first been determined, but not exceeding in the aggregate Php. 200,000.00 per occurrence or any one occurrence, regardle ss of the number of individual claims.
- In terms of and subject to the limitations of this Policy, the Company will indemnify: -
- authorized Driver who is driving the Scheduled Vehicle, provided that he: -
- Observes, fulfills, and be subject to the Terms of this Policy insofar as they can apply;
- is not entitled to indemnity under any other policy subject, however, to Condition No.8 of the Conditions Applicable to All Sections.
- the Insured whilst personally driving a private motor car not belonging to him and not hired to him under a hire purchase agreement.
- authorized Driver who is driving the Scheduled Vehicle, provided that he: -
- In the event of the death of any person entitled to indemnity under this Policy, the Company will, in respect of the liability incurred to such person indemnify his personal representatives in terms of, and subject to the terms and conditions hereof.
- In the event of accident involving indemnity under this Policy to more than one person, the Limits of Liability shall not exceed the aggregate amount so specified by Law to all persons to be indemnified. Should indemnification both to liability of the Insured and that of another party (as provided under Authorized Driver) be provable, the Insured’s shall have prior right thereto.
- Unless the Insured objects, the Company shall: -
- arrange for representation at any inquest or investigation in respect of any death which may be the subject of indemnity under this Section;
- Undertake the defense in the Insurance Commission under Section 385 of the Insurance Code, or in any court of law, for alleged offenses causing, or relating to any event which may be the subject of indemnity under this Section.
SECTION II - NO FAULT INDEMNITY
The Company will pay any claim for bodily injury and/or death to any THIRD PARTY without the necessity of proving fault or negligence of any kind, provided that,
- the total indemnity in respect of any one THIRD PARTY shall not exceed Thirty Thousand Pesos, subject to the foregoing Schedule of Indemnities in case of death or physical injury, without prejudice to the claimant from pursuing his claim further, in which case he shall not be required or compelled by the Company to execute any Quit Claim or document releasing it from liability under the policy of insurance.
- the following proofs of loss, when submitted under oath, shall be sufficient evidence to substantiate the claim: -
- Police report of accident or any evidence sufficient to establish the accident, and
- Medical report and evidence of medical or hospital expenses and/or;
- Death Certificate and evidence sufficient to establish the proper payee.
Applicable to All sections
Policy Overview: This policy and the schedule form one contract; specific meanings apply throughout.
Notifications: All communications must be in writing to the Company.
Vehicle Maintenance: The Insured must keep the Scheduled Vehicle in good condition allowing the Company access for inspection.
Claims Notification: Notify the company of any accident or claim immediately, including criminal acts. Corporate with authorities.
Claim Management: No admissions or payments without the company's written consent. The company may handle claims on behalf of the insured.
Claim Settlement: The Company can pay claims jointly to the Insured and third parties and relinquish claim management.
Policy Cancellation: The Company may cancel the Policy as per the Insurance Code. The Insured can cancel but must secure replacement coverage to avoid gasps.
Other Insurance: If multiple insurance cover the same claim, the Company pays only its share.
Dispute Resolution: Disputes regarding this policy are under the jurisdiction of the Insurance Commissioner
Policy Compliance: Adherence to Policy terms is necessary for the Company's liability to pay claims.
Reimbursement: The Insured must reimburse the Company for claims paid under the " No Fault" provision if any policy conditions are breached.
Dispute Settlement: Parties agree to mediation before pursuing arbitration or litigation.
