Mapfre Insular Insurance Corporation
Mapfre Insular Corporate Center, Acacia Ave., Madrigal Business Park Ayala Alabang, Muntinlupa City
876-4404 <TIN: 000-491-771-000>
and
The Insular Life Assurance Company, Ltd. Inc.
IL Corporate Centre, Insular Life Drive, Filinvest Corporate City Alabang, Muntinlupa City
878-1818 <TIN: 000-464-124>
(The Insurance Providers)
HEREBY ISSUE this Group Yearly Renewable Term Policy to
Sikap Buhay Entrepreneur & Cooperative Office
(The Policyholder)
KaKAMPi Microinsurance
Group Master Policy Number : AC-GPA-HO-0005243 Policy Effective Date : 07/08/2015
POLICY PROVISIONS Definition of Terms
1. Mapfre – refers to Mapfre Insular, a duly licensed insurance company that will undertake the servicing of this policy and payment of the benefits provided under the Insurance Benefit Schedule of this Policy.
2. Insured – refers to any person who is eligible for insurance and covered under this Group Master Policy.
3. Beneficiary – refers to the person/s designated by the Insured, as defined under the “Beneficiary” provision of this group master policy, to receive the insurance proceeds provided for under this policy upon the death of the Insured.
4. Policyholder – refers to associations, employer, or groups and organizations representing their members, employees or clients.
Benefits
This Group Master Policy provides the following life insurance benefits and insurance coverage shall be provided as follows:
Insurance Provider Benefit
Insular Life Assurance Company Ltd., Inc. Natural Death Mapfre Insular Insurance Corporation Accidental Death
Mapfre shall be the Administrator of this Group Master Policy and shall be responsible for the following:
1. Receiving and processing of Life insurance application forms and issuance of Individual Certificates of Insurance.
2. Receiving and processing of natural and accidental death claim notifications and payment of death benefits.
Subject to all conditions and provisions, Mapfre will pay the natural or accidental death benefit in accordance with the Insurance Benefit Schedule under this Group Master Policy, upon receipt and approval of due proof of death of the Insured.
Natural Death
Death resulting from a natural cause or cause other than accidental bodily injury shall be covered by Insular Life.
Accidental Death
Death resulting from accidental bodily injury shall be covered by Mapfre. Accidental death refers to death resulting directly and solely from external, violent, and accidental means visible on the surface of the body or disclosed by an autopsy where not forbidden by law, and occurring within one hundred eighty (180) days from the date of the accident.
Individual Application Required
Each Insured shall submit to Mapfre a duly signed application for insurance, on a form furnished by Mapfre. The Insured shall indicate therein his true and correct personal data and his beneficiary or beneficiaries.
Entire Contract
This policy, the group application, and the individual application, copies of which are attached, shall constitute the entire contract.
Persons Eligible
Any person satisfying all of the following conditions shall be eligible for insurance under this Group Master Policy:
1. At least 18 years old but not more than 75 years old at the time of application;
2. Actively-at-Work at the time of application where the term ”actively-at-work” shall refer to the applicant’s capability of performing his profession from which he derives income or the performance of the applicant’s daily household domestic activities if not gainfully engaged in a profession.
Beneficiary/ies
The Beneficiary/ies is/are the person/s designated to receive the proceeds of this Group Master Policy upon the death of the Insured, unless otherwise changed and provided that they are not disqualified under the law.
Effectivity of the Individual Coverage
The Individual Coverage becomes effective only when the Insured is alive and in good health on the date of payment of the initial premium. The term “Insured” shall be used to refer to any person who is eligible for insurance and covered under this Group Master Policy.
Certificate of Individual Insurance
Mapfre shall issue to each Insured a Certificate of Insurance setting forth a statement as to the insurance protection to which he/she is entitled, to whom the insurance benefits are payable, and the rights set forth in the Conversion Privilege provision. In case of any inconsistency between the Certificate of Insurance and this Group Master Policy, the provisions of this Group Master Policy shall prevail.
Conversion Privilege
If the insurance, or any portion of it, on an insured under this Group Master Policy ceases because of termination of membership under this Group Master Policy, such insured shall be entitled to have issued to him by the Insurance Provider, without evidence of insurability, an individual policy of life insurance without disability or other supplementary benefits, provided application for the individual policy and payment of the first premium to the Insurance Provider shall be made within thirty (30) days after such termination, and provided further that:
1. The individual policy shall be on any of the forms, except term insurance, then customarily issued by the Insurance Provider at the age and for an amount not in excess of the coverage under this Group Master policy; and
2. The premium on the individual policy shall be at the Insurance Provider’s then customary rate applicable to the form and amount of the individual policy, to the class of risk to which such Insured then belongs, and to his age attained on the effective date of the individual policy.
If this Group Master Policy terminates or is amended so as to terminate the insurance of any class of insureds, every insured thereunder at the date of such termination whose insurance terminates and who has been so insured for five (5) years prior to such termination date shall be entitled to have issued to him by the Insurance Provider an individual policy of life insurance subject to the same limitations as set forth in the preceeding paragraph;
If an insured under this Group Master Policy dies during the thirty (30) day period within which he would have been entitled to an individual policy issued to him in accordance with the preceeding paragraphs under this provision, and before such individual policy shall have become effective, the amount of life insurance which he would have been entitled to have issued to him as an individual policy shall be payable as a claim under this Group Master Policy whether or not application for the
Payment of Premiums
Subject to the Grace Period herein provided, all premiums are payable by the Insured on or before the due dates at Mapfre’s duly designated offices or authorized payment centers.
Premium Rates Revision
Any revision in the Premium Rates shall take effect on any anniversary of the Policy Effective Date and shall be subject to the approval of the Insurance Commission.
Grace Period
Except for the initial premium, a grace period of forty-five (45) days from due date of the premium payment is allowed, after which if the premium is not paid, this Group Master Policy shall automatically terminate.
Misstatement of Age
In the event the age of an Insured has been incorrectly stated, Insurance Providers may adjust the premiums or benefits or both according to the correct age of the Insured. If the Insured is not eligible for coverage, Mapfre shall refund all premiums paid.
Contestability
An individual coverage can be contested by Mapfre within one (1) year from the Effective Date of the Insured’scoverage.
Suicide
Except for reason of insanity, Mapfre shall not pay any death benefit if the Insured commits suicide within one (1) year from the effective date of his/her individual insurance coverage. Mapfre however shall refund the premiums paid on behalf of the Insured.
Termination of Group Master Policy
This Group Master Policy shall automatically terminate on the earliest of the following: 1. date of receipt of a written notice from Policyholder to terminate this Policy; or 2. end of grace period if the premium remains unpaid; or
3. date of Mapfre’s written notice of termination to the Policyholder when the number of the insureds falls below 100 lives.
Termination of Individual Insurance
The insurance of any Insured shall terminate on the earliest of the following:
1. date this Group Master Policy terminates in accordance with the Termination of Group Master Policy Provision, provided however, that the unearned premium, if any, for the month under which the individual insurance terminates shall be refunded to the Policyholder for the account of the Insured; or
2. date the Insured ceases to be eligible for insurance under this Group Master Policy as stated in the Persons Eligible Provision; or
3. end of grace period if the premium for the insured remains unpaid; or 4. date the individual insurance of the insured expires.
Notice and Proof of Claim
Notice of claim must be submitted to Mapfre within thirty (30) days and proof of claim within ninety (90) days from date of death, except when it can be shown that failure to submit the notice and proof within such time is due to valid reason.
Claims Settlement
Claims under this Group Master Policy shall be settled within ten (10) working days upon receipt of complete documents.
Limitation of Complaints
Any complaint or grievance on this Group Master Policy must be filed with the proper authorities within two (2) years from the time of rejection or denial of the claim. The venue for filing of complaints and grievances on the Group Master Policy must not be limited to the place of issue of contract.
Dispute Resolution
All disputes arising in connection with this Group Master Policy shall be initially settled through alternative dispute resolution mechanism
Optional Value Added Service
At the sole option of the Beneficiary/ies, the Beneficiary/ies may decide to use the death benefit to pay for expenses related to providing a decent and customary burial for the Insured and/or for livelihood related activities. In this event, the Beneficiary may request Mapfre, at no additional cost, for assistance in facilitating burial related arrangements and/or livelihood related activities.
Availability of Group Master Policy
This Group Master Policy shall be available for inspection by theInsured at any reasonable time in the website or office of Mapfre Insular Insurance Corporation.
Attestation
In witness whereof, we have caused this Group Master Policy to be signed by its duly authorized officer/representative.
MAPFRE INSULAR INSURANCE CORPORATION THE INSULAR LIFE ASSURANCE COMPANY, LTD. INC.
________________________________ _________________________________
TIRSO C. ABAD MONA LISA B. DE LA CRUZ
President and Chief Executive Officer President and Chief Operating Officer
IMPORTANT NOTICE The Insurance Commission, with offices in Manila, Cebu, and Davao, is the
government office in charge of the enforcement of all laws related to insurance and has supervision over insurance providers and intermediaries. It is ready at all times to assist the general public in matters pertaining to insurance. For any inquiries or complaints, please contact the Public Assistance and Mediation Division (PAMD) of the Insurance Commission at 1071 United Nations Avenue, Manila with telephone numbers +632-5238461 to 70 and email address pubassist@insurance.gov.ph. The
Group Master Policy Number : AC-GPA-HO-0005243 Policy Effective Date : 07/08/2015
INSURANCE BENEFIT SCHEDULE
Natural Death Accidental Death
Plan 1 P25,000 P25,000
Plan 2 P40,000 P40,000
Plan 3 P50,000 P50,000
