BERDANT SOLUTIONS CO. LTD.
IN PARTNERSHIP WITH
ADDRESS: 1753 Concepcion Aguila Street San Miguel Manila Tel. 83536704 / 09152651203 EMAIL: buhaykomahalko@gmail.com website: www.sagitariesinsurance.com
BUHAY KO MAHAL KO INSURANCE PROGRAM
POLICY SCHEDULE
GROUP PERSONAL ACCIDENT POLICY NO.: 1060602200000020
INSURED: GROUP NAME MEMBERS OF BUHAY KO MAHAL KO
PERIOD OF INSURANCE: SEPTEMBER 29, 2020 12:00 NOON SEPTEMBER 29, 2022 12: NOON
BENEFITS / PERSON | LIMIT |
Accidental Death | Php 50,000 |
Accidental Permanent Dismemberment / Disability | 50,000 |
Accidental Death due to motorcycling | 50,000 |
Unprovoked Murder & Assault | 50,000 |
Burial Assistance Benefit (Accident) | 25,000 |
ANNUAL PREMIUM / PERSON (TAX INCLUSIVE) | Php200.00 |
DESCRIPTION OF BENEFITS:
Accidental Death
Pays for bodily injury resulting to death due to accident occurring within the declared period of insurance
Accidental Permanent Dismemberment / Disablement
Pays for bodily injury resulting to permanent disablement or dismemberment or complete severance of the limbs occurring within the declared period of insurance.
Accident Burial Benefit
Burial Benefit coverage as financial assistance following death of insured resulting from an accident.
Accidental Death due to motorcycling
Pays for bodily injury resulting to death resulting from driving or riding two wheeled motor vehicle or motorcycle occurring within the declared period of insurance provided insured has a valid driver’s license, not violating traffic rules, is not under the influence of alcohol or drugs at the time of the accident, and is not engaged in racing and other sports related activities.
Unprovoked Murder & Assault Coverage
Coverage for bodily injury or death resulting from murder & assault (subject to geographical limits)
Unprovoked Murder & Assault Coverage
Coverage for bodily injury or death resulting from murder & assault (subject to geographical limits)
The proposed plan does not include coverage for Unprovoked Murder & Assault occurring in the following geographical areas, including their cities, towns, barrios and barangays:
a. Lanao Del Norte b. Lanao Del Sur c. North Cotabato d. South Cotabato
e. Zamboanga del Norte
f. Zamboanga Del Sur g. Maguindanao h. Sultan Kudarat i. Sulu Archipelago j. Basilan
TABLE OF BENEFITS FOR PERMANENT DISABILITY/ DISMEMBERMENT BASED ON PRINCIPAL COVERAGE OF P50,000.00
Loss of two limbs | 100% |
Loss of both hands, or of all fingers and both thumbs | 100% |
Total loss of sight of both eyes | 100% |
Total paralysis | 100% |
Loss of both feet | 100% |
Injuries resulting in being permanently bedridden | 100% |
Any other injury causing permanent total disablement | 100% |
Loss of arm at or above elbow | 50% |
Loss of arm between elbow and wrist | 50% |
Loss of hand at wrist | 50% |
Loss of four fingers and thumb of one hand | 50% |
Loss of four fingers | 35% |
Loss of thumb | 25% |
Loss of index finger | 10% |
Loss of middle finger | 6% |
Loss of ring finger | 5% |
Loss of little finger | 4% |
Loss of metacarpals- first or second (additional) | 3% |
- third, fourth or fifth (additional) | 2% |
Loss of Leg- at hip | 70% |
- between knee and hip | 60% |
- below knee | 50% |
Loss of toes- all of one foot | 15% |
Loss of big toe | 5% |
Loss of any toe other than big toe, each | 1% |
Eye: Loss of - whole eye | 30% |
- sight of | 30% |
- sight of, except perception of light | 30% |
- lens of | 20% |
Loss of hearing - both ears | 50% |
- one ear | 25% |
ADDITIONAL TERMS AND CONDITIONS:
1. This Policy covers the named clients declared by BERDANT SOLUTIONS CO. LTD. / BUHAY KO MAHAL KO. Age eligibility for insurance coverage is between 12 to 70 years old.
2. Insured’s coverage will immediately terminate upon expiry of the insurance coverage , or once insured attains the age of 70, should client’s age reaches 70 during period of coverage, coverage will continue until it reaches expiration date of insurance coverage.
3. Effectivity date of coverage is based on date declared by client of BUHAY KO MAHAL KO in their application form. Should there be no date declared by client in the application form, effectivity date will be the date Insurance Company receive the application form or summary of declaration.
4. Maximum limit of Insurance of insured is up to Php50,000 only regardless of the number of insurance coverage insured is covered or declared under the master policy.
5. Maximum limit for accidental death due to motorcycling riding or driving is up to Php 50,000 only.
6. This Policy is subject to Accumulation limit endorsement max limit up to Php 30,000,000
7. Work related Injuries/Disabilities of Persons who belong under the following categories are not covered under this Policy: Military personnel, people in the police force, crew members of vessels/aircraft, professional athletes, professional entertainers, (including actors), divers, loggers, fireman, miners, pilots, rangers, acrobats/stuntmen, national journalists/news reporters, off-shore oil or gas rig worker, tree feller, politicians and other known celebrities/personalities.
8. This Policy does not include coverage for injuries resulting from any hazardous/professional sports such as hunting, racing (except foot racing), steeple chasing, polo playing, mountaineering, scuba diving, hand gliding, winter sports, professional sports, ice hockey, football or rugby, basketball or any other contact sports.
9. All other terms subject to FPG Insurance standard Group PA policy terms and conditions. COMMUNICABLE DISEASE EXCLUSION (LMA5394) 1.)Notwithstanding any provision to the contrary within the reinsurance agreement, this reinsurance agreement excludes any loss, damage, liability, claim, cost or expense of whatsoever nature, directly or indirectly caused by, contributed to by, resulting from, arising out of, or in connection with a Communicable Disease or the fear or threat (whether actual or perceived) of a Communicable Disease regardless of any other cause or event contributing concurrently or in any other sequence thereto.
2.) As used herein, a Communicable Disease means any disease which can be transmitted by means of any substance or agent from any organism to another organism where:
2.1 the substance or agent includes, but not limited to, a virus, bacterium, parasite or other organism or any variation thereof, whether deemed living or not, and
2.2 the method of transmission, whether direct or indirect, includes but not limited to, airborne transmission, bodily fluid transmission, transmission from any surface or object, solid, liquid or gas or between organisms, and
2.3 the disease, substance or agent can cause or threaten damage to human health or human welfare or can cause or threaten damage to, deterioration of, loss of value of, marketability of or loss of use of property.
“LIST OF INSURED PERSONS (TO BE DECLARED)”
The following Clauses and Endorsements apply to this Policy : Accident Burial Expense Benefit
If injury should result in accidental death of the Insured Person, the Company will, in addition to all other benefits payable under this Policy,
pay for all actual Burial Expenses incurred but not exceeding the amount as stated in the Policy Schedule.
Accidental Food & Gas Poisoning Endorsement
It is hereby declared and agreed that this Policy is extended to cover death, permanent disablement or medical expenses incurred as a result of accidental food and gas poisoning.
Acts of Nature endorsement
It is hereby declared and agreed that death, permanent disablement or medical expenses incurred resulting from natural perils are covered under this Policy.
Animal Bites
It is hereby declared and agreed that this Policy is extended to cover death, permanent disablement or medical expenses incurred as a result of animal bites except mosquito bites.
Automatic Inclusion/Deletion Endorsement
It is hereby declared and agreed that all Employees of the Insured are automatically included for coverage under this Policy, such automatic coverage shall be for an amount equal to that provided under the Schedule of Benefits for that grouping or classification under which the Employee falls, if any such grouping or classification is used in this Policy, otherwise such amount shall be equal to the smallest benefits.
It is further agreed that inclusion of additional persons for coverage or deletion of individuals under this policy shall be made through written advice to the Company within thirty (30) days from effectivity of such inclusion or deletion. No endorsement shall be issued for these inclusions or deletions unless a written advice is submitted to the company within the aforesaid period.
Beneficiary Designation Endorsement
It is hereby declared and agreed that the beneficiary of an Insured Person shall be the first surviving class of the following classes of
Beneficiaries, otherwise the estate of the Insured Person. The Classes of beneficiaries are as follows:
1. The Insured Person`s Spouse;
2. The Insured Person`s Children;
3. The Insured Person`s Parents;
4. The Insured Person`s Brothers and/or Sisters.
Commercial Flying Coverage
It is hereby declared and agreed that coverage as respect to flying is limited to loss occurring while the Name Insured is riding solely as a passenger not as an operator or crew member. In boarding or alighting from a certified passenger aircraft provided by a commercial airline, on any regular, scheduled or non-scheduled, special or chartered flight.
Communicable Disease Exclusion
1. Nothwithstanding any provision to the contrary within the insurance agreement, this insurance agreement excludes any loss, damage, liability, claim, cost or expense of whatsoever nature, directly or indirectly caused by, contributed to by, resulting from, arising out of, or in connection with a Communicable Disease or the fear or threat (whether actual or perceived) of a Communicable Disease regardless of any other cause or event contributing concurrently or in any other sequence thereto.
2. As used herein, a Communicable Disease means any disease which can be transmitted by means of any substance or agent from any organism to another organism where:
1. the substance or agent includes, but not limited to, a virus, bacterium, parasite or other organism or any variation thereof, whether deemed living or not, and
2. the method of transmission, whether direct or indirect, includes but not limited to, airborne transmission, bodily fluid transmission, transmission from any surface or object, solid, liquid or gas or between organisms, and
3. the disease, substance or agent can cause or threaten damage to human health or human welfare or can cause or threaten damage to, deterioration of, loss of value of, marketability of or loss of use of property.
Electronic Data Recognition Exclusion Clause
Notwithstanding any provision to the contrary in the Policy or any Endorsement thereto, it is understood and agreed as follows: (A) This Policy does not insure:
(i) Total or partial destruction, distortion, erasure, alteration, misinterpretation or mis-appropriation of Electronic Data, (ii) Error in creating, amending, entering, deleting using Electronic Data, or
(iii) Total or partial inability or failure to receive, send, access or use electronic data for any time or at all
From any cause whatsoever, regardless of any other contributing cause or event whenever it may occur. Electronic Data means facts , concepts and information converted to a form useable for communications, display, distribution, interpretation or processing by Electronic and Electromechanical Data Processing or Electronically controlled Equipment and includes programmes software and other coded instructions for such equipment
(B) However, in the event that a peril listed below (being a peril insured by this Policy but for this exclusion) is caused by any matters described in Paragraph (A) above, this Policy, subject to all its provisions, will insure:
(i) Physical loss or damage or destruction to property Insured directly caused by such listed peril and/or
(ii) Consequential loss insured by this Policy
Further this Exclusion does not apply in the event that a peril listed below (being a peril insured by this Policy but for this Exclusion ) caused any of the matters described in Paragraph (A) above Fire Explosion, Lightning, Windstorm, Hail, Tornado, Cyclone, Hurricane, Earthquake, Volcano, Tsunami, Flood, Freezing, Weight of Snow, Impact by Aircraft or other Aerial objects dropped therefrom, Impact from road vehicle or animal, bursting, Overflowing, Discharging or Leaking of Water Tanks Apparatus or Pipes, or Theft of Electronic Data solely where such theft is accompanied by theft of the computer hardware, firmware, medium, microchip, integrated circuit or similar device containing such Electronic Data.
(C) For the purposes of the basis of settlement provision in this Policy, computer systems records included Electronic Data as defined in
Paragraph (A) above. Any terrorism exclusion in this Policy or any endorsement thereto prevails over this endorsement.
Maximum Age Endorsement (70 YEARS OLD)
Notwithstanding anything to the contrary contained in this Policy it is hereby stipulated and agreed that the maximum insurable age is 70 years old. An Insured Person`s coverage shall automatically terminate upon annual expiry of the Policy once he attains the maximum insurable age.
Motorcycle Coverage Endorsement
It is hereby declared and agreed that this Policy shall extend to cover accidental death or permanent disablement sustained by the Insured Person while riding any two-wheeled motorized vehicle or as a passenger of any three -wheeled motorized vehicle, provided not as a sports-related activity.
Terrorism & Sabotage Exclusion Clause
Notwithstanding any provision to the contrary within this Insurance or any Endorsement thereto it is agreed that this Insurance excludes loss , damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any act of terrorism regardless of any other cause or event contributing concurrently or in any other sequence to the loss.
For the purpose of this Endorsement an act of terrorism means an act, including but not limited to the use of force or violence and /or the threat thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organization (s) or government(s), which from its nature or context is done for or in connection with political, religious, ideological or similar purposes including the intention to influence any government and/or to put the public, or any section of the public, in fear.
This Endorsement also excluded loss, damage, cost or expense of whatsoever nature directly or indirectly caused by, resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to any act of terrorism.
If the Underwriters allege that by reason of this exclusion, any loss, damage, cost or expense is not covered by this Insurance the burden of proving the contrary shall be upon the Assured .
In the event any portion of this Endorsement is found to be invalid or unenforceable the remainder shall remain in full force and effect .
Total Asbestos Exclusion Clause
This Policy excluded all claims and losses based upon, arising out of, directly or indirectly resulting from or in consequence of, or any way involving:
- Asbestos, or
- Any actual or alleged Asbestos related injury or damage involving the use, presence, existence, detection, removal, elimination or avoidance of Asbestos or exposure or potential exposure to Asbestos .
Twenty-Four (24) Hours On Or Off the Job Coverage
It is hereby declared and agree that the plan provides protection to an insured person twenty -four (24 hours a day, on or out of office throughout one (1) calendar year but not to exceed twelve (12) months.
Benefits
The insured will receive a cash benefit stated in the coverage of the policy schedule in the event of bodily injury resulting to permanent disability due to accident; or the beneficiary will receive a cash benefit in the event of death of the insured.
Claim - duties of the insured
The Insured or beneficiary in case of accidental death shall give within a reasonable time after the occurrence of the loss or damage a written notice to FPG Insurance of the loss. Within sixty (60) days after the loss, the insured or beneficiary shall render to FPG Insurance a proof of loss, signed and sworn to by the insured, or certification of loss from an authorized representative of the Insured.
Fraud
Any dishonest, fraudulent or criminal act of the Insured or authorized representative of the Insured whether acting alone or in conjunction with others will forfeit all benefits under this policy.
Settlement of claim
The amount of benefit for which the company may be liable, under this policy, shall be paid within fourteen (14) working days upon receipt of complete documents by Sagitaries Insurance services.
SAMPLE CARD
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