Total ProtectER

Description

Total ProtectER is a total protection package composed of a term insurance product with a daily hospital income benefit for a six-month coverage; and a one-time use health care voucher that provides up to Php100,000 worth of coverage for emergency cases due to accidents and viral and bacterial illnesses and specific conditions.     With this plan, the member gets the following benefits: 

• Php 3,000 daily hospital income benefit. This benefit is given if hospital confinement is due to accidental injury or sickness (including COVID-19), within the six-month coverage period. Insured can reimburse Php3,000 hospital income benefit per day, as long as hospital confinement is at least 4 days, maximum of 90 days. 

If an injury or sickness results in the hospital confinement of the Insured Individual, the Company will pay the Hospital Income Benefit in the form of a daily hospital allowance upon receipt of satisfactory proof of the hospital confinement of the Insured Individual. The daily hospital allowance of Php3,000 will be paid during the continuance of the Insured Individual’s hospital confinement subject to a maximum period of 90 days for the six-month coverage and to an elimination period of 3 days.  There shall be a maximum of 15 days per hospital confinement.  For related confinements, a gap of not more than 90 days between such confinements is considered as one (1) confinement. For example: gap between a) discharge from confinement 1 and b) admission for confinement 2 is 30 days. Since 30 days is less than 90 days, this is considered as one confinement only.  Pre-existing conditions and limitations shall apply.  Pre-Existing Conditions and Limitations. During the waiting period of two months within the Insured Individual’s coverage, no benefit shall be provided for hospital confinement resulting directly or indirectly from injury sustained or a sickness or condition which was evident or for which the Insured Individual received medical advice or treatment within six (6) months prior to the effective date of this Rider. 

• Php 500,000 life insurance coverage. This benefit is given to the beneficiary upon Insured’s death due to natural or accidental causes (including COVID-19) within the six-month coverage period. 

Notice and Proof of Death. The Company will pay the designated beneficiary the corresponding Amount of Insurance upon receipt and approval by the Company of due proof/s that the Insured Individual died while insured under this contract and in accordance with its terms.  Beneficiary.  The beneficiary designated by the Insured Individual in his application shall receive the death benefit provided that the beneficiary is living at the time of death of the insured individual.  If no qualified beneficiary is designated by the Insured Individual or if no qualified beneficiary survives the insured individual, the following classes of beneficiaries, in this order of preference, shall be deemed named by the insured individual as his contingent beneficiary or beneficiaries: (1) surviving legitimate spouse  (2) surviving legitimate, legitimated, and legally adopted children  (3) surviving illegitimate children  (4) surviving parents  (5) surviving siblings of the full blood  (6) surviving siblings of the half-blood  (7) executors or administrators.  If there be two or more beneficiaries in the same class entitled to the proceeds of the insurance, they shall share equally.  Any minor’s share shall be paid to him in the manner provided for by law.  Suicide. The Company shall be liable in case of suicide committed in the state of insanity.  If suicide is not compensable, the Company would refund the premium paid for the individual.  

• ER Care All-In 100 benefits. Services include outpatient (ER treatment) and inpatient (confinement) care, regular private room use, laboratory and diagnostic procedures, and medicines as medically required. It is accepted in more than 500 iCare-accredited hospitals nationwide excluding Top 6 hospitals*. 

The Php 100,000 benefit limit of ER Care All-In 100 covers:   

• • Doctor’s professional fee 
  • Emergency room treatment 
  • Laboratory and diagnostic procedures 
  • Room accommodation if confinement is required 
  • Required medicines during hospitalization
  • Surgery and surgeon’s fees, if medically required
  • Surgery and surgeon's fees when medically necessary
  • Use of operating room, recovery room, and ICU, as medically necessary
  • Special modalities of treatment as medically required in emergency room care and confinement, and subject to Php 5,000 standard limit.
  • Hospital cash allowance of Php 1,000 when confined (for adults only) 

  Total ProtectER is valid for 1 year or until used, whichever comes first. It can be used in more than 500 iCare-accredited hospitals in the Philippines, excluding the Top 6 hospitals in Metro Manila namely Asian Hospital and Medical Center, Cardinal Santos Medical Center, Makati Medical Center, St. Luke’s Medical Center (QC and BGC), The Medical City.     You can read the complete details of Total ProtectER in this Health Care Agreement.