Procedures

Forms

Insurance Coverage

GROUP PERSONAL ACCIDENTAL INSURANCE (GPAI)

Occupation/Tittle: SPES BENEFICIARIES

Schedule of Rates and Premium of Principal:

Coverage                                                                Insurance Amount                       

Medical Reimbursement                                    5,000.00  

Bereavement Death                                            10,000.00

Accidental Death                                                  50,000.00

Beneficiary in case of Accidental Death: Parent / Spouse

WARRANTIES AND CAUSES AT THE TIME OF ISSUE:

Provision for Filing Notice of Loss

The Insured under the Policy is required to file a Notice of Loss to the Insurance Company, without unnecessary delay, that is, within sixty (60) days from the date of accident or discovery of loss.

Failure to submit said Notice of Loss on the above stipulated prescription period shall mean a loss of interest on the part of the Insured and will exonerate the Insurer from any liability on the benefit of the Insurance to which the Insured may be entitled to.

Provision on GSIS Applicable Taxes & Documentary Stamp Tax (DST):

It is understood that all applicable taxes, including Documentary stamp Tax (DST) if any shall be borne by the Insured.

For this purpose, the Insured acknowledges that the GSIS is not a withholding agent for DST and hereby undertakes and commits itself to make direct payments to the BIR of any DST that may be imposed on the execution and

Inclusion of Unprovoked Murder Or Assault- Pa – 50%

IT IS HEREBY DECLARED AND AGREED that the Principal Sum hereunder for loss of life arising from directly or indirectly due to unprovoked murder or assault fifty percent (50%) of the Principal Sum but not to exceed P50,000.00

CIVIL CODE ARTICLE 1250 WAIVER CLAUSE

IT IS HEREBY DECLARED AND AGREED that the provision of Article 1250 of the Civil Code of the Philippines

(Republic Act No. 386) which reads:

“In case an extraordinary inflation or deflation of the currency stipulated should supervene, the value of the currency at the time of the establishment of the obligation shall be the basis of payment, “. . . shall not apply in determining the extent of liability under the provisions of this policy.

SUBJECT TO GSIS STANDARD PERSONAL ACCIDENT INSURANCE 24HOUR ACCIDENT RIDER INCLUDING ALL COMMERCIAL FLYING (TERRITORIAL LIMIT-WORLDWIDE)

HIS POLICY COVERS AGAINTS LOSS RESULTING DIRECTLY AND INDEPENDENTLY OF ALL OTHERS CAUSES, FROM BODILY INJURIES CAUSED BY ACCIDENT. HOWEVER, COVERAGE AS RESPECTS FLYING IS LIMITED TO LOSS OCCURING WHILE THE INSURED IS RIDING SOLELY AS A PASSENGER, NOT AS AN OPERATOR OR CREW MEMBER, IN, BOARDING OR ALIGHTING FROM:

  1. A certified passenger aircraft provided by a commercial airline on any regular, schedule or non-schedule, special or chartered flight and operated by a properly certified pilot flying between duly established and maintained airports; or
  2. Any transport type aircraft operated by the Military Air Transport Services (MATS) of the Unites States of America or by the similar ait transport services of any duly constituted governmental authority of the recognized government of any nation anywhere in the world.

BENEFITS

The Insurance afforded is only with respect to injuries which, directly or indirectly of all other causes, result in death, dismemberment, total disability or medical expense, as stated hereunder, within the time indicated, but only against so many of the benefits as are specifically indicated in the Declaration page by the insertion of a premium charge or charges.

PART I.  LOSS OF LIFE INDEMNITY

When injury results in loss of life of the Insured within one hundred eighty (180) days after the date of the accident the FUND will pay the LOS OF LIFE INDEMNITY stated in the Schedule.

PART II. DISMEMBERMENT, LOSS OF SIGHT, HEARING, SPEECH INDMENITY

When injury does not result in loss of life of the Insured within one hundred eighty (180) days after the occurrence of the accident but does result in any of the following losses within said one hundred eighty (180) days, the FUND will pay for loss of:

 

Two limbs 100% of the Principal Sum
Both Hands and all Finger and Both thumbs 100% of the Principal Sum
Both Feet 100% of the Principal Sum
Sight of Both Eyes 100% of the Principal Sum
Arm at or elbow 70% of the Principal Sum
Arm at or above Elbow and wrist. 60% of the Principal Sum
One Hand 50% of the Principal Sum
Four Fingers & thumbs of one Hand 50% of the Principal Sum
Four Fingers 35% of the Principal Sum
Thumb 15% of the Principal Sum
Index Finger 10% of the Principal Sum
Middle Finger 6% of the Principal Sum
Ring Finger 5% of the Principal Sum
Little Finger 4% of the Principal Sum
Metacarpal First or second (additional)  Third, fourth of fifth (additional) 2% of the principal Sum
Leg at or above knee 60% of the Principal Sum
Leg below knee 50% of the Principal Sum
One foot 50% of the Principal Sum
Toes-All of one Foot 25% of the Principal Sum
Big Toe 5% of the Principal Sum
Any Toe other than big toe, each 1% of the Principal Sum
Sight of one Eye 50% of the Principal Sum
Hearing-Both Ears 50% Of the Principal Sum
One Ear 25% of the Principal Sum
Speech 100% of the Principal Sum

The occurrence of any specific loss for which indemnity is payable under this part shall at once terminate all insurance under this Policy, but such termination shall be without prejudice to any claim originating out of the accident causing such loss.

No indemnity will be paid under any circumstances for more than one of the losses, the greatest, for which provision is made in this part.

PART III PERMANENT TOTAL DISABILITY

When as the result of injury and commencing within 180 days of the date of the accident, the Insured is totally and permanently disabled and prevented from engaging in each and every occupation or employment for compensation or profit for which he is reasonably qualified by reason of his education, training or experience, FUND will pay, provided such disability has continued for a period of twelve consecutive months and is total, continuous and permanent at the end of his period, the Principal Sum less any other amount paid or payable under this Policy as the result of the same accident, at the rate of one percent per month for 100 months.

PART IV MEDICAL EXPENSE REIMBURSMENT

When by reason of injury, the insured shall require treatment by a legally qualified physician or surgeon, confinement in a hospital or the employment of a licensed or graduate nurse, the FUND will pay the actual expense incurred within fifty two weeks from the date of the accident for such treatment, hospital charges and nurses’ fees which is in excess of the deductible amount (if any) stated in the Schedule, but not exceed the aggregate amount payable stated in the Schedule as the result of any one accident.

PART V EXCLUSIONS

The insurance with respect to the above hazards shall not apply:

  1. To loss caused directly or indirectly, wholly or partly by:
  2. Bacterial infections (except pyogenic infections which shall occur through an accidental cut or wound);
  3. Any other kind of diseases;
  4. Medical and surgical treatment (except such as may be necessary solely for injuries covered by this policy and performed within the time provided in the policy)
  5. Murder, assault or any attempt thereat.
  6. To suicide or any attempt thereat (sane or insane);
  7. To loss occasioned by war, invasion, Act of foreign enemy, hostilities or warlike operations (whether war be declared or not), mutiny, riot, civil commotion, civil war, rebellion, revolution, insurrection, conspiracy, military or usurped power, martial law or state of siege, or any of the events or causes which determine the proclamation or maintenance of martial law or state of siege, seizure, quarantine, or customs regulations or nationalization by or under the order of any government or public or local authority, or any weapon or instrumental employing atomic fission or radioactive force, whether in time of peace or war.

This exclusion shall not be affected by any endorsement which does not specifically refer to it, in whole or in part. The Insured, shall, if so required, and as a condition precedent to any liability any of the FUND, prove that the loss did not any way arise under or through any of the above excepted circumstances or causes.

References

Records

Presentations

Videos

2016 Quality Objective and Plans

2017 Signed Quality Objective and Plans