• Duly accomplished Statement of Claim Form.
  – Please click here to download the form.
  – Ensure to fill out only Parts 1, 3, and 4, and please disregard Part 2.
• Hospital Statement of Account (SOA) or Discharge Summary
  – Should already show the cause of confinement which is due to accident.

(Should Item #2 does not state cause of confinement, the following shall be required:)

• Police Report
• Driver’s License (If the driver is the one Insured.)
• Police certificate whether the insured was wearing a helmet at the time of the accident (for motorcycle related)
• Incident report for work-related accidents and other form of accidents (i.e fall, etc.)

You may refer to your Insurance Acknowledgement Receipt to know the scenarios/ cause of accident/ sickness covered in this insurance feature.

• Duly accomplished Statement of Claim Form
  – Please click here to download the form.
• Certified True Copy of Death Certificate.
• Beneficiary’s ID (photocopy, government issued, with picture & signature).
• Proof of relationship with Beneficiary

(Blood related)

• Parents – birth certificate
• Spouse – marriage certificate
• Children – birth certificate
• Sibling – birth certificate of insured & birth certificate of sibling

(Non-blood relative)

• Non-blood relatives (fiancé, common law spouse, etc.) – CENOMAR or notarized affidavit from a 3rd person (any relative or friend of borrower) stating relationship of insured to beneficiary.