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Total ProtectER

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11,750.00

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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.

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₱11,750.00

Details

For only Php11,750, insured gets the following benefits:

  • Php3,000 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.
  • Php500,000 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.
  • ER Care All-In 100 Adults benefits. Services include outpatient and inpatient emergency care, regular private room use, laboratory and diagnostic procedures, and medicines as medically required. It is accepted in more than 500 IHC-accredited hospitals nationwide excluding Top 6 hospitals*.
  • Available for ages 18-64 years old.
  • No medical exams required, but Insured should be in good health at point of application.
  • Purchase, registration and activation are 100% online.
  • Proof of Cover (POC) and voucher will be delivered via e-mail.

 


 THINGS TO NOTE:

 

HOSPITAL INCOME BENEFIT

Hospital Confinement Due to Injury or Sickness.  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.

 

Risks Not Covered.  This Rider does not cover the following:

1.     Hospital confinement and the continuation of such confinement during the entire period thereof which is not recommended and/or approved by a legally qualified physician;

2.     Any confinement for physical check-up for diagnostic purposes;

3.     Any  hospital confinement caused by any of the following:

3.1. Injuries or illnesses which are self-inflicted, caused by attempt at suicide, or incurred as a result of or while participating in the commission of a crime;

3.2. Pregnancy, childbirth, miscarriage, abortion, or complications of any of these;

3.3. Sex transformations, artificial insemination, or treatment of infertility;

3.4. Rest cures, custodial, domiciliary, or convalescent cares;

3.5. Cosmetic surgery and oral surgery for the purpose of beautification;

3.6. Functional disorders of the mind, drug addiction or alcoholism;

3.7. Sexually transmitted diseases, AIDS and AIDS related diseases;

3.8. Injuries or illness suffered under conditions of declared or undeclared war or strife;

3.9. Congenital deformities and defects;

3.10.Provoked assault;

3.11. Atomic explosion, nuclear fission or radioactive gas; and

3.12. Any bodily injury sustained by the Insured Individual while he is in or on any airplane or aerial device except while traveling as a fare-paying passenger in a passenger airplane which is:

3.12.1.  Operated by a regular passenger airline;

3.12.2.  Operated by a duly licensed pilot; and

3.12.3.  Traveling on a scheduled passenger trip over an established passenger route.

 

Notice and Proof of Disability.  The Insured Individual or his authorized representative should notify the Company in writing of the hospital confinement of the Insured Individual within fifteen (15) days from admission.  Subject to written proof of hospital confinement, all accrued benefits under this Rider will be paid upon the Insured Individual’s discharge from the hospital.

The Company reserves the right to examine the Insured Individual in the manner and at all times that it may find necessary. 

 

BASIC LIFE INSURANCE

Amount of Insurance.  Individual shall be insured for Php500,000 for a period of six (6) months.

 

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 ADULTS

The Php 100,000 benefit limit covers these items:
✓ Doctor’s professional fee

✓ Laboratory and diagnostic procedures

✓ Emergency room care

✓ Regular private room accommodations

✓ Medicines as medically necessary in the emergency room and during confinement

✓ Surgery and surgeon’s fees when medically necessary

✓ Use of operating room, recovery room, and ICU, as medically necessary

✓ Hospital cash allowance of Php 1,000 when confined

 

“Emergency” shall mean the sudden, unexpected onset of illness or injury having the potential of causing immediate disability or death or requiring the immediate alleviation of severe pain and discomfort.

 

“Accident” shall mean a visible, external, sudden and violent event occasioned by a physical or natural cause and occurring entirely beyond the Members’ control causing damage to the health of the Member. Some examples of accidents covered by ER Care All-In 100 are new fractures, new burns, new animal bites, and new cuts that need suturing.

 

“Viral and bacterial illnesses” are diseases caused by viruses and/or bacteria. Some examples of viral and bacterial illnesses covered by ER Care All-In 100 Adults are Acute Upper Respiratory Tract Infection, Amoebiasis, Dengue Fever, Typhoid Fever, and Urinary Tract Infection.

 

This health voucher is applicable to adults, 18 to 64 years old, and is valid for 12 months or up until used. The final medical diagnosis shall be the basis for a Member’s eligibility to emergency care benefits under the Agreement.

*Asian Hospital & Medical Center, Cardinal Santos Medical Center, Makati Medical Center, St. Luke’s Medical Center (QC & BGC) and The Medical City

To know the complete benefit coverage of ER Care All-In 100 Adults, read Insular Health Care’s Health Care Agreement.

FAQs

1. What is Total ProtectER?
Total ProtectER is a total protection package from InLife and InLife Health Care composed of a term insurance product, hospital income benefit rider and the ER Care All-In 100 health care voucher with outpatient and inpatient care coverage for emergency cases due to accidents, viral and bacterial illnesses, and specific conditions.

The ER Care All-In 100 Adults voucher is accepted in more than 500 InLife Health Care (IHC) accredited hospitals nationwide excluding the Top 6 hospitals: Asian Hospital & Medical Center, Cardinal Santos Medical Center, Makati Medical Center, St. Luke’s Medical Center (QC & BGC) and The Medical City.

2. What is Total ProtectER with Top 6 Hospitals?
Same except for the inclusion of the Top 6 Hospitals

Total ProtectER with Top 6 Hospitals is a total protection package from InLife and InLife Health Care composed of a term insurance product, hospital income benefit rider and the ER Care All-In health care voucher with outpatient and inpatient care coverage for emergency cases due to accidents, viral and bacterial illnesses, and specific conditions.

The ER Care All-In 100 Adults with Top 6 Hospitals voucher is accepted in more than 500 InLife Health Care (IHC) accredited hospitals nationwide including the Top 6 hospitals: Asian Hospital & Medical Center, Cardinal Santos Medical Center, Makati Medical Center, St. Luke’s Medical Center (QC & BGC) and The Medical City.

3. How much is the premium amount of each combo package?
Total ProtectER = Php11,750
Total ProtectER with Top 6 Hospitals = Php12,450

4. What is the premium paying period and how do I pay?
One-time premium can be paid via IHC Online Store (credit cards, debit cards, online banking) and over the counter payments.

5. What are the benefits? Are the benefits guaranteed?
Payment of benefits are subject to the terms and conditions of the package you availed.

• Hospital Income Benefit Rider is subject to a) the limitations of the rider, and b) the required minimum and maximum number of days of hospital confinement.
• Basic Life Coverage is subject to a) the contestability period and b) suicide clause.
• ER Care All-In - To know the complete benefit coverage of ER Care All-In 100 Adults, read InLife Health Care’s Health Care Agreement.
• Php3,000 daily hospital income. This benefit is given to the insured if hospital confinement is at least four (4) days due to accidental injury or sickness (including COVID-19) within the six-month coverage period.
            o Payout of daily hospital income begins on the 4th day of hospitalization. There is an elimination period of three (3) days.
            o There is a maximum of fifteen (15) days per hospital confinement.
             For related confinements, a gap of not more than ninety (90) days between such confinements is considered as one (1) confinement.
            o There is a maximum of ninety (90) days total hospitalization for the six-month coverage period.
            o Satisfactory proof of the hospital confinement of the Insured should be submitted.
            o Pre-existing conditions and limitations shall apply.
• Php500,000 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.
• ER Care All-In 100 Adults benefits. One time-use of voucher on outpatient and inpatient emergency care, regular private room use, laboratory and diagnostic procedures, and medicines as medically required for emergency cases due to accidents, viral/bacterial cases, and specific condition. It is accepted in more than 500 IHC-accredited hospitals nationwide (inclusion of Top 6 hospitals depends on the package chosen). Validity period is one year, or up until used, whichever comes first.

6. Does Total ProtectER cover COVID-19?
Yes. The InLife term life insurance coverage and daily hospital income benefit cover death and/or hospitalization due to COVID-19 , if the Insured meets the requirements as to health declaration, waiting period/elimination period where applicable.

The Insured’s medical expenses for COVID-19 treatment is also covered under the ER Care voucher until December 31, 2020 only.

7. How many packages can I buy for myself?
An individual can purchase this package with himself as the Insured, one-at-a-time only. If you are already enrolled in ER Care All-in 100, any prepaid ER Care plan or IHC’s other health care programs with emergency care coverage, you cannot purchase this or register again.

However, since payor or purchaser may be different from the Insured, if you intend to give this as a gift to another person, you can purchase the package more than once. We recommend though that the Proposed Insured should be the one to register.

Please refer to Item #26 on how to register.

8. Is there a limit as to how many Total ProtectER products I can buy?
An individual can purchase this package with himself as the Insured, one-at-a-time only. If you are already enrolled in ER Care All-in 100, any prepaid ER Care plan or IHC’s other health care programs with emergency care coverage, you cannot purchase this or register again.

However, since payor or purchaser may be different from the Insured, if you intend to give this as a gift to another person, you can purchase the package more than once. We recommend though that the Proposed Insured should be the one to register.

Please refer to Item #26 on how to register.

9. Will the Total ProtectER earn cash values and dividends?
No. The Total ProtectER does not earn any cash value or dividends.

10. Can I take a policy loan from this package?
No. It does not have a loan feature or facility.

11. Can everyone avail of this package?
To avail of this package, you:
• Must be 18-64 years old;
• Must be in good health at the time of your application; and
• Must have no existing ER Care All-In 100 Adults or any IHC prepaid ER Care plan or Total Protect coverage

12. Can OFWs working abroad or Filipinos residing abroad apply for this package?
Yes. OFWs may apply if they are present in the Philippines at the time of application. We are not allowed to sell or to offer this package to OFWs currently working abroad or Filipinos residing abroad.

13. If the package cannot be purchased by OFWs, what are the available products for OFWs?
OFWs can give us their contact info and other details for endorsement to a financial advisor who can discuss with them the product options available for OFWs: Name, Date of Birth mm/dd/yy, Location or Address, Email address, Landline or Mobile number.

14. I bought this package in the Philippines but I left the country to work abroad / for a vacation. The accident happened abroad/ I got sick and was confined in a hospital abroad. Will I be able to claim from Total ProtectER?
Yes. For the life insurance and daily hospital income benefit component, Insured will be covered while abroad, as long as the package was purchased in the Philippines. However, the ER Care voucher will not cover and may not be used for claims arising outside the Philippines.

15. Will I be required to go through a medical examination?
No medical examination is required. But you must declare your present health condition (if you are in good health or not) in your application.

16. Can I also purchase this package for my family member/s?
An individual can purchase this package with himself as the Insured, one-at-a-time only. If you are already enrolled in ER Care All-in 100, any prepaid ER Care plan or IHC’s other health care programs with emergency care coverage, you cannot purchase this or register again.
However, since payor or purchaser may be different from the Insured, if you intend to give this as a gift to another person, you can purchase the package more than once. We recommend though that the Proposed Insured should be the one to register.

Please refer to Item #26 on how to register.

17. Who can I designate as beneficiary?
You may designate any one of the following members of your family as beneficiary:
Spouse
Child
Father
Mother
Brother
Sister

18. Can I insure a family member who is mentally incapacitated to register and avail this package? I will be the one to sign up for him.
We do not allow, in this case. It should be the actual Proposed Insured who should fill out the registration form as he needs to declare his state of health. Same Proposed Insured should also have the capacity to read, understand, comply and agree with the terms and conditions on his own, which includes his declaration of good health at point of application.

19. It has a hospital income benefit. Can I buy this even if I have an HMO / health card with other companies?
Yes. Total ProtectER can be a supplement or a supplementary coverage to your existing HMO/health plans.
However, if you already have an existing ER Care All-In 100 Adults or any IHC prepaid ER Care plan, you are no longer eligible to buy this for yourself.

20. Can I use this as alternative for travel insurance??
Although you can use this as an alternative, please be advised that a travel insurance plan has inclusions which are not covered by our insurance plan such as repatriation, baggage loss, baggage delay, document loss, flight delay, missed connecting flight, among others. Travel insurance also offer bigger coverages for the duration of your trip. However, your insurance coverage ends after your trip. Under Total ProtectER, you will be covered for six (6) months.

22. Does this cover critical illnesses?
The Hospital Income Benefit Rider component of Total ProtectER provides a ₱3000 daily income if Insured is hospitalized due to injury or sickness (including COVID-19 and critical illnesses) for at least four (4) days. Payout begins on the 4th day of hospitalization (elimination period is three [3] days) with a maximum of ninety (90) days for payouts. Satisfactory proof of the hospital confinement of the Insured should be submitted. However, if the critical illness is a pre-existing condition or was not declared upon application, this is excluded in the coverage.
For the ER Care component, the case will not be covered.

23. Can I buy this package from any of your agents or district/field offices?
This package is available only at the IHC online store https://shop.insularhealthcare.com.ph/
If you have an existing financial advisor (FA) and you wish to discuss this with him, you are welcome to do so.
If you have no FA yet, please provide your contact info so we can have an InLife FA get in touch with you: Name, Date of Birth mm/dd/yy, Location or Address, Email address, Landline or Mobile number.

24. What happens if I don’t receive my registration details within 24 hours?
You may follow up your order with IHC through the following:

Chat via https://shop.insularhealthcare.com.ph/

Customer Relations Assistant Helpdesk:
(632) 8-813-0131 local 8364
(632) 8-813-0131 (Press 1)
24/7 support through InLife Health Care’s Call Center (Toll Free Number 1-800-10-8177857)

25. Is there a window period for me to activate my coverage? What happens if I am not able to activate my coverage before the end of this period?
Upon receiving your product serial code, you have ninety (90) calendar days to register your plan. From the day you register (“registration date”), the plan will be activated after ten (10) calendar days. Your health voucher is valid for twelve (12) months or up until used whichever comes first.

Example: Registration date is Day 0. If you register on August 1, your health voucher will be activated on August 12. It will then be valid from August 12, 2018 to August 11, 2019 or up until used whichever comes first; while the term insurance and hospital income benefit will be valid from August 12, 2018 to February 11, 2019.

26. How do I activate my coverage?
Payor (or purchaser) may be different from the Proposed Insured.
Upon purchase, Payor receives confirmation email with product serial code.
Registration page is at https://services.insularhealthcare.com.ph/

If Payor is same as Proposed Insured:
    • Payor goes to the Registration page to register himself as the Proposed Insured.

If Payor is different from Proposed Insured:
    • It is recommended that the Proposed Insured be the one to register.
    • Payor forwards the confirmation email with product serial code to the Proposed Insured.
    • Proposed Insured goes to the Registration page to register using the product serial code forwarded to him and to agree to the health declaration.

Proposed Insured’s application may be declined (please refer to #28).
    • If Payor is different from Proposed Insured, Proposed Insured should notify the Payor about the declined application so that the latter can request for a refund.
    • Refund shall be processed and issued by IHC to the Payor, net of the handling fee. For details, please refer to IHC’s Refund Policy: https://shop.insularhealthcare.com.ph/return-replacement-and-refund-policy

If application / registration is successful
    • Insured receives confirmation email containing IHC voucher, Health Care Agreement (HCA), and Proof of Cover (POC)
    • If Payor is different from Insured, we also encourage the Insured to notify the Payor of the successful registration.

Payment Acknowledgment Receipt will be sent respectively by InLife and IHC to registered email address of the Payor.

27. What will I receive as proof of my coverage?
The Insured will get a secured digital copy of the POC which reflects the coverage information (e.g. start and end date of insurance coverage as well as the terms and conditions, limitations, and other provisions).
For the ER Care, you will receive a voucher indicating the validity period.

28. Will application be automatically approved? Will I be notified if my coverage has been approved or denied?
No, it is not automatically approved.

If you are the Proposed Insured, we shall validate the information provided and determine if you meet the eligibility requirements mentioned in item #10 above. Insured receives confirmation email containing the IHC voucher, Health Care Agreement (HCA), and Proof of Cover (POC). If Payor is different from Insured, we also encourage the Insured to notify the Payor of the successful registration.

If your application is declined or denied, Insured will also receive an email notification. If Payor is different from the Proposed Insured, Proposed Insured should notify the Payor about the declined application so that the latter can request for a refund. Refund shall be processed and issued by IHC to the Payor, net of the handling fee. For details, please refer to IHC’s Refund Policy: https://shop.insularhealthcare.com.ph/return-replacement-and-refund-policy

29. Will my insurance coverage extend beyond age 65 years old if I have not yet reached the end date of my insurance coverage?
Yes. If you are the Insured, you will be covered by the term insurance and the daily hospital income benefit up to the End of Coverage date specified in the Proof of Cover even if you have already turned sixty-five (65) years old within the period of coverage.

30. The term insurance and hospital income benefit only up to six (6) months. What will happen if coverage expires?
If your term insurance and hospital income benefit expire after six (6) months, the ER Care benefit is still active up to the End of Coverage or Validity Date specified in your Voucher or up actual use, whichever comes first.

31. Can I still enjoy my ER Care coverage even if the six-month insurance coverage has expired?
Yes. You will be able to use your ER Care coverage up to the End of Coverage or Validity Date specified in your Voucher.
Meanwhile, if you have already used the ER Care voucher, your term insurance and hospital income benefit will remain valid if still within the six-month coverage period.

32. If my insurance coverage starts 16 June 2020 when will my coverage end, up to December 2020 only?
Your coverage is up to six (6) months, thus you will be covered from 16 June 2020 to 15 December 2020 (less by a day).
For ER Care, validity date is until 15 June 2021, or up until used, whichever comes first.

33. When can i register my product?
You have to register a name to your prepaid plan within 90 days from purchase date. The serial code will be valid up to then. After which, your serial code will no longer be available for register.

34. I have not received my POC. What shall I do?
Kindly check your junk or spam inbox. If POC has not been received within 24 hours from activation, you may contact:

Chat via https://shop.insularhealthcare.com.ph/

Customer Relations Assistant Helpdesk:
(632) 8-813-0131 local 8364 (632) 8-813-0131 (Press 1) 24/7 support through InLife Health Care’s Call Center (Toll Free Number 1-800-10-8177857)

35. Who do I call in case I have inquiries about my coverage?
For ER Care / InLife Health Care:

Chat via https://shop.insularhealthcare.com.ph/

Customer Relations Assistant Helpdesk:
(632) 8-813-0131 local 8364
(632) 8-813-0131 (Press 1)
24/7 support through InLife Health Care’s Call Center (Toll Free Number 1-800-10-8177857)

For the term insurance and hospital income benefit:
Policy-related inquiries and servicing concerns may be directed to InLife’s Policyholders Services Division:
Trunkline: (02) 876-1800 press 0
Provincial Toll-Free: 1800-10-INSULAR (4678527)
Facsimile: (02) 771-1945
Email: customercare@insular.com.ph

Filing of claims / submission of documents and requirements may be made through any InLife office. These shall be forwarded to Corporate Solutions Division, IHC Building Makati office.
Processing of claims will be done at InLife, IHC Building Makati office.

36. Where and how do I file a claim? What are the requirements?
Please see claim requirements below. Or you may visit https://www.insularlife.com.ph/policyholders-servicing-requirements

For the claim requirements, you may visit https://www.insularlife.com.ph/policyholders-servicing-requirements

37. What is the usual turn-around-time (TAT) for claims processing?
For the term insurance and hospital income benefit:
Standard TAT for claims processing is fourteen (14) working days from submission of complete requirements.

38. What does elimination period mean? Why do payouts begin on the 4th day of hospitalization?
This shall refer only to the daily hospital income benefit under Total ProtectER.
The elimination period is a period of time the Insured must be hospitalized due to injury or sickness before he begins receiving the hospital income benefit.

39. How do I compute for the daily hospital income benefit?
In this case, he will only receive the Php3000 daily income on the 4th day of hospitalization, as elimination period is 3 days. But the benefit can be applied retroactively, meaning the daily hospital income benefit is computed based on the exact number of days you were confined in the hospital. To illustrate:

1. Day 1
2. Day 2
3. Day 3
4. Day 4 – beginning of payouts but the count of the Php3000/day benefit will start from Day 1.
5. Day 5
E.g. No. of Days Confined = 5 days
Daily Income Benefit = Php3000/day
Computation of Benefit
Php3000.00 x 5 days (Day 1 to Day 5) = Php15,000

Thus, total benefits will be Php3000x5days = Php 15,000
Maximum number of daily hospital income benefit payable is ninety 90 days.

No daily hospital income benefit shall be paid for confinements of 3 days or less. Further, fractional part of a day shall not be considered (e.g. 4.5 days – benefit is for 4 days only).

40. What if my confinement is only for one (1) day or two (2) days? Or three (3) days? Can I be entitled to the hospital income benefit?
No, under the daily hospital income benefit , you will not be entitled to any hospital income benefit.

However, if you used your ER Care voucher and your specific case is covered, you will receive a hospital cash benefit of Php1,000.

41. What if I already availed of the daily hospital income benefit once and I get hospitalized again within the same year, can I claim another daily hospital income benefit?
Yes. This applies only to the daily hospital income benefit component. The daily hospital income benefit can be paid / reimbursed to you up to a maximum of ninety (90) days for the six-month coverage period.

Please take note that there is a maximum of fifteen (15) days per hospital confinement. For related confinements, a gap of not more than ninety (90) days between such confinements is considered as one (1) confinement.

For the ER Care, you may only use the voucher once, but coverage is up to Php100,000.

Pre-existing conditions and limitations shall apply.

42. Can I reimburse my hospitalization expenses or medicine expenses?
Under the daily hospital income (DHI) benefit , medical expenses (doctor’s fee, ER, lab tests, medicine expenses, outpatient procedures, check-up, consultations, etc) are not reimburseable. DHI is fixed at Php3000 per day.

On the other hand, ER Care shall take care of the following, up to Php100,000:
✓ Doctor's professional fee
✓ Laboratory and diagnostic procedures
✓ Emergency room care
✓ Regular private room accommodations
✓ Medicines as medically necessary in the emergency room and during confinement.
✓ Surgery and surgeon's fees when medically necessary
✓ Use of operating room, recovery room, and ICU, as medically necessary.
✓ Hospital cash allowance of Php 1,000 when confined.

43. What are the rules on pre-existing conditions/limitations regarding the Hospital Income Benefit (injury/sickness) for this package?
Upon availing of this package, you will be asked to declare if you are in good health or not. As one of our eligibility requirements, you must be in good health at the time of your application. Hence, pre-existing conditions/illnesses are excluded in the coverage.

44. Is there a waiting period before I could file a claim?
During the two (2) months waiting period, as the Insured, you will not be entitled to the hospital income benefit (for hospital confinement due to injury/sickness) if your injury or sickness was already existing or evident or you already received medical advice or treatment for it within six (6) months prior to the start of your coverage.

45. How about for illnesses which were diagnosed after availment of the package?
As the Insured, you are entitled to the daily hospital income benefit of Php3000 if you are confined in the hospital due to sickness or accident for at least four (4) days, maximum of ninety (90) days, as long as required hospital documents are presented / submitted as proof of confinement (for example, statement of account to reflect number of days of confinement).

Please take note that there is a maximum of fifteen (15) days per hospital confinement. For related confinements, a gap of not more than ninety (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 thirty (30) days. Since thirty (30) days is less than ninety (90) days, this is considered as one confinement only.

For ER Care, please refer to the InLife Health Care Agreement.

46. Does this plan have a contestability provision? What if the insured dies within the contestability period?
Yes, claims are always contestable. If insured dies, is disabled, or is confined in the hospital, claim may be denied if it is found out that insured made any misrepresentation or concealment in his application for coverage. (e.g. He declared in his application for coverage that he was in good health even if he was already sick at that time).

47. Can I renew my coverage?
Insured can renew the insurance coverage after the six-month period, or after the End of Coverage date indicated on the Proof of Cover. You may come back to this page (or to the IHC store) later to know how you can renew your coverage. The renewal premium may be adjusted based on the attained age of the Insured.

If the Insured wishes to renew the package (term insurance, daily hospital income benefit, health care voucher), this can be done by purchasing Total ProtectER again after both the insurance coverage has expired as indicated on the Proof of Cover and ER Care All-In 100 has been used or has expired as indicated on the Validity Period of the voucher.

48. What if I am confined in the hospital due to accident, will my expenses be covered? Am I entitled to any hospitalization benefit?
Yes. ER Care All-In covers emergency cases due to accidents. It will cover outpatient and inpatient care. Under ER Care, you will receive Php1000 if you are confined.

49. Am I entitled to the daily income hospital benefit if the reason for hospitalization is due to accident?
The hospital income benefit of Php3000/day applies if hospital confinement due to accident is at least four (4) days.

50. Am I entitled to the daily hospital income benefit if the reason for hospitalization is due to sickness/illness and not accidental in nature?
The hospital income benefit of Php3000/day applies if hospital confinement due to sickness/illness is at least four (4) days.

For ER Care, please refer to the InLife Health Care Agreement.

51. If benefits were not availed by the insured within the six- month or one-year coverage period, are they already forfeited? Can I get a refund?
Yes, the benefits are no longer available once the coverage has expired. There will be no refunds for unused benefits.

Terms and Conditions

Registration and Availment Process
How to register and use your Insular Health Care health voucher:

General exclusions applicable to ER Care All-In 100 Adults
1. Viral and bacterial illnesses that are complications of or contracted due to a compromised or impaired immune system. The following are examples but not limited to:
a. Patients with malnutrition
b. Patients with uncontrolled diabetes mellitus
c. Recipients of organ transplant
d. Patients with hematologic malignancies
e. Patients undergoing radiation, chemotherapy, and immunosuppressive therapy
f. Patients with HIV/AIDS infection
g. Patients with foreign objects/implants such as venous or urinary catheters
h. Patients with auto-immune diseases such as Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis, Multiple Sclerosis, and Guillain-Barre Syndrome

2. Viral infections like:
a. Hepatitis B, C, D, and E
b. Herpes infections like Epstein-Barr and Cytomegalovirus

3. Accidents and viral / bacterial illnesses that are secondary to or contracted due to having a degenerative disease such as but not limited to Alzheimer’s disease, Amyotrophic lateral sclerosis (ALS), Parkinson’s disease.

4. Conditions secondary to all pregnancy and fertility-related illnesses / treatments.

5. Lithiasis/stones of the gallbladder and genitourinary system.

6. Sexually transmitted infections such as, but not limited to, syphilis, gonorrhea, chlamydia, human papillomavirus (HPV) infection, and HIV/AIDS.

7. Pre-existing conditions except Hepatitis A.

8. Chronic viral and bacterial illnesses.

9. Congenital illnesses acquired through viral and bacterial infections.

10. Care by non-accredited Physician and/or in a non-accredited hospital.

11. All dental-related conditions and services.

12. Complications from sterilization of either sex or reversal of such, artificial insemination, sex transformations, and circumcision.

13. Rest cures, custodial, domiciliary, or convalescent care.

14. Complications arising from cosmetic surgery, dental/oral surgery and dermatological procedures for the purpose of beautification, including reconstructive surgery to treat a dysfunctional defect due to a disease or accident.

15. Psychiatric disorders, psychosomatic illnesses, hyperventilation syndrome, stress related conditions, adjustment disorders, alcoholism and its complications or conditions related to substance or drug abuse, addiction, and intoxication.

16. Medical and/or surgical procedures which are not generally accepted as standard treatment by the medical profession like acupuncture..

17. Procurement or use of corrective appliances, artificial aids and durable equipment, and orthopedic prosthesis and implants.

18. Surcharges resulting from additional personal (luxuries/accommodation) request or service including special nursing services.

19. Injuries or illnesses due to military, paramilitary, police service, high risk activities, or suffered under conditions of war.

20. Injuries or illnesses which are self-inflicted, caused by attempt at suicide or incurred as a result of or while participating in a crime or acts involving the violation of law, administrative order or ordinances.

21. Outpatient/Take home medicines.

22. Valvular Heart Disease and/or Rheumatic Heart Disease.

23. All hospital expenses and professional fees incurred by a Member when discharged against medical advise and those subsequent expenses incurred by the said Member for the same condition and its complications after such discharge during the contract period.

24. All hospital charges and professional fees after the day and time hospital discharge have been duly authorized.

25. Professional fees of assistant surgeons.

26. Use of emergency room facilities on non- emergency cases or by reason of conditions/ injuries not falling under the term “Emergency” as defined under this Agreement.

27. Diseases declared by the Department of Health as “epidemic”.

28. Miscellaneous Fees not related in the diagnosis and treatment of a member's condition such as, but not limited to, “nursing fee”, waste/biologic hazard disposal fee, management fee, local taxes, and other analogous fees.

29. Medico-legal consultations and confinements.

To know the complete benefit coverage of ER Care All-In 100 Adults, read Insular Health Care’s Health Care Agreement.






Terms and Conditions of Purchase, Registration, Use, Coverage, and Exclusions for ER Care All-In 100 Adults


By purchasing, registering, or using ER Care All-In 100 Adults, I hereby certify that I have read, understood, and agreed to the Insular Health Care’s Health Care Agreement and these Terms and Conditions. Should I disagree with the Agreement and these Terms and Conditions prior to registering the product, I can request a refund according to Insular Health Care’s Return & Refund Policy.

I certify that the information hereunto and to be given by me, or by an authorized representative on my behalf, is true and correct, and that any material misrepresentation or falsity contained therein shall be construed as an act to defraud Insular Health Care (IHC), and serves as sufficient ground for any and all of the following actions: the rejection and/or cancellation of my application and termination of membership; non-coverage of medical expenditures by IHC at its accredited providers and partners; and collection of receipts from me in case of advance payments for medical expenses already covered by IHC.

I also hereby authorize IHC to question, independently verify, and investigate any and all information that I have declared from any and whatever sources IHC may deem appropriate.

I also agree that receipt of the corresponding membership fees by IHC does not constitute acceptance of my registration until the corresponding registration has been properly processed approved. For ER Care All-In 100 Adults, approval of application is automatically effective ten (10) calendar days from notice of successful registration. I understand that coverage shall also automatically begin , regardless of the status of receipt of notice to the Member advising successful registration and the commencement of coverage. Any incident, illness, or condition that occurs prior to the start date of coverage, even if such incident, illness, or condition persists up to and/or beyond the Effectivity Date, will not be covered.

I also agree to the non-coverage of illnesses as stated in IHC’s list of General Exclusions applicable to its health care programs. IHC shall have the final, exclusive decision to determine the scope of coverage for a specific illness or condition based on, but not limited to, registration date, start date of coverage, final diagnosis, evaluation of the case as an emergency, hospital billing, professional fees, and the list of General Exclusions.

Lastly, I agree to the retrieval and processing by IHC of any and all personal medical information drawn or obtained pursuant to its products and services based on my coverage, provided that: (a) such information shall be utilized solely for legitimate and official business purposes of IHC; (b) such information shall not, at any time, be disclosed or transmitted to non-essential and/or unauthorized personnel or entities; and (c) all reasonable efforts shall be taken to maintain the confidentiality of such information.

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