GROUP INSURANCE FOR OXORD COMPUTER SOLUTION AND REPAIR CENTER

INSURED: Customers of OXORD (OXORD COMPUTER SOLUTION AND REPAIR CENTER)

PLAN: Group Accident Insurance

COVERAGE:

• Accidental Death and Disablement Insurance with Php100,000.00
• Accidental Death due to Motorcycling Insurance with Php 100,000.00

ELIGIBILITY: Any customer of OXORD COMPUTER SOLUTION AND REPAIR CENTER who qualifies for its promotional program and at the inception of the policy, is:

1. In good health (actively performing the normal duties of life and free from physical and mental disability)
2. At least seven (7) years old but not more than sixty-four (64) years old.

INSURANCE TERM: One (1) year from the date of enrollment

POLICY TERMS AND CONDITIONS

DEFINITION OF COVERAGE

Accidental Death Benefit – In the event of an accidental death and or disablement of the covered person within 180 days from the date of the accident, the sum insured as shown in the Schedule will be paid to the Insured person’s next of kin, or his legal representative. Loss of hand or foot means complete severance or loss of use through or above the wrist or ankle joint, and of sight means an entire and irrecoverable loss of sight. The aggregate of all payments in respect of any one accident shall not exceed the capital sum as shown in the schedule for any one person.

Accidental Death due to Motorcycling
The policy is extended to cover accidental death and disablement sustained by an insured person arising from motorcycling as a rider or back rider, provided that this extension does not cover motorcycling whilst pacemaking, speed-testing, taking part in reliability trials or riding on habal-habal type of motorcycles or on motorcycles beyond their seating capacities. The insured person should be:
a. operating a motorcycle as a driver must be a duly licensed driver as permitted by law or other regulations to drive such motorcycle; and
b. whether as a rider or back rider of a motorcycle wears a protected crash helmet as approved by the DTI when riding a motorcycle in accordance to the Motorcycle Helmet Act of 2009.

Insuring Conditions:

If during the Period of Insurance the Insured Person shall suffer ACCIDENTAL BODILY INJURY which shall independently of any other cause result within one year in the DEATH or PERMANENT DISABLEMENT for which the Benefit is claimed, the Company will indemnify the Insured or any Beneficiary named in the Policy Schedule in accordance with the Schedule of Benefits.

SCHEDULE OF BENEFITS

Compensation Limits In Respect Of Any One Insured Person

The Company shall not be liable to pay, in aggregate, for more than 100% of the Sum specified in the Policy Schedule for Accidental Death in respect of Coverage 1) Accidental Death and/or Coverage 2) Accidental Permanent Total Disablement of any one Insured Person during the Policy Period.

EXCEPTIONS:

THE COMPANY SHALL NOT BE LIABLE TO PAY ANY BENEFIT in respect of Death or Bodily injury sustained:

1. By any person below 7 years or beyond 65 years of age.
2. Consequent upon the Insured Person
   a. committing or attempting to commit suicide, unlawful act(s), or resisting arrest;
   b. engaging in military or para-military activities or while performing his duties as a member of the Police, Armed Forces, Military, or Fire Protection Bureau or association, including while serving or providing escort and security services in whatever capacity or form;
   c. engaging in or practicing for or taking part in training peculiar to any dangerous activities or sports or hobbies such as American football, rugby, bungee jumping, caving, parachuting, trekking above 2,500 meters, aviation other than as a fare-paying passenger on a scheduled flight, hang-gliding, sky diving, microlight flying, mountaineering with the use of ropes, rock climbing, scuba diving , white water canoeing, white water rafting, water skiing, yachting, motor sports, racing of any kind other than on foot, boxing, wrestling, martial arts or mixed martial arts or any fighting or self-defense sports;
   d. engaging in motor-cycling in any form (including pillion riding) unless coverage is specifically included which coverage shall be limited to only as provisioned under the Policy;
   e. or contributed to by the Insured Person: having taken any un-prescribed drug; while under the influence of alcohol unless it can be established that alcohol was not a factor contributing to the happening of the injury; being pregnant or suffering from sickness or disease not resulting from bodily injury or bodily injury due to a gradually operating cause; suffering from pre-existing physical
   or mental defect or infirmity which had not been declared to and accepted in writing by the Company;
3. Medical expenses in any form whether or not due to a covered accident unless coverage is specifically included which coverage shall be limited to only as provisioned under the Policy.
4. Due to Murder and/or Assault unless coverage is specifically included which coverage shall be limited to only as provisioned under the Policy.
5. Arising directly or indirectly out of or in connection with insect bites.
6. Arising directly or indirectly out of or in connection with: (a) ionizing radiation or contamination by radioactivity from any nuclear fuel, weapon, medical isotope, waste or other material whether occurring naturally or otherwise; or (b) the radioactive, toxic, explosive or other hazardous properties of explosive nuclear assembly or nuclear component thereof; or (c) the storage, transport, assembly, disassembly, maintenance or operation of any nuclear weapon or nuclear component thereof;
7. Caused directly or indirectly, contributed by or traceable to war, invasion, act of foreign enemies, hostilities or warlike operations (whether war be declared or not), strike, riot, civil commotion, mutiny, rebellion, insurrection, military or usurped power;
8. Caused directly or indirectly, contributed by or traceable to any act of terrorism or any action taken in controlling, preventing, suppressing, in any way relating to, any act of terrorism.

DEFINITIONS:

FOR THE PURPOSES OF THIS POLICY:

1. “Accident” or “Accidental” means a sudden, unforeseen and involuntary event caused by external, visible and violent means.
2. “Act of Terrorism” means an act, including but not limited to, the use of force or violence, atomic/biological/chemical weapons, weapons of mass destruction, disruption or subversion of communication and information systems infrastructure and/or the contents thereof, sabotage or any means to cause harm of whatever nature and/or threat of any of the aforementioned acts, of any person or group(s), whether acting alone or in behalf of or in connection with any organization(s) or government(s), committed for 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.
3. “Injury” means accidental physical bodily harm directly caused by “Accident”.
4. “Loss” means the permanent and total loss of functional use or complete and permanent severance.
5. “Loss of Hand or Foot” means a) in case of Loss of Hand, loss by physical severance of at least all four fingers in their entirety or permanent total loss of use of an entire arm or hand; b) in case of Loss of Foot, loss by physical severance at or above the ankle or permanent total loss of use of an entire leg or foot.
6. “Loss of Hearing” means total and irrevocable loss of hearing.
7. “Loss of Sight” means total and irrevocable loss of sight.
8. “Loss of Voice or Speech” means total permanent inability to communicate verbally.
9. “Permanent” means lasting twelve (12) calendar months and at the end of that period being beyond hope of improvement.
10. “Permanent Total Disablement” means the permanent inability of the Insured Person due to “Injury” to engage in any occupation or employment for compensation or profit for which the Insured Person is reasonably qualified by education, training or experience. If at the time of the loss the Insured Person is unemployed, it shall mean inability to perform all of the usual and customary duties and activities of a person of like age and sex.
11. “Period of Insurance” means the period between the inception date and earlier of a) the Expiry Date specified in the Schedule b) the date of cancellation of this Policy by either Policyholder or Insurer.
12. “Policy Schedule” means that portion of the Policy which sets out the coverage details such as but not limited to the insured persons, type and/or plan of insurance cover in force, sum(s) insured, period of insurance, etc. Any Annexure or Endorsement to the Schedule shall also be a part of the Schedule.
13. “Pre-existing Mental Defect or Infirmity” means a condition (that already exists prior to the effectivity of the policy) characterized by substantial disorder of thinking, mood, perception, orientation or memory that grossly impairs judgement, behavior, capacity to recognize reality or ability to meet the ordinary demands of life. It shall also mean a condition of arrested or incomplete development of mind of a person specially characterized by sub normality of intelligence. This condition was in any way evident to the Insured before the effectivity of the Policy or the natural history/pathogenesis of such condition can be clinically determined to have started
    two (2) years prior to the effectivity of the Policy, whether or not the Insured is aware of such sickness, or for which the Insured received treatment, or have consulted a physician for treatment or have been taking medications.
14. “Pre-existing Physical Defect or Infirmity” means a condition (that already exists prior to the effectivity of the policy) of a person with physical impairment that adversely affects either his mobility, manual dexterity, physical coordination, ability to lift, carry or move everyday objects, hearing, or eyesight.
15. “Sum Insured” means the amount shown in the Policy Schedule against each coverage or benefit, which shall be the maximum liability for each Insured Person for any one and all benefits claimed during the Period of Insurance subject to the provisions of “Compensation Limits In Respect Of Any One Insured Person”.

OTHER CONDITIONS:

1. Entire Contract. This Policy including the endorsements thereto and the insurance proposal submitted by the Insured constitute the entire contract of this insurance. No change in the policy or waiver of any kind of its provisions shall be valid and binding unless approved and endorsed hereon by a duly authorized officer of the Company.
2. Premium Payment. This Policy shall not be valid and binding unless and until the premium stated herein is paid and fully acknowledged in an official receipt signed by an authorized official or representative of the Company.
3. Policy Compliance. The due observance and fulfillment of the terms, provisions, conditions, and endorsements of this Policy by the Insured insofar as they refer to anything to be done or complied with by him and the truth of the statements and answers in the proposal made by the Insured shall be conditions precedent to any liability of the Company.
4. Notice of Claim. A written notice of claim must be given to the Company as soon as possible but not later than 30 days from the happening of any event which may give rise to a claim.
5. Claims Requirements. All certifications, information, and evidence as may be required by the Company shall be furnished free of expense to and in the form prescribed by the Company. The Insured Person shall as often as required submit to medical examination on behalf of and at the expense of the Company in connection with any claim.
6. Settlement of Claim. The amount of loss or damage for which the Company may be liable under this policy shall be paid within ten (10) working days from receipt of the Company of the complete required proof of loss or supporting documents.
7. To Whom Benefits are Payable. All benefits payable under this Policy other than for the death of the Insured shall be payable to the Insured. In the event of the death of the Insured, all sums of money payable under this policy shall be paid to the designated beneficiary/ies or his/her legal personal representatives. If any indemnity of this Policy is payable to the estate of the Insured, or to a beneficiary who is a minor or otherwise not competent to give a valid release, the Company may pay such indemnity to any relative by blood or connection by marriage of the Insured who is deemed by the Company to be equitably entitled thereto. Any payment made by the Company in good faith pursuant to this provision shall fully discharge the Company to the extent of such payment.
8. Free-Look Period. If the Insured is not completely satisfied with this Policy, he may return it to the Insurer within fifteen (15) calendar days from receipt of this Policy, together with a written notice, signed by the Insured, requesting cancellation. This Policy is received by the Insured when it is delivered at his residence and received by a person of suitable age and discretion then residing therein or at his office or regular place of business, with some competent person in charge thereof. If sent by mail, the Policy shall be deemed received by the Insured within ten (10) days from the date of mailing. If sent via electronic means, the Policy shall be deemed received on the date it is sent to the e-mail address registered with the Insurer.
9. Dispute Resolution. All differences as to the amount of any loss or damage covered by this Policy shall be referred to the decision of an arbitrator to be appointed by the parties in difference or if they cannot agree upon a single arbitrator, to the decision of two arbitrators one to be appointed in writing by each of the parties within thirty (30) days after having been required to do so by either of the parties or in case of disagreement between the arbitrators to the decision of an umpire to be appointed in writing by the arbitrators. The decision of the arbitrator or arbitrators or umpire shall be a condition precedent to any right of action against the Company but only in cases of differences as to the amount of liability arising out of this Policy.
10. Suit Against the Company. If a claim is made and rejected and a suit is not commenced either in the Insurance Commission or any court of competent jurisdiction within 12 months from receipt of notice of such rejection, or in case of arbitration within 12 months after due notice of award is made, then the claim shall be deemed to have been abandoned and shall not be recoverable hereunder.
11. Civil Code Article 1250 Waiver Clause. It is hereby declared and agreed that the provisions of Article 1250 of the Civil Code of the Philippines (Republic Act No. 386) which reads: “In case of 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 xxx” shall not apply in determining the extent of liability under the provisions of this Policy.
12. Cancellation. This Policy may only be cancelled by or on behalf of the Company in accordance with and pursuant to the provisions of Sections 64 and 65 of the Insurance Code. Likewise, this Policy may be cancelled at the request of the Policy Holder. Should this Policy be cancelled, however, all the individual Proofs of Cover issued thereunder that are still in effect at the time of cancellation shall remain in effect up to the Period of Insurance so indicated in each Proof of Cover. It shall be the duty of the Policy Holder to inform all the Insured Persons of the intended termination or cancellation of this Policy by the Company or by the Policy Holder.
13. Renewal Clause. Unless the Company at least forty-five (45) days in advance of the end of the policy period mails or delivers to the Policy Holder at the address shown in the Policy notice of its intention not to renew the Policy or to condition its renewal upon reduction of limits of or elimination of coverages, the assured shall be entitled to renew the policy upon payment of the premium due on the effective date of renewal.

IMPORTANT NOTICE

The Insurance Commissioner, with offices in Manila, Cebu, and Davao is the Government Official in charge of the enforcement of all laws relating to insurance and has supervision over insurance companies. He is ready at all times to render assistance in settling any controversy between an insurance company and a policyholder relating to insurance matters.

This insurance is provided by Philippine British Assurance Company, Inc., and powered by EnsureMePh Insurance Broker, Inc. (InsuranceKo). For inquiries regarding your insurance policy, you may contact InsuranceKo at customersupport@insuranceko.ph or at (033) 329-0729. In the event of a claim, you may contact us at claims-ph@insuranceko.ph.