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Home > Accident Insurance > Frequently Asked Questions (FAQs)

Frequently Asked Questions (FAQs)


Do you have inquiries? We prepared some frequently asked questions that may serve as quick answers to your current queries. Should you have questions that are not in the list below feel free to get in touch with us.

If I missed to declare my designated beneficiary, which of my relatives are entitled to claim the Insurance proceeds in case of death?
In the absence of a named beneficiary, the beneficiary will be the estate of the insured or any relative by blood or connection by marriage who is deemed by the Company to be equitably entitled thereto.
Is there a limitation to geographic scope of coverage?
No. The coverage is worldwide, 24 hours a day, 7 days a week, 365 days a year.
Can I apply for more than one policy?
Yes. An insured may avail of more than one personal accident insurance provided that the limit of his coverage does not exceed the maximum benefit allowed based on the percentage of his Gross Annual Income.
Is motorcycling automatically covered?
No. Motorcycling is not automatically covered. One may request subject to underwriting approval.
Up to what age can I be allowed to get Personal Accident Insurance?
Individuals between 1-60 years old may avail of personal accident insurance. However, minors between 1-16 years old should be accompanied and represented by their guardian upon applying. Clients who wish to renew their policies may do so until they reach 65 years old.
Is Unprovoked Murder and Assault automatically covered?
No. Unprovoked murder and assault is subject to underwriting approval depending on the nature of occupation of the applicant.
Can I automatically avail of a high coverage under Personal Accident?
The limit of coverage is normally based on the insured’s gross annual income and his/her occupation.
What is a pre-existing illness? Is this covered?
Pre-existing illness is defined as any illness or medical condition already affecting the insured, whether known or unknown to the insured, before the effectivity date of his/her coverage. No. The company does not cover losses attributable to pre-existing illness.
What is the maximum limit of benefits of the Company will provide for self-employed individuals?
For self employed individuals, the maximum coverage allowed will be determined based on the insured’s Gross Annual Income during the previous year, verifiable through his/her Income Tax Return (ITR).
I have 5 children , the eldest is graduating from college and the youngest just entering pre-school, will the coverage of my eldest transfer to my youngest child?
Yes. The coverage is intended to cover the educational expenses of ANY four (4) currently studying children for the first five years of the insured’s death.
How do I claim monthly shelter allowance benefit? Monthly Pension?
The company shall pay the monthly shelter allowance and the monthly pension in full lump sum amount, which the beneficiaries may claim together with all the other benefits.
If a dependent were hospitalized due to sickness a year after the insured/s death, will he/she be covered?
Yes. If the insured dies, the Company will pay for the hospitalization expenses of his/her dependents up to the policy limit for the first five (5) years of his/her absence whether or not the dependent’s confinement is caused by an accident or sickness.
Will my domestic employee be covered on her day off?
Yes. The domestic employee is covered for as long as he/she is employed with you. Coverage ceases to attach upon his/her termination or replacement.
Is the coverage transferable in case my domestic employee resigns?
Yes. As soon as the previous domestic employee leaves her coverage automatically ceases. The coverage will be extended to your new domestic employee provided that you inform the insurance company of the changes made.
How many times can I be allowed to transfer the coverage?
The insured may transfer the coverage to his/her new domestic employee up to two (2) times each year.
How much can a domestic employee claim in case he/she dies whilst riding the employer’s vehicle?
A domestic employee is entitled to twice the face value in case he/she dies due to an accident whilst riding the employer’s vehicle.
Can I claim if I were treated as an outpatient?
No. The insured must be confined as a resident patient for atleast 24 hours in a licensed hospital or clinic registered with the Bureau of Medical Services in order to be entitled to the daily cash benefits.
When will the benefits be received?
The applicable cash benefits will be paid upon the covered person’s discharge from the hospital. However, advance payment may be requested for confinement exceeding 14 days.
To whom will the Company pay the benefits?
MAPFRE Insular pays all the cash payables directly to the insured and not to the hospital. This allows the insured to use the money in any way he wants – for medicines, laboratory fees, etc.
If I were hospitalized due to a continuing sickness after the policy has expired, would I still be covered?
Yes, the Company will still pay for the daily benefits provided the confinement is within one year from the first confinement and is due to the same and continuing sickness.
After earning 20% increase in hospitalization benefit limit for two (2) consecutive claim-free years, will my benefits revert to its original limit after a claim
No. The increased hospital benefit limit shall remain the same.

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