Maxicare Group Life Insurance w/
Accidental Death, Dismemberment & Disablement (ADD&D) Benefits
Amount of Benefit (Death)
Principal & Enrolled Dependents
PHP 50,000.00
*note: 71-75 y.o. dependents – Life Insurance only
Requirements:
Kindly email to HR Total Rewards accomplished forms together with the following requirements:
1. Claimant Statement - Accomplished by the Claimant
2. Physician Statement - Accomplished by the Insured Attending Physician of the Deceased
Death Certificate (ORIGINAL PSA COPY)
Birth Certificate of Deceased (ORIGINAL PSA COPY)
Birth Certificate of Claimant (ORIGINAL PSA COPY)
PHOTOCOPY of two (2) valid IDs (deceased member)
PHOTOCOPY of two (2) valid IDs with three (3) specimen signatures (principal)
Bank details to be used once approved: Proof (Deposit Slip, Passbook, etc)
Insured Name: Name of the dependent
Policyholder: MAXICARE HEALTHCARE CORP.
Payee (Beneficiary): Name of the employee
Account Name:
Account Number:
Bank Name:
Bank Location
Contact details
Death Claim processing time is 3-4 MONTHS upon receipt of the complete documents by our Death Insurance Provider.