SFH NMCD

Policy Document
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Set for Health
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Quick Reference
About this policy 1
Your benefits at a glance 3
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What you are covered for 5
Major critical illness benefit 5
Minor critical illness benefit 7
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Death benefit 8
Surrender benefit 8
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Healthy life benefit 8
Waiver of premium benefit 8
Claiming this benefit 9

Taking unpaid loans or premiums from benefit payments 9
Benefit limit 9
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What we do not cover 10
When this policy starts and ends 12

When this policy starts 12
Canceling this policy 12
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When this policy ends 12

Making changes to this policy 12
Reinstating this policy 13
The main people under this policy 14

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Policy owner (you) 14

Changing the policy owner 14
Using your policy as collateral 14
Insured person 15
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Beneficiaries 15
Premiums and loans 18

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When you need to pay your premiums 18

What happens when you do not pay your premiums 18
Policy loan 19
SFH.DIG.AG.2023.06 Set for Health

Keeping it legal 20
Contract and governing law 20
We rely on your information 20
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Incorrect age or gender Contestability 20
Time limit on legal action 20
Payments under your policy 21
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Payments are not adjusted for inflation or deflation 21
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Medical definitions for major critical illness 22
Medical definitions for minor critical illness 30

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Important words and phrases 33
Table of cash values 35

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About this policy
Thank you for choosing FWD. We’re pleased to be protecting you,

so you can focus on living life to the fullest.
Easy to read
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We’re here to change the way you feel about insurance–starting with this document. We’ve
made it easy to read, so you can understand your benefits and what you are covered for.
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We highlight important information like this. Read these carefully.
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Words with special meaning
Some words in this policy have special meaning. We show those meanings on page 33
Important words and phrases. Please refer to this section when you need to.
90-day no-claim period Cancer-free for five years Minor critical illness
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Accident Cash value Medical practitioner
Activities of daily living Major critical illness Pre-existing condition
Benefit amount
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What makes up your policy

This insurance policy is made up of the documents listed below. We will provide them to you in
electronic form. You may also request for a paper version to be provided to you.
– This policy document.
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– The policy data page.

– The application form and any documents you provided with it.
– Any policy endorsement.
– The rewards terms and conditions.
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A policy endorsement is the document we provide to tell you about any official
change to your policy.
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Questions?
Please call our Customer Connect Hotline at +632 8888 8388. We are here for you 24/7.
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For and on behalf of FWD Life Insurance Philippines,
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Antonio Manuel G. De Rosas
President and Chief Executive Officer
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Set for Health
This policy pays a lump sum if the insured person is diagnosed with
a major or minor critical illness.
Your benefits at a glance
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or
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Major critical Minor critical Death Surrender
illness illness benefit benefit
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Details on page 5 Details on page 7
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We pay 100% of the We pay 20% of the We pay 100% of the We pay the cash value
benefit amount if benefit amount if benefit amount if the (if any) if you request
the insured person is the insured person insured person dies. that we end this
diagnosed with a major suffers a minor policy before its
critical illness. critical illness. expiry date.
PLUS The amount of cash
value is shown in
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We pay 100% of the page 35 Table of

benefit amount if cash values
the insured person
is diagnosed with a
second major critical
illness. The diagnosed
condition must be from
a group that is
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different to the first This policy ends upon

major critical illness. payment of the benefit.
We believe that those who live a healthy life should be
PLUS rewarded. 100% RETURN OF TOTAL PREMIUMS is given
Health Life if the insured person does not suffer any of the eligible
We pay 100% of the
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Benefit major critical illnesses until the policy expiry date.

benefit amount if
the insured person is
diagnosed with a third
major critical illness.
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The diagnosed
condition must be
from a group that
is different to the
previous major critical
illnesses.
We pay all future premiums from the date the insured

Waiver of person is diagnosed with a major critical illness.
Premium
This is a simplified diagram. For more important details see page 5 What you’re covered for.

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This is a protection product
This Set for Health policy is a protection product and does not contain any savings or
investment components. This policy provides critical illness benefit or death benefit or
surrender benefit (if this policy has a cash value).
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What you are covered for
In this section, we explain what benefits you are covered for, and
any conditions that apply to those benefits. General exclusions also
apply – see page 10 What we do not cover.
Summary of your policy benefits
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You can claim the following benefits while the policy is active.
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We pay 100% of the benefit amount if the insured person is diagnosed
with a major critical illness shown in the table below Major critical
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illnesses covered. We will pay this benefit if all of the following
Major critical conditions are met:
illness
– the major critical illness first occurs, is first diagnosed or, symptoms
leading to the diagnosis of the major critical illness are first
experienced by the insured person after the 90-day no-claim period;
and
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– the insured person survives at least 14 days after the diagnosis of the
major critical illness.
If the first major critical illness benefit described above has been paid,
we will pay a second, and a third major critical illness benefit where
appropriate. Each benefit will be equal to 100% of the benefit amount.
We will only pay the benefit if all of the following conditions are met:
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– the insured person is diagnosed with a major critical illness;

– the insured person has not previously been diagnosed with and
received a major critical illness benefit due to:
» loss of independent existence; or
» terminal illness
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– the second or third major critical illness is diagnosed at least one year
after the diagnosis of the most recent major critical illness where a
benefit is claimed;
– each major critical illness benefit claimed belongs to a different
group shown in the table below Major critical illnesses covered. In
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the case of group one (cancer), you can claim up to two major critical
illness benefits provided that the insured person is cancer-free for
five years prior to the diagnosis of the second cancer; and
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– the insured survives at least 14 days after the diagnosis of a major

critical illness.
We do not pay any major critical illness benefit if signs of a

condition become apparent to the insured person within the
90-day no-claim period even if the condition is diagnosed on or
after this period by a medical practitioner.
We do not pay any major critical illness benefit if the claim

arises from a pre-existing condition.

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Major critical illnesses covered
Group 1: Cancers 1. Late-stage cancers
Group 2: Major organ failure 2. Aplastic anemia 10. Major organ and bone
3. Chronic liver disease marrow transplant
4. Chronic lung disease 11. Medullary cystic
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5. Chronic recurrent disease
pancreatitis 12. Progressive
6. Crohn’s disease scleroderma
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7. Fulminant viral hepatitis 13. Renal failure
8. Loss of hearing (deafness) 14. Terminal illness
9. Loss of sight (blindness) 15. Ulcerative colitis
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Group 3: Heart and blood 16. Cardiomyopathy 19. Heart valve surgery
vessels 17. Coronary artery disease 20. Primarypulmonary
18. Heart attack (myocardial arterial hypertension
infarction) 21. Surgery to aorta
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Group 4: Neuro-muscular 22. Alzheimer’s disease 28. Motor neurone
related 23. Apallic syndrome disease
24. Benign brain tumor 29. Multiple sclerosis
25. Cerebral aneurism 30. Muscular dystrophy
requiring surgery 31. Paralysis
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26. Coma 32. Parkinson’sdisea

27. Loss of independent 33. Stroke
existence
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Group 5: Others 34. Bacterial meningitis 39. Major burns

35. Encephalitis 40. Major head trauma
36. HIV/AIDS due to blood with severe brain
transfusion 41. damage
37. Loss of limbs 42. Occupationally-
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38. Loss of speech acquired HIV/AIDS

43. Severerheumatoid
arthritis
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We pay 20% of the benefit amount if the insured person is diagnosed

with a minor critical illness shown in the table below Minor critical
Minor critical illnesses covered. We will not pay more than Php 500,000 for this
illness benefit across all policies we issue for the insured person. We will pay
this benefit if all of the following conditions are met:
– the minor critical illness first occurs, is first diagnosed or, symptoms
leading to the diagnosis of the minor critical illness are first
experienced by the insured person after the 90-day no-claim period;
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– the minor critical illness is first diagnosed at least one year after the
date of diagnosis of the most recent major critical illness where a
benefit was paid; and
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– the insured person survives at least 14 days after the diagnosis of the
minor critical illness.
You can only claim for the minor critical illness benefit once.
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We do not pay any minor critical illness benefit if signs of a
condition become apparent to the insured person within the
90-day no-claim period even if the condition is diagnosed on
or after this period by a medical practitioner.
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We do not pay any minor critical illness benefit if the claim
arises from a pre-existing condition.
Minor critical illnesses covered

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1. Accidental fracture of 3. Diabetic retinopathy 7. Removal of one

spinal column 4. Early-stage cancer kidney
2. Angioplasty and other 5. Loss of one limb 8. Severe osteoporosis
invasive treatments for 6. Loss of one lung 9. Surgical removal of
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coronary artery disease pituitary tumor

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We pay 100% of the benefit amount if the insured person dies.
Death
benefit
We pay the cash value of this policy as stated in page 35 Table of cash
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values, if you request that we end this policy before its expiry date.
Surrender
benefit You cannot reinstate this policy after you receive the surrender benefit.
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We pay 100% of the total premiums paid if this policy is active until the
expiry date and no major critical illness benefit has been paid.
Healthy Life
benefit
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We pay all future premiums from the date the insured person is
diagnosed with a major critical illness.
Waiver of
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Premium
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Claiming this benefit
Claiming this benefit

To claim for this benefit, we need to receive signed claim documents and any other information
that we need. We will not be able to process your claim until we receive this information and
your signed claim documents.
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We are not responsible for any of the costs of filing any forms or getting any documents or
reports.
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What you need to do
You must make every effort to send your claim to us within 90 days of the insured person’s
death or diagnosis of a critical illness as it is difficult to assess claims after this period. Your
claim will not be declined or reduced if there were good reasons why you could not send us
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your claim on time.
When the unexpected happens, we’re here to help. Just call our 24/7 Customer Connect
Hotline on +632 8888 8388 and we’ll help you with your claim.
What we will do
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We will assess your claim, and if it is valid, we will pay the benefits less any outstanding loans
and any unpaid premiums
Taking unpaid loans or premiums from benefit payments

If there are any unpaid policy loans (including interest on those loans) or premiums, we will
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deduct these amounts from the benefit payment when we pay it. Your outstanding loan would
be the total of the unpaid policy loans and any interest on the policy loans.
Benefit limit
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If the insured person suffers a major or minor critical Illness as a direct result of participation
in any dangerous sports or hobbies such as racing on wheels, glider flying, or sailing, the total
amount payable from this policy and all other insurance policies that we issue for the insured
person is subject to a limit of Php 10,000,000.
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What we do not cover

This policy has certain exclusions, meaning situations where we will not pay the benefits. We
list below the exclusions that apply.
Exclusions that apply to major and minor critical illness benefits
90-day no-claim period We will not pay any major or minor critical illness benefit:
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– if the condition was diagnosed;
– if the signs or symptoms leading to diagnosis became
apparent to the insured person; or
– if the signs or symptoms would have been apparent to a
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reasonable person in the insured person’s place within 90 days
after the latest of:
» the start of coverage;
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» the date of last reinstatement; or
» the date of increase of the benefit amount
(for the added benefit amount).
Drugs or alcohol We will not pay any major or minor critical illness benefit if the
claim arises from Alzheimer’s disease, late-stage cancer, chronic
liver disease, chronic recurrent pancreatitis, coma, or Parkinson’s
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disease due to alcohol or drug abuse:
– if the condition was diagnosed; or
– if the signs or symptoms leading to diagnosis
– became apparent to the insured person
within two years after coverage starts, is reinstated, or is

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HIV We will not pay any major or minor critical illness benefit if the
claim arises from diagnosis of cancer or encephalitis in the
presence of human immunodeficiency virus (HIV) infection.
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Loss of independent We will not pay any major or minor critical illness benefit if the
existence claim arises from loss of independent existence due to
psychiatric-related causes.
Pre-existing condition We will not pay any major or minor critical illness benefit if the
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claim arises from a pre-existing condition. We will only pay the

benefit if you have declared the pre-existing condition in your
application form and we have included the pre-existing condition
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in this policy.
Suicide or We will not pay any major or minor critical illness benefit if the
self-inflicted act claim arises from attempted suicide or a deliberate self-inflicted
act by the insured person within two years after this policy
effective date, last reinstatement date, or date of any increase in
the benefit amount (for the added benefit amount).
Unlawful acts We will not pay any major or minor critical illness benefit if the
claim arises from you or the insured person committing any
illegal or unlawful act (including terrorist act).

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War We will not pay any major or minor critical illness benefit if the
claim arises from war or any act of war (whether declared or not),
or any civil or military uprising.
Exclusion that applies to death benefit
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Suicide or self- inflicted We will not pay the death benefit if the claim arises from
act attempted suicide or a deliberate self-inflicted act by the insured
person while sane within two years after this policy’s effective
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date, last reinstatement date, or date of any increase in the
benefit amount (for the increased amount). In this case, we will
return the total premiums paid to your beneficiaries after
deducting any benefit we have paid. We will pay the benefit if
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the insured person committed suicide while insane.
Disqualification of If the insured person dies from any of the policy beneficiaries
beneficiaries due to committing any illegal or unlawful act or failure to act, we will not
unlawful acts consider those policy beneficiaries to be ‘qualified’ claimants for
any benefit under this policy (including supplementary benefits).
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We will pay the death benefit to substitute beneficiaries as
discussed in page 16 Substitute beneficiaries.
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When this policy starts and ends
When your policy starts

This policy starts on the effective date shown on the policy data page, unless we tell you that it
will start on a different date. You can only claim for this policy after it has started.
Receiving your policy
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We will provide you this policy contract in electronic form, and we will consider it delivered to
you, 10 days after the effective date. A paper version of this policy is available at your own cost
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Canceling this policy
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You can cancel this policy by sending us a written request within 15 days after this policy has
been delivered to you.
We will provide you this policy contract in electronic form, and we will consider it delivered to
you, 10 days after the effective date.
This policy can be accessed by downloading our supercharged 2-in-1 app, Omne by FWD,
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which allows you to easily manage your insurance policy anytime, anywhere. You can
download Omne by FWD at Google Play Store or App Store.
Upon cancellation, we will return all your paid premiums for this policy. No interest will be
paid on the refunded amount. If a claim is payable for this policy, we will not refund the
premiums.
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When this policy ends

Your policy ends on the earliest of the following dates:
– on the date of the insured person’s death.
– on the date we approve your request to surrender or cancel this policy;
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– on the expiry date of this policy as shown in the policy data page;
– On the date that any outstanding policy loan amounts (including interest) are equal to or
greater than the cash value of this policy;
– on the premium due date, if you have not paid your premium for this policy after the 31-day
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grace period and the cash value is zero.
You can claim a benefit after this policy ends if the minor critical illness, major
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critical illness, or death happened before this policy ended.
Making changes to this policy

You can ask us to make a change to this policy at any time. Minor changes such as change of
contact information can be made through our Customer Connect Hotline at +632 8888 8388.
We are here for you 24/7.

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Changes to your policy coverage such as adjustment to the sum assured, payment frequency, or
change in beneficiaries will require you to submit a policy change form.
We will provide a letter documenting the change when we approve the changes.
If you have irrevocable beneficiaries or assignees

You will need written permission from all irrevocable beneficiaries or assignees if you are
making a change that will reduce any benefit they can receive under this policy. See page 15
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Type of beneficiaries to find out more about irrevocable beneficiaries.
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Reinstating your policy
If this policy has changed to reduced paid-up cover
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If this policy has been changed to reduced paid-up cover because your premiums were not paid
and it is still active, you can apply to reinstate (restart) this policy within three years from the
date your premiums were not paid.
If we approve your reinstatement application, this policy will no longer be reduced paid-up
cover, and the original benefit amount will apply.
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If this policy ended because premiums weren’t paid
You can apply to reinstate (restart) this policy within three years of it ending, if it ended because
the premiums were not paid. You cannot reinstate this policy if the surrender benefit has been
paid.
If we approve your reinstatement application, the policy benefits will be effective from the date
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we reinstate this policy.
This policy will restart from the date we reinstate it.
What you need to do

To apply to reinstate this policy, you need to do the following:
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– Send us a written request to reinstate this policy using our standard for and provide any
other document and information we will ask to [email protected], or call
our 24/7 Customer Connect Hotline at +632 8888 8388.
– Pay us all premiums due for this policy, including any interest, at an interest rate we set
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upon our confirmation.
What happens next

We will review your request, and if we are satisfied that you have met our requirements, we
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will reinstate this policy.

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The main people under your policy
We refer to the policy owner, insured person, and beneficiaries

throughout this policy document. This section explains who they
are, what rights they have, and how they are treated under your
policy.
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Policy owner (you)
You (the policy owner) own this policy, and your details are shown in the policy data page or
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endorsement. Only you can make changes to, or enforce any rights under your policy subject to
your irrevocable beneficiaries’ permission.
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You receive all of the benefits under this policy, except for the death benefit and funeral benefit
which are paid to the beneficiaries.
Changing the policy owner
What you need to do

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To change the policy owner, you need to tell us in writing and give us any other information
we need.
What we will do
We will provide a letter documenting the change.
Using your policy as collateral

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You can choose to assign the benefits under your policy to someone else (assignee) as collateral
for a loan. We will only recognize a policy assignment if we have made a record of it, and issued
you with a policy endorsement.
What you need to do

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If you want to assign your policy interests, you need to send us a signed and notarized
collateral assignment form and provide us with any additional information we need.
What we will do
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We will make a record of your assignment, and provide you with acknowledgement in writing.
We are not responsible for the effect, sufficiency or validity of any assignment.
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If you owe us money under this policy, our rights will take priority over any other
person or assignee.

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Insured person
This is the person you chose for us to protect under this policy. You can also be the insured
person or you can choose someone else such as your spouse. The insured person cannot receive
any benefit under this policy, and cannot make changes to your policy, unless you are also the
insured person.
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Beneficiaries
The beneficiaries are the people you chose to receive any amounts paid under this policy when
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the insured person dies. You can appoint one or more beneficiaries, and you may decide how
much of the death benefit each beneficiary will receive.
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Choosing your beneficiaries
The law sets certain requirements for who can be named as your beneficiary. If you are the
policy owner and the insured person, you can choose any person as your beneficiary. If you are
not the insured person, anyone you choose as beneficiary must have an ‘insurable interest’ in
both you and the insured person when your policy starts.
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Any person generally has an insurable interest in another person if they gain a
financial benefit or support from that person being alive and in good health.
If it is found that a beneficiary did not have an insurable interest in both you and the insured
person, they will be disqualified from being a beneficiary
You can choose any legal entity (including a corporation, partnership, charity, or
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trust) to be a beneficiary.
Rights
Beneficiaries receive the death benefit under your policy. Beneficiaries cannot receive any other
benefit under your policy, and they cannot make changes to your policy.
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Types of beneficiaries
When you choose your beneficiaries, you classify them as ‘revocable’ or ‘irrevocable’, and
‘primary’ or ‘contingent’. These choices affect how easily you can change your policy, and who
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is first in line to receive the benefits.

Revocable or irrevocable
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Your beneficiaries will be revocable or irrevocable.
Revocable
If you make all of your beneficiaries revocable, you can make any change to your policy without
the permission of your revocable beneficiaries.
Irrevocable
If you make any of your beneficiaries irrevocable, you need written permission from all of your
irrevocable beneficiaries if you are making a change that will reduce any death benefit they can
receive under this policy.

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Beneficiaries are considered to be irrevocable if you made no changes to your beneficiaries

while the insured person was alive.
Revocable [OR] Irrevocable
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Policy can be Must agree
changed any time to change the policy
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Primary or contingent beneficiaries
Your beneficiaries will be primary or contingent. Primary beneficiaries are first in line to receive
the death benefit. If there are no living primary beneficiaries, we will pay the death benefit to
the contingent beneficiaries, if any.
Contingent beneficiaries are the back-ups for your primary beneficiaries.

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They only receive a benefit if there are no primary beneficiaries.
Primary
We will pay the entire death benefit to the surviving primary beneficiaries in the shares you
have chosen. If you have not chosen any shares, we will pay them in equal shares.
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Contingent
If there are no living primary beneficiaries, we will pay the entire death benefit to the surviving
contingent beneficiaries, if any, in the specific shares you have chosen. If you have not chosen
any specific shares, we will pay them in equal shares.
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Primary [OR] Contingent

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First in line Second in line
Substitute beneficiaries when there are no primary or contingent beneficiaries

We think it’s important to be ready for anything, so your policy has rules if there are no primary
or contingent beneficiaries when the insured person dies. This may happen if the beneficiaries
have been disqualified by law, or if they die before the insured person.
If there are no primary or contingent beneficiaries, we will pay you the basic death benefit, and
any benefits paid under a supplementary rider in the event of death. Otherwise, we will pay
those benefits in equal shares to whoever comes highest up on the list below.

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The insured person’s:
– legal spouse;
– legitimate children;
– illegitimate children;
– parents;
– brothers and sisters; or
– half-brothers and half-sisters.
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If we cannot pay any of the people above, the death benefit will be paid to the insured person’s
estate.
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Beneficiary payment order
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If no If no
primary beneficiaries, primary owner,
we pay we pay
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Primary Contingent Substitute
Policy Owner
beneficiary beneficiary beneficiaries
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This applies at the time of the If no

insured person’s dealth contingent beneficiaries,
we pay
Changing a beneficiary
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You can change or add a beneficiary at any time before your policy ends.
If you have any irrevocable beneficiaries and you want to:
– reduce the death benefit share of the irrevocable beneficiaries; or

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– remove any of the irrevocable beneficiaries;
you need to get the consent of the current irrevocable beneficiaries whose death benefit may
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be reduced, before we can make the change.
What you need to do

To change the beneficiary, you need to tell us in writing and give us any other information we
need (including the consent of any of the irrevocable beneficiaries).
What we will do
We will provide a letter documenting the change.

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Premiums and Loans
You need to keep paying your premiums for this policy during the
duration (number of years payable) shown in the policy data page.
We have the right to change the premium for this policy if

approved by the Insurance Commission. If we do, we will notify
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you at least 45 days before your anniversary date.
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When you need to pay your premiums
When you apply for this policy, you will be told how much you need to pay and when the
premiums are due (the premium due dates).
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The frequency of your premiums for this policy (for example every month, or once a year) will be
shown in the policy data page.
What happens if you don’t pay your premiums

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31-day grace period to pay
We give you a 31-day grace period after the premium due date to pay the premium. This policy
will continue if you pay the premium within the grace period.
Non-forfeiture options if you don’t pay within the 31-day grace period
If we do not receive payment within the grace period, you can tell us to do one of the following
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non-forfeiture options.
– Continue this policy, but change it to reduced paid-up cover (see details below); or
– Continue this policy under an automatic premium loan arrangement (see details below); or
– Surrender (end) your policy, and receive the cash value.
If you have not told us your choice, we will use the reduced paid-up cover non-forfeiture option.
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Reduced paid-up coverage

Under this option, we keep this policy active, but reduce the policy benefits. This means that the
expiry date will remain the same, but the benefit amount will be lower.
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We determine the new benefit amount based on the available cash value and the insured per-
son’s age at the date of the change.
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While this policy is still active, you can apply to change this policy back from reduced paid-up
cover within three years from the date you missed your premium. See page 13 Reinstating your
policy for details.
Automatic premium loan

You can nominate for premiums due to be automatically borrowed from this policy’s cash value.
We will notify you in writing when we lend you the premium due. However, the amount lent will
not exceed this policy’s cash value less any indebtedness. When this option takes effect, this
policy will continue to be active for a period proportionate to the amount borrowed after which
time this policy will terminate with any remaining cash value of this policy being refunded to
you.

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Policy loan
You can apply to us for a policy loan, for any purpose including premium payments for your
policy, if the following conditions apply:
– the cash value of your policy has a minimum value based on our current rules and
procedures;
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– the loan amount you applied for is lower than your cash value less any outstanding loans; and
– your policy has not been changed to reduced paid-up cover.
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If we accept your application, you will owe us the amount loaned (the principal) as well as
interest on that amount. We will advise you of the interest rate we will apply and we will apply
interest on a daily basis from the date we provide the loan.
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Repaying your policy loan
You can repay any part of the principal and interest owed at any time
Policy ends if loan balance is greater than the cash value

Your policy will automatically terminate (end) when the outstanding loan balance is greater than
the cash value of your policy.
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What you need to do
To apply for a policy loan, you need to send us a completed policy loan request form and any
other information we request.
If we accept your application, you need to repay the principal and interest.
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What we will do
We will review your application, and if we approve, we will provide you with the loan amount
and advise you of the interest rate.
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Keeping it legal
Contract and governing law

This policy is a legal contract of insurance between you and us, and is governed by Philippine
law. Under this policy, we agree to provide the policy benefits, and you agree to keep to the
terms and conditions of your policy.
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We rely on your information
We relied on the information you and the insured person gave us during the application process
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to provide you with this policy. It is important that you and the insured person had given us
complete, correct, and true information, as this information helped us decide if you and the
insured person were eligible for this policy, and what you needed to pay.
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You must let us know immediately if the information you or the insured person gave us was not
complete, correct, or true. If you don’t let us know and don’t provide complete, correct, or true
information, your benefits under this policy will be affected and, in some cases, we may cancel
this policy.
Incorrect age or gender

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If we discover that we were given the incorrect age or gender for the insured person, we will
adjust the benefit amount of this policy to reflect the correct age and gender.
If the insured person was not eligible for insurance coverage at their correct age or gender, we
will treat this policy as having never existed, and we will refund all premiums you have paid for
this policy less any outstanding loans.
EF
Contestability
If we contest (dispute) a claim, we will review the claim and decide if we have any reason to
treat this policy as having never existed. If we do, we will not pay any benefit, and we will
refund all premiums you have paid less any outstanding loans (to you or to your beneficiaries).
R
Death
We can contest (dispute) the validity of any death benefit claim within two years from:
R
– the effective date or the date we last reinstated this policy (whichever is later); and
– the date of the increase in the benefit amount (for the increased amount)
if we discover that you or the insured person did not give us complete, correct, or true
FO
information when you applied for this policy.
We cannot contest (dispute) the validity of any death benefit claim after the two-year period,
unless we are allowed by law or jurisprudence.
Major and Minor Critical Illness
We can contest (dispute) the validity of any major and minor critical illness benefits claim
(including any increase) anytime, unless we are disallowed by law or jurisprudence.

21
Time limit on legal action

No one can take legal action in connection with your policy after five years from the time the
reason for the legal action arose. Legal actions done on your policy can be made anywhere
within the legal jurisdiction of the Philippines.
E
Payments under the policy
All amounts paid to us, or by us, in connection with your policy will be paid in the currency
shown in the policy data page.
C
We will only make payments in the Philippines.
EN
Payments are not adjusted for inflation or deflation
Article 1250 of the Civil Code of the Philippines does not apply to any payments under your
policy. Article 1250 says:
“In case an extraordinary inflation or deflation of the currency stipulated should supervene,
ER
the value of the currency at the time of establishment of the obligation shall be the basis of
payment...”
No adjustments are made if there is any extraordinary rise or fall in the value of the
currency you chose for your policy.
EF
R
R
FO

22
Medical definitions for

major critical illness
A major critical illness means any of the conditions specified

below. We can change these definitions from time to time to reflect
changes in medical terminologies and practices subject to the
E
approval of Insurance Commission. If we do change them, we will
tell you in writing. All diagnosis must be confirmed by a medical
practitioner defined in page 34 Important words and phrases.
C
Group 1: Cancers
EN
1. Late-stage cancers A malignant tumor characterized by the uncontrolled growth and
spread of malignant cells with invasion and destruction of normal
tissue. The cancer must be confirmed by histological evidence of
malignancy.
The following are not classified as Late stage cancers but,

ER
instead, are classified as Early Stage Cancers under the ‘Medical
definitions for minor critical illness’ section:
– Early bladder cancer: papillary carcinoma (Ta) of bladder
– Early chronic lymphocytic leukemia: chronic lymphoctic
leukemia (CLL) RAI Stage one or two
– Early prostate cancer: prostate cancer histologically described
EF
– Early thyroid cancer: thyroid cancer histologically described
micro-carcinoma of thyroid where the tumor is less than one cm

in diameter
– Early invasive melanomas: invasive melanomas of less than 1.5
R
mm breslow thickness or less than clark level three

–
critical illness’ section.
Non-melanoma skin cancer and all carcinoma in-situ of skin or

R
earlier stages do not meet the definition of Late Stage Cancers or

Early Stage Cancers.
FO
Group 2: Major organ failure
2. Aplastic anemia Chronic persistent bone marrow failure which results in anemia,
neutropenia and thrombocytopenia requiring treatment with at
least one of the following:
– Blood product transfusion
– Marrow stimulating agents
– Immunosuppressive agents, or
– Bone marrow transplantation.
3. Chronic liver End-stage liver failure as evidenced by each of permanent jaundice,

disease ascites and hepatic encephalopathy.

23
4. Chronic lung End-stage lung disease, causing chronic respiratory failure, as

disease evidenced by all of the following:
– FEV1 test results consistently less than one litre
– The requirement for permanent supplementary oxygen therapy for
hypoxemia
– Arterial blood gas analyses with partial oxygen pressures of
55mmHg or less (PaO2 < 55mmHg), and
– Dyspnea at rest.
E
5. Chronic The Chronic Relapsing Pancreatitis as a result of progressive severe
recurrent destruction with all of the following characteristics:
pancreatitis
– Recurrent acute pancreatitis for a period of at least two years
C
– Generalize calcium deposits in pancreas from imaging study, and
– Chronic continuous pancreatic function impairment resulting in
mal-absorption of intestine (high fat in stool) or diabetes.
EN
6. Crohn’s disease A chronic, transmural inflammatory disorder of the bowel, as
evidenced with continued inflammation in spite of optimal therapy,
with all of the following having occurred:
– Stricture formation causing intestinal obstruction requiring
admission to hospital
ER
– Fistula formation between loops of bowel, and
– At least one bowel segment resection
The diagnosis must be proven histologically on a pathology report

and/or the results of sigmoidoscopy or colonoscopy.
7. Fulminant viral
EF
A sub-massive to massive necrosis of the liver by the hepatitis virus,

hepatitis leading precipitously to liver failure. The diagnosis in respect of this
illness must be evidenced by all of the following:
– A rapidly decreasing liver size
– Necrosis involving entire lobules, leaving only a collapsed reticular
framework
R
– Rapid deterioration of liver function tests

– Deepening jaundice, and
– Hepatic encephalopathy.
8. Loss of hearing – The irreversible loss of hearing at least 80 decibels in all

R
(Deafness) frequencies in both ears as a result of illness or accident. The

inability to hear must be established for a continuous period of six
months and must (at the end of that period) be deemed permanent
on the basis of audiometric and sound-threshold test results.
FO
9. Loss of sight Total and irreversible loss of sight in both eyes as a result of illness or
(Blindness) accident.
10. Major organ The actual undergoing (as a recipient) of a transplant, solely as a result
and bone of irreversible end-stage failure, of either:
marrow
– One of the following human organs: (a) heart, (b) lung, (c) liver, (d)
transplant
kidney or (e) pancreas, or
– Human bone marrow replaced by hematopoietic stem cells only
and which is preceded by total bone marrow ablation.

24
11. Medullary A progressive hereditary disease of the kidneys characterized by the

cystic disease presence of cysts in the medulla in both kidneys, tubular atrophy and
interstitial fibrosis with the clinical manifestations of anemia, polyuria
and renal loss of sodium. The condition must present as the chronic
irreversible failure of both kidneys to function, requiring regular renal
dialysis.
Diagnosis must be supported by renal biopsy.
12. Progressive A systemic collagen-vascular disease causing progressive diffuse
E
Scleroderma fibrosis in the skin, blood vessels and visceral organs. An unequivocal
diagnosis of this disease must be supported by biopsy and serological
evidence and the disorder must have reached systemic proportions
to involve the heart, lungs or kidneys such that two of the following
C
criteria are met:
– Pulmonary involvement showing carbon monoxide diffusing
capacity (DLCO) < 70% of the predicted value, or forced expiratory
EN
volume in 1 sec (FEV1), forced vital capacity (FVC) or total lung
capacity (TLC) < 75% of the predicted value
– Renal involvement showing glomerular filtration rate (GFR) < 60 ml/
min
– Cardiac involvement showing evidence of either congestive
– heart failure, cardiac arrhythmia requiring medication, or
ER
pericarditis with moderate to large pericardial effusion.
13. Renal failure Chronic irreversible failure of both kidneys, requiring either
permanent renal dialysis or kidney transplantation.
14. Terminal illness Means the conclusive diagnosis by a medical practitioner that the
insured person is suffering an illness that is expected to result to his/
EF
her death within 12 months. The insured person must no longer

be receiving active treatment other than that for pain relief.
15. Ulcerative Acute fulminant ulcerative colitis with life threatening electrolyte
colitis disturbances meeting the following criteria:
– the entire colon is affected with severe bloody diarrhea, and
R
– the necessary treatment is total colectomy as

– diagnosed based on histopathological features.
Group 3: Heart and blood vessel related

R
16. Cardiomyopathy An impaired function of the heart muscle, unequivocally diagnosed

as Cardiomyopathy by a cardiologist, and which results in permanent
physical impairment to the degree of New York Heart Association
FO
classification Class III or Class IV, or its equivalent, for at least six
months based on the following classification criteria:
– Class III - Marked functional limitation. Affected patients are
comfortable at rest but performing activities involving less than
ordinary exertion will lead to symptoms of congestive cardiac
failure.
– Class IV - Inability to carry out any activity without discomfort.
Symptoms of congestive cardiac failure are present even at
rest. With any increase in physical activity, discomfort will be
experienced.
The diagnosis of Cardiomyopathy must be supported by echographic

findings of compromised ventricular performance.

25
17. Coronary Severe coronary artery disease in which at least three major coronary
artery disease arteries are individually occluded by a minimum of 60%or more,
as proven by coronary angiogram only (non-invasive diagnostic
procedures excluded).
For purposes of this definition, “major coronary artery” means any of

the left main stem artery, left anterior descending artery, circumflex
artery and right coronary artery (but not including their branches).
18. Heart attack Death of a portion of the heart muscle arising from inadequate blood
E
(Myocardial supply to the relevant area. This diagnosis must be supported by three
infarction) or more of the following four criteria which are consistent with a new
heart attack:
C
– New electrocardiogram (ECG) changes proving infarction
– History of typical chest pain for which the insured person is
admitted to hospital
EN
– Left ventricular ejection fraction less than 50% measured 3 months
or more after the event
– Diagnostic elevation of cardiac enzyme CK-MB or diagnostic
elevation of Troponin T > 1 mcg/L (1 ng/ml) or AccuTnl > 0.5ng/ ml
or equivalent threshold with other Troponin I methods.
All other acute coronary syndromes, including, but not limited to,
ER
unstable angina, micro infarction and minimal myocardial damage do
not meet the definition of ‘Heart Attack (Myocardial Infarction)’.
19. Heart valve The actual undergoing of open-heart surgery to replace or repair heart
surgery valve abnormalities. The diagnosis of heart valve abnormality must
be supported by cardiac catheterization or echocardiogram and the
procedure must be considered medically necessary.
EF
Repair via intra-vascular procedure, key-hole surgery or similar

techniques do not meet the definition of ‘Heart Valve Surgery’.
20. Primary Primary pulmonary hypertension with substantial right ventricular

R
pulmonary enlargement, established by investigations including cardiac

arterial catheterization and resulting in permanent physical impairment to
hypertension the degree of at least Class IV of the New York Heart Association
classification of cardiac impairment.
R
Class IV is defined as the inability to carry out any activity without

discomfort. Symptoms of Congestive Cardiac Failure are present
even at rest. With any increase in physical activity, discomfort will be
experienced.
FO
21. Surgery to The actual undergoing of major surgery to repair or correct an

aorta aneurysm, narrowing, obstruction or dissection of the aorta through
surgical opening of the chest or abdomen. For the purpose of this
definition, aorta shall mean the thoracic and abdominal aorta but not
its branches. The procedure must be considered medically necessary
by a cardiologist.
Surgery performed using only minimally invasive or intra-arterial

techniques do not meet the definition of ‘Surgery to Aorta’.

26
Group 4: Neuro-muscular related
22. Alzheimer’s Deterioration or loss of intellectual capacity as confirmed by clinical

disease evaluation and imaging tests, arising from Alzheimer’s disease or
irreversible organic disorders, resulting in there being at least three of
the activities of daily living.
The diagnosis must be clinically confirmed by medical practitioner

who specializes in Alzheimer’s disease.
E
23. Apallic Universal necrosis of the brain cortex with the brainstem intact. The
syndrome definite diagnosis must be evidenced by specific findings in neuro-
radiological tests and medically documented for at least one month.
C
24. Benign brain A benign tumor in the brain as evidenced by all of the following:
tumor – the tumor is life threatening
EN
– it has caused damage to the brain, and
– it has undergone surgical removal or, if inoperable, has caused a
permanent neurological deficit.
The presence of the underlying tumor must be supported by findings

on Magnetic Resonance Imaging, Computerized Tomography, or other
reliable imaging techniques.
ER
Cysts, granulomas, vascular malformation, hematomas and tumors of
the pituitary gland or spine do not meet the definition of ‘Benign Brain
Tumor’.
25. Cerebral Actual undergoing of brain surgery with craniotomy to correct an

aneurysm abnormal dilation of cerebral arteries, involving all three layers of
EF
requiring the walls of the cerebral arteries. The aneurism must be at least 10
surgery millimeter in size or increasing by at least 0.95 millimeter per year
and the need for surgery must be confirmed by a neuro- surgeon as
evidenced by the results of cerebral angiography.
Infection aneurysms, mycotic aneurysms, limited craniotomy and burr-

R
hole procedures do not meet the definition

of ‘Cerebral Aneurysm Requiring Surgery.’
26. Coma A coma that persists for a continuous period of at least 96 hours and
evidenced by all of the following:
R
– There is no response to external stimuli for at least ninety-six 96

hours
– Life support measures are necessary to sustain life, and
FO
– There is brain damage that results in a permanent neurological

deficit.
The permanence of the neurological deficit must be assessed by a

neurologist at least 30 days after the onset of the coma.
27. Loss of Inability to perform without the continuous assistance of another

independent person at least three of the activities of daily living for a continuous
existence period of at least six months and leading to a permanent inability to
perform the same.
The benefit for Loss of Independent Existence will automatically cease

after the insured person attains age 65.

27
28. Motor neurone Motor neurone disease of unknown etiology, as characterized by

disease progressive degeneration of corticospinal tracts and anterior horn
cells or bulbar efferent neurones. These include spinal muscular
atrophy, progressive bulbar palsy, amyotrophic lateral sclerosis and
primary lateral sclerosis.
The condition must result in the insured person being unable to

perform without the continuous assistance of another person at least
three of the activities of daily living for a continuous period of at least
three months and must (at the end of that period) be confirmed by a
E
neurologist as progressive and resulting in permanent disability and
neurological deficit.
C
29. Multiple The definite occurrence of multiple sclerosis, as evidenced by all of
sclerosis the following:
– Investigations unequivocally confirm the diagnosis to be multiple
EN
sclerosis
– Multiple neurological deficits have occurred over a continuous
period of at least six months, solely and directly due to the
diagnosis of multiple sclerosis, and
– There is a well-documented history of exacerbations and remissions
of said symptoms or neurological deficits.
ER
30. Muscular A group of hereditary degenerative diseases of muscle, characterized
dystrophy by weakness and atrophy of muscle. The diagnosis of muscular
dystrophy must be unequivocal.

EF

six months and must (at the end of that period) be deemed permanent
by a consultant physician.
31. Paralysis Total and irreversible loss of use of at least two entire limbs due
to injury or disease. This condition must have persisted for a
R
continuous period of at least six months and must (at the end of that
period) be deemed permanent by a consultant neurologist.
32. Parkinson’s The unequivocal diagnosis of idiopathic Parkinson’s Disease by a

R
disease consultant neurologist, as evidenced by all of the following:

– Cannot be controlled with medication
– Shows signs of progressive impairment, and
FO
– Results in the insured person being unable to perform without

the continuous assistance of another person at least three of the
activities of daily living.
The disability must have persisted for a continuous period of at least

six months and at the end of that period must be deemed permanent
by a consultant neurologist.

28
33. Stroke A cerebro-vascular incident including infarction of brain tissue,

cerebral and subarachnoid hemorrhage, cerebral embolism and
cerebral thrombosis, as evidenced by all of the following:
– There is evidence of permanent neurological damage confirmed by
a neurologist at least six weeks after the event, and
– There are findings on Magnetic Resonance Imaging, Computerized
Tomography, or other reliable imaging techniques consistent with
the diagnosis of a new stroke.
The following do not meet the definition of ‘Stroke’:
E
– Transient ischemic attacks
– Brain damage due to an accident or injury, infection, vasculitis, and
C
–
– Ischemic disorders of the vestibular system.
EN
Group 5: Neuro-muscular related
34. Bacterial Bacterial infection resulting in severe inflammation of the membranes
meningitis of the brain or spinal cord resulting in significant, irreversible and
permanent neurological deficit confirmed by a consultant neurologist.
Confirmation of bacterial infection in cerebrospinal fluid by lumbar
puncture is required and the neurological deficit must persist
ER
continuously for at least six weeks.
35. Encephalitis Severe inflammation of brain substance, resulting in permanent

neurological deficit which is documented for a minimum of 30 days
36. HIV/AIDS Infection with the Human Immunodeficiency Virus (HIV) through a
due to blood blood transfusion, as evidenced by all of the following:
EF
transfusion – The infection was due to a blood transfusion that was medically
necessary or given as part of a medical treatment
– The blood transfusion was received in Philippines after the effective
date or date of Reinstatement of this policy (whichever is later)
– The source of the infection is established to be from the institution
that provided the transfusion and the institution is able to trace the
R
origin of the HIV tainted blood, and

– The insured person does not suffer from thalassemia major or
hemophilia.
No payment will be made under this condition where a cure has

R
become available prior to the infection. “Cure” means any treatment

that renders the HIV inactive or non-infectious.
FO
37. Loss of limbs Severance of two limbs at or above wrist or ankle as a result of illness
or injury.
38. Loss of speech Total and irrecoverable loss of the ability to speak solely to the insured
person’s vocal cords being permanently damaged from an injury or
disease. The inability to speak must be established for a continuous
period of twelve months and must (at the end of that period) be
deemed permanent on the basis of medical evidence furnished by an
Ear, Nose and Throat Specialist.
39. Major burns Third degree (full thickness of the skin) burns covering at least 20% of
the surface of the insured person’s body. Diagnosis must be evidenced
by specific results using the Lund Browder Chart or equivalent burn
area calculators.

29
40. Major head Accidental head injury resulting in the insured person being unable to
trauma with perform without the continuous assistance of another person at least
severe three of the activities of daily living.
The neurological deficit must have persisted continuously for at least

six weeks and must (at the end of that period) be deemed permanent
by a consultant neurologist, as supported by unequivocal findings on
Magnetic Resonance Imaging, Computerized Tomography, or other
reliable imaging techniques.
E
For the avoidance of doubt, head injuries due to any other cause and
spinal cord injuries do not meet the above description.
C
41. Occupationally Infection with the Human Immunodeficiency Virus (HIV) which
acquired resulted from an Accident occurring after the Effective Date or date
HIV/AIDS of Reinstatement of this policy (whichever is later) and while the
EN
insured person was carrying out the normal professional duties of
his/her occupation in Philippines. All of the following proofs must be
submitted to Our satisfaction:
– The Accident giving rise to the infection must be reported to Us
within 30 days of the Accident taking place;
– The Accident involved a definite source of the HIV infected fluids;
and
ER
– The sero-conversion from HIV negative to HIV positive occurring
during the 180 days following the documented accident. This proof
must include a negative HIV antibody test conducted within five
days of the accident.
This benefit is only payable when the occupation of the insured

EF
person is a medical practitioner, medical student, state registered

nurse, medical laboratory technician, dentist (surgeon or nurse)
or paramedical worker, registered with the appropriate body and
working in a licensed medical center or clinic (in the Philippines).
No payment will be made under this condition where a cure has

become available prior to the infection. “Cure” means any treatment
R
that renders the HIV inactive or non-infectious.
42. Severe Severe rheumatoid arthritis, with the diagnosis confirmed by a

rheumatoid consultant rheumatologist and as evidenced by all of the following:
R
arthritis – X-ray reveals typical rheumatoid change

– The joint deformity change persists continuously for at least six
months, and
FO
– At least three of the following groups of joints are involved and

deformed: (a) finger joints, (b) wrist joints, (c) elbow joints, (d) knee
joints, (e) hip joints, (f) ankle joints or (g) spine.

six months and must (at the end of that period) be deemed permanent
by a consultant physician.

30
Medical definitions for

minor critical illness
A minor critical illness means any of the conditions specified

below. We can change these definitions from time to time to reflect
changes in medical terminologies and practices subject to the
E
approval of Insurance Commission. If we do change them, we will
tell you in writing.
C
1. Accidental A new spinal fracture caused by an accident, and requiring
fracture of hospitalization for open surgical repair, resulting in a permanent
EN
spinal column neurological deficit in motor function or bladder function. The spinal
column is defined as one bone as a whole, and the diagnosis of the
fracture of the spinal column must be based on an examination of
an X-ray or any other similar imaging technology by a specialist
orthopaedic surgeon or a radiologist.
2. Angioplasty
ER
Angioplasty and Other Surgeries for Coronary Artery means either of
and other the following procedures:
invasive – Angioplasty and/or stenting, being the actual undergoing of balloon
treatments for angioplasty and/or stenting to correct narrowing or blockage of
coronary artery one or more coronary arteries; or
disease – The actual undergoing of atherectomy, laser relief, transmyocardial
laser revascularisation, or other intra-arterial techniques to correct
EF
narrowing or blockage of one or more coronary arteries.
Angiographic evidence must be provided that at least one coronary

artery has stenosis of 50% or higher and the procedure must be
certified as medically necessary and performed by a cardiologist.
R
3. Diabetic Diabetic Retinopathy means advanced changes to the retinal blood

retinopathy vessels as a consequence of diabetes mellitus. All of the following
criteria must be met:
– Presence of diabetes mellitus at the time of diagnosis of diabetic
R
Retinopathy;
– Visual acuity of both eyes is 6/18 or worse using Snellen eye chart;
and
– Actual undergoing of treatment such as laser treatment to alleviate
FO
the visual impairment.

31
4. Early stage cancer Early Stage Cancer is any of the below conditions.
– Early Bladder Cancer: Papillary carcinoma (Ta) of Bladder
– Early Chronic Lymphocytic Leukemia: Chronic Lymphocytic
Leukemia (CLL) RAI Stage one or two
– Early Prostate Cancer: Prostate Cancer histologically described
– Early Thyroid Cancer: Thyroid Cancer histologically described
of thyroid where the tumor is less than one centimeter in diameter
E
– Early Invasive Melanomas: Invasive melanomas of less than 1.5 mm
Breslow thickness, or less than Clark Level 3. Nonmelanoma skin
cancer and all carcinoma in-situ of skin or earlier stages do not
C
–
EN
Carcinoma in situ (CIS) means the focal autonomous new growth of
carcinomatous cells confined to the cells in which it originated and
has not yet resulted in the invasion and/or destruction of surrounding
tissues. ‘Invasion’ means an infiltration and/or active destruction of
normal tissue beyond the basement membrane. The CIS diagnosis
must be supported by both a histopathological report and microscopic
examination of the fixed tissue and supported by a biopsy result.
ER
In the case of the cervix uteri, pap smear results must be accompanied
with cone biopsy or colposcopy with the cervical biopsy report clearly
indicating presence of CIS. Clinical diagnosis alone does not meet this
definition of CIS.
Cervical Intraepithelial Neoplasia (CIN) classification which reports

EF
CIN I, CIN II and CIN III (where there is severe dysplasia without CIS)
does not meet the definition of CIS.
5. Loss of one limb Total and irreversible loss of use of one entire limb (above elbow or
above knee) due to illness or accident.
R
6. Loss of one lung The complete surgical removal of a lung as a result of an illness of
the insured person.
7. Removal of one The complete surgical removal of one kidney necessitated by any
kidney disease or accident of the insured person. The need for the surgical
R
removal of the kidney must be certified to be medically-necessary by a

nephrologist and/or surgeon.
FO
Kidney donation does not meet the definition of ‘Removal of One

Kidney.’
8. Severe The occurrence of osteoporosis with fractures where the following

osteoporosis conditions are met:
– A fracture of the neck of femur or two vertebral body fractures, due
to or in the presence of osteoporosis;
– Bone mineral density measured in at least two sites by dualenergy
x-ray densitometry (DEXA) or quantitative CT scanning is consistent
with severe osteoporosis (T-score of less than -2.5); and
–
the fractured bone.

32
9. Surgical removal The actual undergoing of surgical excision of pituitary tumor

of pituitary tumor necessitated as a result of symptoms associated with increased
intracranial pressure caused by the tumor, endocrinological disorder
with pituitary origin or neurological deficit due to oppression of
pituitary tumor onto normal brain tissue. The presence of the
underlying tumor must be confirmed by imaging studies such as
computed tomography scan or magnetic resonance imaging. The
surgery must be certified to be medically necessary by a medical
practitioner who specializes in this field.
E
Surgical excision of pituitary microadenoma (tumor of 8mm in size or
below in diameter) does not meet the definition of ‘Surgical Removal
of Pituitary Tumor’.
C
The following Minor Critical Illnesses also apply while the insured
person is aged 17 years or younger.
EN
ER
EF
R
R
FO

33
Important words and phrases
The list below explains the meanings of certain words and phrases
used in this document.
90-day no-claim The 90-day no claim period means the 90 days after the latest of:
period – the start of coverage;
– the last reinstatement date; or
E
–
amount)
C
Accident An accident is the abrupt, unexpected, and unwanted contact
between the insured person and an external object or substance.
EN
The accident must be the sole and direct cause of the condition.
Activities of daily The activities of daily living refers to the following activities:
living – Washing : the ability to wash in the bath or shower (including
getting into and out of the bath or shower) or wash satisfactorily by
other means.
–
ER
surgical appliances.
– Transferring : the ability to move from a bed to an upright chair or
wheelchair and vice versa.
– Continence: the ability to control bowel and bladder function so
as to maintain a satisfactory level of personal hygiene.
EF
– Feeding: the ability to feed oneself once food has been prepared
and made available.
Benefit amount Refers to the benefit amount or sum assured of this policy as stated in
the policy data page.
R
Cancer-free for Cancer-free for five years means that the insured person has been
five years cancer-free continuously in the last five years as confirmed by the
insured person’s medical practitioner and supported by clinical,
radiological, histological and laboratory evidence. The cancer-free
R
period shall start on the date of completion of treatment of cancer,

which shall include any surgery, chemotherapy, radiation therapy,
immunotherapy, monoclonal antibody therapy or other conventional
FO
cancer treatments that have been used as prescribed by the insured

person’s medical practitioner.
Cash value The amount shown in the table below that is used to determine:
– the surrender benefit; and
– the amount used to calculate your cover if this policy is changed to
the reduced paid-up status because the premiums aren’t paid.
Major critical Major critical illness is any of the conditions listed and defined in page
illness 22 Medical definitions for major critical illness. The insured person
must be certified by a medical practitioner as suffering any of these
covered conditions.

Important words and phrases 34
Minor critical Minor critical illness is any of the conditions listed and defined in page
illness 30 Medical definitions for minor critical illness. The insured person
must be certified by a medical practitioner as suffering any of these
covered conditions.
Medical A medical practitioner is a person who is licensed and registered in

practitioner the Philippines to practice medicine. Unless we agree in writing, a
E
medical practitioner cannot be any of the following people:
– you or the insured person;
– your insurance agent, family member, business partner, employer,
C
or employee; or
– the insured person’s insurance agent, family member, business
partner, employer, or employee.
EN
Pre-existing Pre-existing condition means either:
condition –
amount) of this policy. The insured person may or may not know
the presence of such condition.
– A condition whose treatment, medication, advice, or diagnosis has
ER
been sought or received by the insured person before the latest of
policy.
EF
The Insurance Commission, with offices in Manila, Cebu and Davao, is the government
office in charge of enforcing all laws related to insurance and supervising insurance
companies and intermediaries. They help the general public in matters relating to
insurance. For any questions or complaints, please contact the Public Assistance and
Mediation Division (PAMD) of the Insurance Commission at 1071 United Nations Avenue,
Manila. Phone +632-85238461 to 70 or email [email protected]. The
R
official website of the Insurance Commission is www.insurance.gov.ph

R
FO

35
Table of non-forfeiture values
Policy Year Age With Major Critical Illness Claim Without Major Critical Illness Claim
Guaranteed Cash Reduced Paid-up Guaranteed Cash Reduced Paid-up

Values Insurance Values Insurance
E
2
3
C
4
EN
5
6
7
ER
8
9
10
EF
11
12
13
R
14
15
R
16
17
FO
18
19
20
*Policy is paid-up since Waiver of Premium is applied upon claim of major critical illness
The values shown in this table of non-forfeiture values are for every PHP 1000.00 of benefit amount. These
are guaranteed for the number of years indicated, as long as premiums are paid in full and where no
indebtedness is assumed. You may request for the values applicable to the durations not shown in this table.

SFH NMCD

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SFH NMCD

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Policy Document

About this policy 1

Your benefits at a glance 3

Claiming this benefit 9

When this policy starts and ends 12

When this policy ends 12

The main people under this policy 14

Policy owner (you) 14

Premiums and loans 18

When you need to pay your premiums 18

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Medical definitions for minor critical illness 30

Table of cash values 35

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About this policy

Thank you for choosing FWD. We’re pleased to be protecting you,

What makes up your policy

– The policy data page.

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SFH.DIG.AG.2023.06 Set for Health

Set for Health

Your benefits at a glance

We pay 100% of the page 35 Table of

different to the first This policy ends upon

Benefit major critical illnesses until the policy expiry date.

We pay all future premiums from the date the insured

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This is a protection product

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What you are covered for

Summary of your policy benefits

– the insured person is diagnosed with a major critical illness;

– the insured survives at least 14 days after the diagnosis of a major

We do not pay any major critical illness benefit if signs of a

We do not pay any major critical illness benefit if the claim

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Major critical illnesses covered

Group 1: Cancers 1. Late-stage cancers

26. Coma 32. Parkinson’sdisea

Group 5: Others 34. Bacterial meningitis 39. Major burns

38. Loss of speech acquired HIV/AIDS

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We pay 20% of the benefit amount if the insured person is diagnosed

Minor critical illnesses covered

1. Accidental fracture of 3. Diabetic retinopathy 7. Removal of one

coronary artery disease pituitary tumor

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We pay 100% of the benefit amount if the insured person dies.

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Claiming this benefit

Claiming this benefit

Taking unpaid loans or premiums from benefit payments

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What we do not cover

Exclusions that apply to major and minor critical illness benefits

within two years after coverage starts, is reinstated, or is

claim arises from a pre-existing condition. We will only pay the

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Exclusion that applies to death benefit

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When this policy starts and ends

When your policy starts

Receiving your policy

When this policy ends

grace period and the cash value is zero.

critical illness, or death happened before this policy ended.

Making changes to this policy

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If you have irrevocable beneficiaries or assignees

we reinstate this policy.

This policy will restart from the date we reinstate it.

What you need to do

upon our confirmation.

What happens next

will reinstate this policy.

SFH.DIG.AG.2023.06 Set for Health