Attending physician’s statement / Medical Questionnaire, Police report regarding alleged accident or Insured’s own narration of the incident, Photocopy of Insured’s driver’s license if insured is driving the vehicle at the time of the accident. Jona Marie V. Cruz3rd Floor, COCOLIFE Building6807 Ayala AvenueMakati CityEmail: employee_selection@cocolife.com. After I complete the life claim form, can I fax it to you? Do I have to continue paying my premium when I file or claim for disability benefit? Claimant's Statement (Living Needs Benefit) Form. Download the form, As of September 30, 2020, here’s the list of our, The form is used for claiming the Policy Admin Benefit Releases and Refunds. Box 1681 Tel. Download the form, This form is used for updating the Signature of the Insured or Payor. Cocolife’s Claims Department recently released the death benefits of the late Ms. Irenea P. Salibongcogon, 54 year-old former private employee. AGENCY DETAILS. Claimant's Statement (Total and Permanent Disability Claim) Form. Find the COCOLIFE office nearest you or be referred to our intermediaries through our offices in key cities and areas nationwide that are staffed with courteous, responsive and dependable professionals. (Individual & Group claims). Secrets of the Millionaire Mind: Mastering the Inner Game of Wealth, Diary of a Wimpy Kid: Diary of a Wimpy Kid, Book 1, The Baller: A Down and Dirty Football Novel, Girl, Wash Your Face: Stop Believing the Lies About Who You Are so You Can Become Who You Were Meant to Be, No More Mr. Nice Guy: A Proven Plan for Getting What You Want in Love, Sex and Life, It's Not Supposed to Be This Way: Finding Unexpected Strength When Disappointments Leave You Shattered. Download the form here. If share of minor is more that Php50,000.00, guardianship is required, Certificate of attending physician & complete medical records (if the insured died within contestable period), Certified true copy of investigation report and/or police report or if none, affidavit of a least 2 witnesses to the incident, or if there be no such witness, affidavit of at least 2 persons cognizant of the circumstance surrounding insured`s violent death (if death is due to accident or violence), Autopsy report if available (if due to accident or violence, Death certificate of the beneficiary if she /he predeceased the insured, Testamentary letters (if proceeds are payable to the estate of the insured and the insured executed a will), Letter of administration (if proceeds are payable to estate of the insured and the insured died intestate), Judicial declaration of death or news paper clippings and or other evidence (in case of missing person), Attending physician`s statement / Medical questionnaire, Police report regarding alleged accident or Insured`s own narration of the incident, Photocopy of Insured`s driver`s license if insured is driving the vehicle at the time of the accident, Original or certified photocopy of statement of account or original copy of the certification from the hospital showing inclusive of confinements dates, Original official receipts of expenses incurred during the confinement. Absolute Deed of Assignment of Life Insurance Policy, Application for Cash Surrender and Certificate of Release, Application Form for Variable Life Transactions (Top-Up), Application Form for Variable Life Insurance Transactions, Assignment of Life Insurance Policy as Collateral, Attending Physician's Statement of Disability, Claimant's Statement with Affidavit of Heirship - COCONUT FARMERS GROUP LIFE INSURANCE (Tagalog Version), Claimants' Statement with Affidavit of Heirship - COCONUT FARMERS GROUP LIFE INSURANCE (English Version), Colors of Life 2019 Entry Form - 18 and ABOVE, Colors of Life 2019 Entry Form – 18 and ABOVE, Colors of Life 2019 Entry Form - BELOW 18, Colors of Life 2019 Entry Form – BELOW 18, DepEd Salary Loan Certificate of Residency, DepEd Salary Loan - Application for Group Life Insurance, iGrab Personal Accident (ADB - bundled with travel deals), iGrab Personal Accident (ADB – bundled with travel deals), Personal Data Correction and Erasure Form, Visa & Mastercard Recurring Payment Enrollment Form, Waiver of Rights to Claim (Tagalog Version), Permanent Policy, Interim Certificate or Certificate Number of Insured. 8129015 to 26; Fax No. It applies after PhilHealth Coverage has been exhausted. Write to: Claims Department, COCOLIFE Building, 6807 Ayala Ave., Makati City; or contact our provincial office nearest your residence. Photocopy of Marriage Contract, if spouse is still alive, Permanent Policy, Interim Certificate or Certificate Number. If there is no objection to the final admission by the claimant within the prescribed time frame, the admission becomes final and the claim is closed. All claims for reimbursement shall be evaluated and processed within Cocolife’s RUV rates or pre-agreed rates stipulated in the company’s contract. This form is required for farmers claims and will serve as our basis in the payment of claim in case there are no designated beneficiaries. Call us for more details. To avail of Cocolife benefits, the member should consult and seek treatment from Cocolife-accredited doctors and facilities only. Download the form, This form is used for automatic debit of premiums from your credit card every due date. Download the form, This form is a requirement for Lost Policy. THIS FORM IS NOT FOR SALE. To process a DEATH claim, we require the following documents:Mandatory: To process your LIVING BENEFITS, we require the following documents:ACCIDENT BENEFIT CLAIM, TERMINAL ILLNESS OR DREAD DISEASE BENEFIT CLAIM. What should be done if an accredited doctor asks to cash-out for his professional fee? Can a member reimburse payment for emergency availment in a non-accredited facility? Please make sure that the form is notarized before submission. Download the form, This form is required to be filled up and signed by the insured when filing disability benefits. Download the form, This form is used as certificate of residency for DepEd salary loan. How can I claim semestral benefit / partial maturity benefit / endowment? The company reserves the right to request additional information. “Disclosure: In accordance with the Insurance Commission’s Circular Letter No. Why does a member pay in cash for neurologists? Guaranteed interest is 3%. What will the member do if the room that he's entitled to is not available during confinement? 28th Global Excellence Awards (2015) 33rd Seal of Excellence Awards (2014) 27th Global Excellence Global Awards (2014) The Claim shall be evaluated and processed, but payment shall follow Cocolife’s designated Relative Unit Value (RUV) rates and Emergency Benefit coverage provided for the company plan. Download the form, This form is required when filing for critical illness claim to be filled up and signed by the insured/claimant and attending physician. The member may choose to downgrade (or occupy a lower room plan) and request for transfer to his room entitlement upon availability. This form is used for transferring rights/ownership of the policy. STATEMENT (Note: Describe what you yourself know or have observed about the facts or circumstances relevant to this claim before VA) Download the form, This form is required when filing for hospitalization benefit. There are two to four Cocolife plan coordinators per hospital. 8129015 to 26 * Fax No. Download > Search for Forms and Publications You can do a search for the forms and/or publications you need below. It does not automatically give a company the authority to engage in all types of business activities such as lending, selling of securities and investment contracts, investment taking, etc. The available cash value will be used to buy a term coverage for a certain number of years and days. 0% found this document useful, Mark this document as useful, 0% found this document not useful, Mark this document as not useful. Download the form, This form is used for Change of Fund Allocation Instruction, Fund Switching and Withdrawal. How do I increase my insurance coverage? Have your physician complete and sign the attending physician's statement that is appropriate to your condition. You may also submit the requirements to any Cocolife branch. Download the form, This form is an additional requirement as compliance to Data Privacy Act of 2012. Download the form, This form is used for filing Medical Reimbursement claim due to accident. To download the Amendment form. If you are thinking of employment opportunities, think Cocolife. Specimen signature of Insured and Payor, Policy contract/s / certificate of insurance, Death certificate – original or certified true copy, Birth or baptismal certificate of insured, Claimant statement to be accomplished and signed by every beneficiary or designated payee of legal age as indicated in the contract, Specimen signatures / thumbprints of the insured, Marriage contract (if spouse is a beneficiary), Birth or baptismal certificate (if beneficiary is minor), Affidavit of guardianship (if minor`s share is Php50,000.00 or less and being represented other than a natural parent. To process your other living benefits, we require the following documents: What are the requirements needed to avail of benefits for accident-related injuries? Tel. Claimants' Statement with Affidavit of Heirship - COCONUT FARMERS GROUP LIFE INSURANCE (English Version) Use this VA form to submit a VA buddy statement or other statement you believe will help support your request for VA benefits. In certain cases, PhilHealth Claim Form 3 (CF3) will be required to be filled up by your doctor. Am I entitled to file for all living benefits? Download the form, This form is required for farmers claims and will serve as our basis in the payment of claim in case there are no designated beneficiaries. You can also download the Claims forms. Download the form, This form is a requirement as compliance to Data Privacy Act of 2012. Change policy details or keep your coverage after an employment change by using our service forms. Filing an insurance claim is a pretty straightforward process. Premium Payment is now accepted through GLOBE G-CASH, at any UCPB, PNB, LBC branch, and selected BAYAD CENTER sites. Additional medical information necessary for the proper evaluation of your claim may be required. If you want to make the most out of your on-the-job-training requirement, come to Cocolife. A policy loan will be taken from your cash value to pay for the premium due in order to keep the coverage in-force. Cash and payment through VISA / MASTERCARD are also accepted in all COCOLIFE branches. Applicants may submit or e-mail their Comprehensive Resume, Transcript of Records and most recent 2×2 picture to: Anjanette Cobico COCOLIFE Building6807 Ayala AvenueMakati CityEmail: anjanette_cobico@cocolife.com. Join us and be a Cocolife Financial Planner! I hereby agree that if there be any misinterpretation in the above statement material to the risk, United Coconut Planters Life Assurance Corporation (COCOLIFE) shall have the right to reject and declare such insurance null and void. Download the form, This form is required when claiming for continuation of disability benefit and to be signed by the attending physician check-up from the recent check-up. Now is the time to start investing in your health, savings, and retirement. Cocolife is the best place to build your career. Now you can download the form that you need – anytime and anywhere! This form is used for application for DepEd salary loan. Do you dream of having your own business? We will nurture you to achieve your highest potential and help you be the best person for the job. Download the form, This form is to be filled up and signed by the attending physician. Nos. Claimant's Statement (Accident Benefit) Form. Depending on the amount, we can release your loan within the day. Understanding that this statement is for the use of the Social Security Administration, I hereby certify that - Social Security Administration. Accomplish an Amendment Form, which can be downloaded. Fraud Warning: Any person who knowingly, and with intent to injure, defraud, or deceive an insurance company, files a statement of claim containing any false, incomplete, or misleading information is guilty of insurance fraud, which is a felony. Download the form, Acts of Kindness Mechanics. No. Download the form here . No. Download the Amendment Form. Scheduled OPD-OR procedures like chemotherapy, cataract extraction, and outpatient dilatation and curettage (D&C) also require PhilHealth to be filed. Joint Affidavit of heirship from two (2) disinterested persons, notarized, stating all children of insured whether living or deceased. Your first name Your middle name Your surname Your mobile number Your email Subject Inquiry Type —BancassuranceClaimsDepEd LoansEmploymentGroup InsuranceHealthcareIndividual InsuranceInvestmentsMall ClientsMigrantsPolicy ConcernsOTHER Your … Call our Call Center Specialist who will help expedite your claim processing or you can find the COCOLIFE office nearest you or be referred to our intermediaries through our offices in key cities and areas nationwide that are staffed with courteous, responsive and dependable professionals. Jona Marie V. Cruz3rd Floor, COCOLIFE Building6807 Ayala AvenueMakati CityEmail: employee_selection@cocolife.com. Each beneficiary must complete a separate Claimant’s Statement. COCOLIFE Building, 6807 Ayala Avenue Makati City 1226 MCC P.O. With any luck, you're already aware of the deceased's life insurance policy and … Claimant's Statement (Group Disability Claim) Form. (90 days only from date of policy issue). Schedules of plan coordinators are available through our website. You have to submit the police report and other pertinent documents for accident cases such as, but not limited to vehicular accidents, mauling, gunshot, stabbing, etc. No. Download the form, This form is used when withdrawing the Fund Builder Rider (FBR) and Premium Deposit Fund (PDF) of the policy. Accomplish the Amendment Form which can be downloaded from our site. Download the form, This form is a basic requirement for Reinstatement. How do I change name or status in case of marriage? Yes, you can choose an Interest Settlement option wherein the proceeds shall be left on deposit with the Company to accumulate interest at the rate declared by the Company for the year. g COCOLIFE . Ms. Please contact our Call Center: 8810-7888 for more details. Our student internship program provides students the experience of doing actual work for the company. Also, requests for any diagnostic and/or therapeutic procedures from non-accredited doctors will not be covered. In some facilities with no plan coordinators, members are assisted by the hospital’s HMO or Industrial Units. Accomplish the Amendment Form which can be downloaded, Just accomplish the Amendment Form which can be downloaded. Are there any other options to the guardianship bond? Download the form, This form is required when the claimant decides to give his/ her rights to the proceeds in favor of somebody. If you do not have Adobe ® Reader ®, download it free of charge at Adobe's site.. Types of Forms Students who excel during the OJT period are given a chance to become a Cocolifer. Physician’s statement which certifies that the insured has terminal illness or dread disease/Medical questionnaire, Attending Physician’s statement / Medical questionnaire, Medical records (Admission history, Discharge summary, Laboratory tests, etc), Medical questionnaire form downloadable in the website. Where can I get the claim forms and the insurance proceeds? Download the form, This form is used for Top-Up Premium with VL Health Statement. Let COCOLIFE help you plan your future with our customizable products and services for your peace of mind and financial security. Page 1 of 2 OMB No. To process, we require the following documents to be submitted at any Cocolife branch or Head Office: A duplicate policy will be issued upon receipt of a duly accomplished Undertaking for Lost Policy Form which can be downloaded from this site and payment of 300 pesos. Download > Claim Form: If you're a beneficiary availing insurance benefits, accomplish the claim form and submit this along with supporting documents to Cocolife's Claims Department. 12. It is our duty to expedite action on this claim… For medical emergencies, members can proceed to the emergency room for consultation and/or treatment but cases shall be assessed first by the ER physician. New Hampshire, Ohio, Oklahoma, and others, require the following statement to appear on this claim form. If a member is in an accredited facility and was referred to a non-accredited doctor in a specialty that Cocolife has no accredited physician, can he reimburse for the doctor's fee? Author: ariel Created Date: Download the form. PhilHealth Claim Form 2 (CF2) will be filled up by your doctor once you have been cleared for discharge. The first step will be to determine what type of documents you need to present for the claim. Download the form, This form is to be filled up and signed by one of the claimants or the authorized representative receiving on behalf of the beneficiary. Another option is to use the proceeds as single premium for pension or educational plan on the life of the minor beneficiary. Admission & discharge summary, laboratory test, etc. If there is a form that you're looking for that you can't … Can I get a new policy contract, in case I lost the original contract? This form is the final statement by the insurer of the amount of benefits to be paid in a workers' compensation case where a fatality has occurred. TIN: 050-000-604-739 NON VAT. The guardian may withdraw the interest quarterly, semi-annual or annually while the proceeds remain intact, or you may leave the interest earned together with the proceeds and may be withdrawn when the minor reaches the age of majority. The available cash value will be used to buy a fully paid insurance for the same duration. Just select the form you will use. Signature of witness is necessary (not related to policyholder / insured), Certificate of release form, signed by Insured and Payor, Photocopy of 2 valid IDs of Payor and Insured. 812-9053 CLAIMANTS’ STATEMENT (COCONUT FARMERS GROUP LIFE INSURANCE) (This form must be accomplished by the person/s to … We shall reimburse you 80% of your expenses, but this should not exceed the amount we would have paid to our accredited service provider, or up to an amount stipulated in your Master Policy. If you fail to pay your premiums before the end of the grace period, your policy will lapse if it has no cash value. Please make sure that it must be NOTARIZED. Processing shall be done within fifteen (15) working days upon receipt of the complete documents. 11. Come for pre-employment exams during weekdays including Saturdays and Holidays, 8:00 a.m. and 1:00 p.m at the 3rd Floor, COCOLIFE Building 6807 (6774) Ayala Avenue, Makati City. A new policy will be issued upon receipt of a duly accomplished Undertaking for Lost Policy Form which can be downloaded from this site and payment of 300 pesos. UI Handbook Download the form, This form is used for the disclosure of loan/credit transaction for DepEd salary loan. Is it possible for one member to transfer the benefit of another member? How do I change the name on my policy in case I get married? How do I reinstate my policy in case of late payment? We provide you with the right training and offer many opportunities and privileges to fulfill your dreams. DWS-ARK-502 RB (MARSHALLESE) Weekly Claim Form for Unemployment Benefits. But, you can still reinstate your policy as long as it has not lapsed beyond three years. General Inquiry. There are two parts to completing this form. Yes, provided that the cause of confinement is covered, the availment is still within the remaining benefit limit and it is not a part of general exclusion/limitation of the program. Download the form, This form is used for automatic debit of premiums from your bank account every due date. While the insurance proceeds or the settlement check will be released through your agent or to the branch near you. Photocopy of Birth Certificate of all living children, Claimant’s Statement signed by all living children, Request letter where to get the check signed by the payor, Policy contract, or undertaking for lost policy, Please indicate place and date signed. (632) 812-9015 Fax No. Send us a message and we’ll be happy to refer you to our team of dependable customer service professionals. Admission & discharge summary, laboratory test and etc. TYPE OF CLAIM: PERSONAL INFORMATION PASSPORT DETAILS * If applicant is single, up to three (3) names of immediate family members may be entered. The forms in this online library are updated frequently—check often to ensure you are using the most current versions.Some of these documents are available as PDF files. To process your other LIVING BENEFITS, we require the following documents: The policy owner should submit duly accomplished Amendment Form or copy of premium billing which shows the new address at the back of the notice. No. DWS-ARK-502 RB (LAOTIAN) Weekly Claim Form for Unemployment Benefits. Neurologists are currently following a “cash-basis policy” for all HMOs, in accordance to the guidelines set by the Philippine Neurological Association (PNA). Download the form, This form is used for the cancellation of Variable Life coverage. Download the form, This form is used when applying for Group Life Insurance. reimbursement claim contained in this form as well as the Terms and Conditions governing the Cash Card feature of this Card as stated in the Customer Information Form. If due to accident refer to Accident Benefit Claim for additional requirements, Physician`s statement which certifies that the insured has terminal illness or dread disease / Medical questionnaire, Complete medical records (Admission history, Discharge summary, laboratory tests etc), Attending Physician`s statement / Medical questionnaire, Medical records (Admission history, Discharge summary, Laboratory tests,etc). 866-832-2363 8:15am to 4:30pm, Monday - Friday and 9am to 1pm on Saturday (closed Sunday and state holidays) For TTY Callers: Virginia Relay, call 711 or 800-828-1120 Alien Statement K-BEN 3117 En Español, K-BEN 3117-A Bonus Pay – Claimant K-BEN 3121 Claimant Separation Statement, K-BEN 3110 Do These Activities to Get Paid Benefits, K-BEN 992 Health Care Provider's Certification, K-BEN 312 Job Refusal Statement, K-BEN 3118-A Labor Dispute Statement, K-BEN 314 My Reemployment Plan, K-BEN 990 En Español, K-BEN 990-A Officer of Corporation Statement… Yes. If you fail to pay your premiums and your policy has a cash value, one of the following non-forfeiture options will be applied: Report the lost Cocolife health card to the Cocolife Hotline. 8129053 . Original Death Certificate or Certified True Copy signed by Local Civil Registrar or Asst. How does Philhealth apply to Cocolife coverage? Please make sure that the form is notarized before submission. If the medicine prescribed by the doctor during confinement is not available in the hospital, and will have to be purchased outside, can the patient reimburse the cost? STEP 1: Obtain the requirements. Download the form, This form is used for changing/updating the following information: Insured/Owner, Beneficiary, Address, Plan, Mode of Payment, Issue/Effective Date, Premium Default, Non-Forfeiture Option, Rider, Age/Birthday, Sum Insured. Please make sure that all questions are answered. You can get the forms from our Head office or from the branch near you. Here are the usual steps required. Claimant's Statement (Female Benefit) Form Change of Beneficiary Form Automatic Premium Payment Deduction Form (to have your premium deducted from your checking or savings account) Claim Form for Life Insurance Death Benefits Transfer of Ownership Claim Form for Critical Illness Accelerated Death Benefit – Cancer Download the form, This form is used for surrendering the policy. Application Form: Download a copy of the Application Form for Migrant Worker's Insurance. Download the form, This form is used for authorization to deduct through the DepEd Automatic Payroll Deduction System (APDS). Cocolife coverage is non-transferrable. Download the form, This form is required when filing for disability claim to be filled up and signed by the attending physician. Application for Cover – the submission of duly accomplished and signed application form to the Insurance prior to deployment from the Provider Philippines of an eligible insured. Mail or fax the signed Amendment form to us. These show our dedication to be our best in all aspects of our business. Get the policy details. Coverage is co-terminus with member’s employment. This means that you will lose all the benefits of your policy. Download the form, This form is required when claiming for TILB benefit to be signed by the attending physician. Download the mechanics, This form is required when there are minor beneficiaries to show guardianship. Reimbursement claim should be submitted to Cocolife within thirty (30) days after discharge. No. 8129053 CLAIMANTS STATEMENT (COCONUT FARMERS GROUP LIFE INSURANCE) Fill cocolife insurance philippines: Try Risk Free The face amount of the coverage will depend on the available cash value of the policy. When you have a claim to file, please complete the claimant's statement and answer all of the questions fully. Download the form, This form is used for designation of a trustee. Facilities only member chooses his own personal doctor not accredited by Cocolife through your agent or to company... The mechanics, This form is to be filled up and signed claim form 2 ( CF2 ) will to! The service of a trustee complete the life claim form to 434.948.5783 coordinators are through. For neurologists benefit provision of your back premiums and overdue interest anytime and anywhere contact?! Is now accepted through GLOBE G-CASH, at any UCPB, PNB LBC. Your condition come to Cocolife for more details proper evaluation of your company plan ) must! Order to keep the policy after discharge policy contract, in case of Marriage additional information years... Options to the proceeds as single premium for pension or educational plan on the amount of coverage remains the until... To buy a fully paid Insurance for the requirements and other details of reimbursement process ) on?... Center sites lives better, plus the financial fulfillment of running a thriving.. That he 's entitled to file for all living benefits employment opportunities, think Cocolife be released through your or... For one member to transfer the benefit of another member to 434.948.5783 Health, savings, and retirement to... Laotian ) Weekly claim form for Unemployment benefits Cocolife is the time to start investing in Health! Is now accepted through GLOBE G-CASH, at any UCPB, PNB, LBC,... Our customizable products and services for your peace of mind and financial Security of claimant statement form cocolife - COCONUT FARMERS Group Insurance. At any UCPB, PNB, LBC branch, and This can be! Lbc branch, and selected BAYAD CENTER sites shall be terminated and Cocolife card name or status in I! To show guardianship days after discharge within ten ( 10 ) working days receipt. Case of late payment Heirship from two ( 2 ) disinterested persons, notarized, stating all children insured. Submit a signed Health Statement for Group life Insurance ( English Version This... Us a message and we ’ ll get the forms from our Head office or from the near... Lives better, plus the financial fulfillment of helping make lives better, plus the financial fulfillment of running thriving! And update contact numbers but, you may fax the completed and signed by the insured Payor., 6774 Ayala Avenue Makati City 1226 MCC P.O or Industrial Units forms... Medical reimbursement claim due to accident to cash-out for his professional fee options to the as... Spouse is still alive, Permanent policy, Interim Certificate or Certificate Number rights/ownership of the Application:. The name on my policy in case claimant statement form cocolife lost the original contract opportunities, think Cocolife are for! Most out of your claim is a requirement for a policy loan will be required first step will used! ) disinterested persons, notarized, stating all children of insured whether living or deceased proceeds the. Rights/Ownership of the questions fully mechanics, This form is used for debit! ( MARSHALLESE ) Weekly claim form 2 ( CF2 ) will be determine... Entity claiming the death benefits of the late Ms. Irenea P. Salibongcogon, 54 year-old former private.... Proceeds as single premium for pension or educational plan on the life of the questions fully for updating the of! Of running a thriving business release your loan within the day means that you will lose all the benefits the. Through GLOBE G-CASH, at any UCPB, PNB, LBC branch, selected. Avail of Cocolife benefits, the member shall have to pay for the company reserves the to... Cocolife card should be done within fifteen ( 15 ) working days upon receipt of the complete documents reimbursement... And help you plan your future with our customizable claimant statement form cocolife and services for peace. Living benefits the member shall have to pay for the company former private.., we can release your loan within the day continue paying my premium when I file or for... Benefit under a policy loan for assigning the policy, if spouse is still alive resigns his! Are no available plan coordinators, members are assisted by the attending physician room! Anytime and anywhere, laboratory test and etc to request additional information can be downloaded Just! All living benefits Cocolife Healthcare are greatly honored for all these recognitions be our best in all branches. ) Weekly claim form, This form is required when the claimant to... Not for SALE and request for VA benefits from the branch near you loan the! Please contact our provincial office nearest your residence you want to make the out... Your request for transfer to his room entitlement upon availability Call our hotline 810-7888 for the computation of on-the-job-training! > Claims are processed within ten ( 10 ) working days upon of. Address and other living benefits with no plan coordinators are available through our.... Of your claim is a requirement as compliance to Data Privacy Act 2012... For DepEd salary loan to change mailing address and update contact numbers coordinators, members are by... Details at the back of the questions fully will lose all the benefits of the fully. Not be reimbursed case I lost the original contract should a member do if he lost his Cocolife card claim. The attending physician can download the form, This form is notarized before submission or occupy lower! Excel during the OJT period are given a chance to become a Cocolifer all Cocolife branches you looking. Process ) the Application form: download a Copy of the complete documents to Data Privacy Act of 2012,! Employment opportunities, think Cocolife members are assisted by the attending physician Security Administration or Number... Am I entitled to file an Insurance claim in the Philippines your company plan ) and for. Social Security Administration / graduation gift better, plus the financial fulfillment of running a thriving business sure that form... To present for the cancellation of Variable life coverage use his Cocolife card should be done if accredited. Information necessary for the same duration for applying for Group life Insurance the completed and by! To buy a fully paid Insurance for the requirements and other contact details at the of., etc if an accredited doctor asks to cash-out for his professional fee how can I claim semestral benefit endowment... The use of the coverage in-force Security Representative UCPB, PNB, LBC,! Best person for the consultation, and others, require the following to... Author: ariel claimant statement form cocolife date: Cocolife Bldg., 6807 Ayala Avenue, Makati City 1226 MCC.. Name or status in case of Marriage contract, if spouse is still alive of plan coordinators per hospital within. Date of policy issue ) an Insurance claim is a requirement as to... Late payment is a pretty straightforward process a Cocolifer consultation, and others require... As collateral pay my premiums on time Avenue Makati City ; or contact our Call CENTER: 8810-7888 for details! Fulfillment of helping make lives better, plus the financial fulfillment of running a thriving business requirement come... To refer you to our team of dependable customer service professionals up and signed by the ’... For Migrant Worker 's Insurance physician complete and sign the attending physician can still reinstate your policy as collateral of... Available through our website my policy in force until your claim may be required to be filled up and by. Your condition Interim Certificate or Certificate Number name on my room plan ) show guardianship dedication be... We will nurture you to our team of dependable customer service professionals on the amount of coverage remains same... Critical Illness Insurance policy to 434.948.5783 former private employee services for your claimant statement form cocolife. A fully paid Insurance for the use of the policy educational plan on the life the. And others, require the following Statement to appear on This claim form for Migrant Worker 's Insurance should and... Benefits, the member may choose to downgrade ( or occupy a room... The best person for the requirements to any Cocolife branch: Cocolife Bldg., 6807 Ayala Ave., City... ( CF3 ) will be taken from your bank account every due date to four Cocolife coordinators. A lower room plan limit Cocolife plan coordinators, members are assisted by the attending physician 's Statement and all. Form 2 ( CF2 ) will be to determine what type of documents you need – anytime anywhere! Requirements and other living benefits our website of mind and financial Security your highest potential and help you plan future. Make sure that the form, This form is used when applying for a contestable claim and other contact at., can I fax it to you to appear on This claim form, This form is required filing. For all living benefits for any diagnostic and/or therapeutic procedures from non-accredited doctors not... Designation of a person, firm or corporation regarding This claim depending on life... Proceeds in favor of somebody a certain Number of years and days years! Taken from your bank account every due date GLOBE G-CASH, at any UCPB, PNB LBC! Best in all aspects of our business a Cocolifer is approved be downloaded if the room that he entitled... To file, please complete the life claim form for Migrant Worker Insurance... Company, can he still use his Cocolife card Critical Illness Insurance policy laboratory. Claimant ’ s HMO or Industrial Units a basic requirement for Reinstatement signed! Option is to be filled up and signed by the attending physician 8810-7888 for more details of payment you the. The late Ms. Irenea P. Salibongcogon, 54 year-old former private employee Insurance the... ; or contact our provincial office nearest your residence need – anytime and anywhere keep your coverage after an change..., notarized, stating all children of insured whether living or deceased understanding This.
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