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And
WITNESSETH THAT
The COMPANY will not be held liable by the HOSPITAL to pay for any
medical availment of its member with no LOA.
5. The HOSPITAL shall honor the LOA issued by the COMPANY for the
medical availment of its member. The LOA shall state payment by the
COMPANY of the expenses incurred by the member within benefit limits.
6. The HOSPITAL shall collect from the member the excess amount
incurred during medical availment not covered by the LOA prior to
release from the facility. The HOSPITAL shall have no recourse to
any reimbursement from the COMP ANY should it fail to charge and
collect any expenses charge to COMP ANY members.
MARZAN HEALTHCARE
Claims Department
#33 V. Luna Ave., Brgy. Pinyahan, Quezon City
15. In case litigation arising from this Agreement, the parties hereby
agree that exclusive jurisdiction shall be vested in the courts of Quezon
City, Metro Manila.
16. This Agreement shall be for a period of one year from the date
hereof, and shall be automatically renewed every year thereafter,
unless either party gives notice of its intention to terminate or
modify the condition of the agreement at least sixty (60) days
before
intended date of termination or modification.
IN WITNESS WHEREOF, the parties have set their hands this ___________
at _____________________ in _______________________.
BY: BY:
ACKNOWLEDGMENT
Republic of the Philippines)
_________________________ ) S.S.
__________________________
__________________________
WITNESS MY HAND AND SEAL, affixed on the date and place first above
written.
NOTARY PUBLIC
Doc. No. ____;
Page No. ____;
Book No. ____;
Series of 2017