Requirements for Underwriting & Claim Applications

Fire

A. Insurance

Accomplish Property Insurance Application (F1-1 & F1-2). Attach details of the
assessment of the properties and equipment being insured. Certification of
approved budget allocation for premium payment shall also be included.

B. Claim

Give immediate notice to GSIS, General Insurance group, Claims Department.

Notice shall include date and time of loss, nature of loss (fire, typhoon, flood,
etc.), description and location of property involved and policy number and its
date of effectivity. The documentary requirements are as follows:

Fire Claim

· Fire Claim Form

· Detailed estimates of damage to buildings to be prepared by a Civil Engineer

or Architect; for damage to contents, Inventory List. For machinery and
equipment, quotation from authorized dealers.

· Pictures of damaged properties or contents

· Police/Fire Investigation Report

· Building Plans/Sketch (if necessary)

· Sworn Statement in Proof of Loss

Typhoon, Flood, Earthquake and Other Allied Perils Loss

· Detailed estimates of damage to buildings to be prepared by a Civil

Engineer or Architect; for damage to contents, Inventory List For
machinery and equipment, quotation from authorized dealers.

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 · Pictures of damaged properties or contents

· Building Plans/Sketch (if necessary)

· Sworn Statement in Proof of Loss

· PAGASA Report (for typhoon)

· Philippine Institute of Volcanology (for earthquake)

Motor Car

A. Insurance

Newly Acquired Vehicles

· Motor Car Application Form (F2).

· Stencil of Chassis and Motor Numbers.

· Stencil of Chassis and Motor Numbers.

Renewal

· Duplicate copy of previous policy and bill

· Xerox copy of GSIS Official Receipt (previous year's payment)

· Certificate of registration, latest Official Receipt issued by LTO

Endorsement

· ·· Xerox copy of car Registration

· Copy of latest Official Receipt issued by LTO

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 Expired Policy

· Motor Car Application Form (F2).

· Inspection Report (to be accomplished by GIG) of the vehicle to be

insured

· Copy of the previous policy and bill

· Xerox copy of GSIS Official Receipt (previous year's payment)

B. Claim

Give immediate notice to GSIS, General Insurance Group, Claims

Department. Notice shall include date and time of loss, description and
location of property involved and policy number and its date of effectivity. The
documentary requirements are as follows:

Own Damage/Theft

· Notice of Loss/Accident

· Automobile Accident Report (F3)

· Copy of Policy and Official Receipt of premium payment

· Certificate of Registration and/or Official Receipt

· Pencil Stencil of Motor and Serial/Chassis Numbers

· Copy of Driver's License and Official Receipt

· Police Investigation Report/Certification from Assured

· Three Repair Estimates

· Pictures of Damaged Vehicle/Property

Third Party Property Damage

· Same as 1-7 of Requirements for Own Damage

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 · Certificate of No Claim

· Certificate of Registration/Official Receipt (adverse vehicle)

· Pencil Stencil of Motor/Serial Numbers (adverse vehicle)

· Copy of Driver's License and Official Receipt (adverse vehicle)

· Three Repair Estimates

· Pictures of Damaged Vehicle/Property

Third Party Liability fro Death/Bodily Injury

· Same as 1-7 of Requirements for Own Damage

· Medical Certificate

· Statement of Account/Hospital Bills

· Official Receipts

· Birth Certificates (Minor Person)

· Death Certificate/Post Mortem Examination Report

· Marriage Certificate

· Funeral Receipt

Property Floater

A. Insurance

Submit letter request to insure the property with complete details of the item(s)
to be covered like the motor and serial number, the value of the property, the
year model, the brand and manner of purchase. Inspection of the property is
optional.

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B. Claim

The assured must give immediate notice to GSIS, GIG in case of a loss
caused by a peril insured against under the insurance policy. The documents
to be submitted are as follows:

o Picture

o Police/Incident Report
o Estimate of Loss

Marine & Aviation

A. Insurance

Accomplish the corresponding form:

· Cargo - Insurance Coverage Request (F4)

· Hull - Hull Insurance Application Form (F5)

· Aviation - Aviation Insurance Proposal Form (F6)

Attach Certification of Availability of Funds to each application.

B. Claim

Give immediate notice to GSIS, GIG, and Claims department. Notice shall
include date and time of loss, nature of loss, description and location of
property involved and policy number and its date of effectivity. The
documentary requirements for each type of cover are given below:

Aviation

· Pilot's Reports

· Pilot's License

· Certification of Number of Flying Hours

· Aircraft's Registration Papers

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 · Certificate of Airworthiness

· Pictures

· Estimates/Quotations

Marine Hull

· Note of Marine Protest

· Vessel Registration Papers

· Certificate form Lloyd's, if foreign registry

· Certificate of Ownership

· Certificate of Inspection

· Coastwise License

· Pictures

· Estimates/Quotation

Marine Cargo

· Bill of Lading

· Packing List

· Short landed Certificate (cargo unloaded fell short of quantity loaded

as per Bill of Lading)

· Bad Order Certificate

· Way Bill (Forwarder)

· Warehousemen's Reports

· Commercial Invoice

Engineering

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A. Insurance

For Contractors All Risk and Erection All Risk covers, accomplish
questionnaire and proposal form (F7). For EEI, submit Letter of Intent.

Other Requirements:

o List of description of items to be covered

o Copy of Contract
o PERT/CPM
o Construction Plan

B. Claim

Give immediate notice to GSIS, General Insurance group, Claims Department.

Notice shall include date and time of loss, description and location of property
involved and policy number and its date of effectivity. The documentary
requirements are as follows:

For CAR

· Contract

· Accomplishment Reports (weekly and monthly)

· Pictures

· Estimate of repair

· Plan

· Bill of Materials

· Various Purchase Orders or Requisitions (stocks/materials)

· Incident Report

For EAR

· Accomplishment Reports (weekly and monthly)

· Pictures

· Estimate of repair

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 · Various Purchase Orders or Requisitions (stocks/materials)

· Incident Report

For EEI

· Pictures

· Estimate of repair

· Warehouseman's Report

Personal Accident

A. Insurance

Prepare request for cover indicating the following (F8):

o Declaration of Insured Persons reflecting the name, date of birth,

basic monthly salary, designation/position, beneficiary

o Amount of insurance and medical reimbursement, if any. For any

change in designation of beneficiary accomplish corresponding
form F (9).
o Inception date of the policy

For group coverage, the Holder (the office to which the assureds are
employed with) must endorse the request.

B. Claim

For Individual Coverage

The insured or his representative or beneficiary must give written notice of the
injury directly to the Claims Department of the General Insurance Group,
GSIS within thirty days after the date of the accident. In case of accidental
death, immediate notice must be given to the department.

For Group Coverage

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The Holder of the master policy shall endorse immediately the Notice of Loss
by or on behalf of the insured or his beneficiary to the Claims Department,
GIG.

The following are the documentary requirements

Medical Reimbursement/Dismemberment/Loss of Sight, etc

1. Vehicular Accidents/Medico Legal Cases

· Police/NBI Investigation Report

· Original Official Receipts of payments for actual medical expenses

· Medical Certificate of attending physician

· Endorsement of claim by the office of the injured employee

2. Non-vehicular/Non-medico Legal Cases

· Affidavit of injured employee giving details of the accident

· Affidavit of two disinterested witnesses to accident (if available)

· Original Official Receipts of payments for actual medical expenses

· Medical Certificate of attending physician

· Endorsement of claim by the office of the injured/insured

Death Claim

· Police/NBI Investigation Report (for vehicular accident/medico legal

cases)

· Affidavit of insured's employee or authorized representative giving

details of the accident (non-vehicular accident/non-medical cases)

· Marriage Contract (if married)

· Parent's Marriage Contract (if single)

· Death Certificate

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 · Birth Certificate

· Endorsement of claim by the office of the insured

A. Insurance

The following are the documentary requirements:

· Xerox Copy of Articles of Incorporation and By-laws with the latest

amendments, if any; Certificate of Registration of Business Name for single
proprietorship; Contractor's License

· Financial Statements for the last two years as certified by an independent

Certified Public Accountant, and if available, latest interim Financial
Statements

· Certification of Corporate Secretary, duly notarized of the following:

 Present directors and principal executive officers of the corporation

 Present lists of the shares of stock issued and outstanding indicating

the name of stockholders, number of shares held and total par value

· Certification of Corporate Secretary, duly notarized, that the official

signing the bond and the Indemnity Agreement on behalf of the
corporation is authorized to do so by its Board (F10)

· Bond Application Form (F11), if single proprietorship or Co-Signer

Statement Form (F12), if corporation by authorized signing official
who will also be required to sign the Indemnity Agreement in his
personal and individual capacity, except if merely a career executive
without personal holdings in the company. For all types of bond,
accomplish Action Sheet (F13)

· Xerox copy of Residence Certificate and Income Tax Return of the

authorized signing official

· For Bidders/Proposal Bond, xerox copy of Invitation to Bid/Letter of

Inquiry/Request for Quotation/Circular Proposals

· For Performance/Surety Bonds, xerox copy of the Letter/Notice of

Awards and Purchase Order or Contract including the specifications
and other documents which form part of the contract; if not feasible,
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 pertinent portions wherein the obligations to be guaranteed by the
bond are stated

· Brief history of the firm as certified by the Corporate Secretary or by

the Owner, if single proprietorship citing the following:

 For Supplies Contract - experience, particularly in similar or

comparative work as contemplated undertaking and giving a list
of past and present supplies contracts specially with the
government stating the amount, kind of supplies, etc. and the
reliability of the manufacturer of the supplies that it has been
contracted to furnish and deliver to the obligee under the bond

 For Service Contracts - experience, particularly in similar or

comparative work as the contemplated undertakings and giving
a list of past and present service contracts especially with the
government stating the amount, kind of service, etc.
 For Construction, Furnishing and Installation Contract -
Summary of Operations including list of projects completed
indicating among others the name and address of owner or
prime contractor, class of work with brief description of
undertakings, year started, year completed, amount of contract.

· For Customs Bond, Xerox copy of Import Entry/Bill of Lading,

Approval from the Department of Finance and Bureau of
Customs/Proforma Invoice/Packing List/Cancellation of Previous
Bonds/Liquidation

· Xerox copy of land title of signatory, real estate property with

assessed value exceeding the amount of bond

· In the absence of a Co-Signer, collateral in the form of real estate

property, bank guarantee, cash deposit equivalent to the amount of
the amount is needed.

B. Claims

The Obligee must submit a written Notice of Claim to the Claims department,
GIG. The requirements for each type of bond are as follows:

Bidders

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 · Instructions to bidders

· Copy of the bond

· Notice of Award/Purchase Order

· Bid Bond of second lowest bidder

· Demand Letters to the Principal

Performance

· Copy of the contract

· Notice to Proceed/Notice of Award

· Accomplishment Report of the Principal

· Inventory of Usable Materials and Equipment left at the jobsite

· Unpaid billings or retention money due the Principal

· Demand Letter of the Obligee to the Principal

· Reply of the Principal to the demand letters

· Contract with the new contractor, if awarded

· Cost to complete the project by the new contractor

· Purchase Order

Surety

· Copy of the contract

· Progress billing applied to the advance payment

· Demand Letters to the Principal

· Reply of the Principal to the demand letters

Judicial Bond
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 · Writ of Execution/Alias Writ of Execution

· Decision/Order from the labor arbiter

· Motion to Stay Execution

· Resolution to the Motion

· Demand Letters to the respondent

All the above documents will be evaluated during the Claims committee
meeting, which is held regularly. The Committee will either deny or approve
the payment of the claim. Before payment is made by the GSIS, Demand
Letter will be sent to the Principal advising him to settle the bond undertaking;
otherwise, the terms and conditions of the Indemnity Agreement executed in
favor of GSIS will be enforced.

Miscellaneous

A. Insurance

Submit a written request for cover stating the details of the property/item to be
insured.

B. Claims

Submit a written Notice of Claim to Claims Department, GIG stating the date
of loss and corresponding policy number. The private adjuster that will be
assigned to the claim will give all the other requirements.

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