FORMS

 

Policy Values Transaction

Forms needed to withdraw dividends and apply for a policy loan.

Dividend Withdrawal Form

Policy Loan Agreement

 

Policy Amendment forms

Forms required for policy amendment and reissuance of policy contract.

Application for the Issuance of a Duplicate Insurance Policy

Application for Reinstatement/Policy Change

Deed of Assignment (Transfer of Ownership)

Life Insurance Trust Agreement

Lost/Damaged Policy Affidavit with Discharge of Policy
Request for Policy Change Form
Application for Accidental Death Benefit Clause (A.D.B.) or Total and Permanent Disability Waiver of Premium Certificate (W.P.D.) and/or Special Accident Rider (S.A.R.) with/without Disability Indemnity (D.I.)

 

VUL Transaction

Forms for Variable product investment transactions.

Wealth Secure Application for Increase / Decrease in Regular Premium

Wealth Secure Application for Premium Redirection

Wealth Series Application for Fund Switch
Wealth Series Application for Top-Up
Wealth Secure Application for Increase/Decrease in Sum Insured
Wealth Series Application
Wealth Series Application for Cooling-off
Wealth Series Customer Information
Wealth Series Application for Fund Withdrawal
Wealth Series Application for Rider Addition/Cancellation
I-Dollar Wealth Multiplier Application for Fund Withdrawal
I-Dollar Energy 5 Application for Fund Withdrawal
I-Dollar Pay 7 Application for Cooling-off Refund
I-Dollar Pay 7 Application for Fund Withdrawal
I-Peso Optimizer Application for Fund Withdrawal

 

Death and Disability/Hospitalization Claim

Forms required for death claim, disability and hospitalization benefits.

Attending Physician’s Statement

Death Notice
Hospitalization Claim Form
I-Heal Insured’s Statement Accident Form I
I-Heal Insured’s Statement  Sickness Form I
I-Heal Physician’s Statement – Accident form III
I-Heal Physician’s Statement – Sickness form III
I-Heal Hospital’s Certification form II
Insured’s Statement Disability claim
Insured’s Statement for Dread Disease Claims
I-Shield Claimant’s Statement Form I-B
I-Shield Hospital’s Certification Form II
I-Shield Insured’s Statement for I-A
I-Shield Physicians Statement Form III
Physician’s Statement – Disability Claim

 

Identity Validation

Forms for updating of basic personal information and for validation purposes.

Customer Information Update Form

Special Power of Attorney

Signature Affirmation Form

 

Payment Facilities

Forms for enrolling under a specific premium payment facility.

Application for Easy Pay Plus Fund(Premium Deposit Fund) Form

Authorization for Automatic Charging Option (ACO) Form

- Easy Payment Option (EPOn) Form