Total ProtectER

Total ProtectER is a total protection package composed of a term insurance product with a daily hospital income benefit for a six-month coverage; and a one-time use health care voucher that provides up to Php100,000 worth of coverage for emergency cases due to accidents and viral and bacterial illnesses and specific conditions.  

With this plan, the member gets the following benefits: 

Php 500,000 life insurance coverage. This benefit is given to the beneficiary upon Insured’s death due to natural or accidental causes (including COVID-19) within the six-month coverage period. 

Notice and Proof of Death. The Company will pay the designated beneficiary the corresponding Amount of Insurance upon receipt and approval by the Company of due proof/s that the Insured Individual died while insured under this contract and in accordance with its terms. 

Beneficiary.  The beneficiary designated by the Insured Individual in his application shall receive the death benefit provided that the beneficiary is living at the time of death of the insured individual. 

If no qualified beneficiary is designated by the Insured Individual or if no qualified beneficiary survives the insured individual, the following classes of beneficiaries, in this order of preference, shall be deemed named by the insured individual as his contingent beneficiary or beneficiaries: (1) surviving legitimate spouse  (2) surviving legitimate, legitimated, and legally adopted children  (3) surviving illegitimate children  (4) surviving parents  (5) surviving siblings of the full blood  (6) surviving siblings of the half-blood  (7) executors or administrators. 

If there be two or more beneficiaries in the same class entitled to the proceeds of the insurance, they shall share equally.  Any minor’s share shall be paid to him in the manner provided for by law. 

Suicide. The Company shall be liable in case of suicide committed in the state of insanity.  If suicide is not compensable, the Company would refund the premium paid for the individual.  

Total ProtectER is valid for 1 year or up until used, whichever comes first. It can be used in more than 500 IHC-accredited hospitals in the Philippines, excluding the Top 6 hospitals in Metro Manila namely Asian Hospital and Medical Center, Cardinal Santos Medical Center, Makati Medical Center, St. Luke’s Medical Center (QC and BGC), The Medical City. Option is given to inlcude access to Top 6 hospitals, by paying additional fee.

Php 3,000 daily hospital income benefit. This benefit is given if hospital confinement is due to accidental injury or sickness (including COVID-19), within the six-month coverage period. Insured can reimburse Php3,000 hospital income benefit per day, as long as hospital confinement is at least 4 days, maximum of 90 days. 
If an injury or sickness results in the hospital confinement of the Insured Individual, the Company will pay the Hospital Income Benefit in the form of a daily hospital allowance upon receipt of satisfactory proof of the hospital confinement of the Insured Individual. The daily hospital allowance of Php3,000 will be paid during the continuance of the Insured Individual’s hospital confinement subject to a maximum period of 90 days for the six-month coverage and to an elimination period of 3 days. 

There shall be a maximum of 15 days per hospital confinement. 

For related confinements, a gap of not more than 90 days between such confinements is considered as one (1) confinement. For example: gap between a) discharge from confinement 1 and b) admission for confinement 2 is 30 days. Since 30 days is less than 90 days, this is considered as one confinement only. 

Pre-existing conditions and limitations shall apply. 
Pre-Existing Conditions and Limitations. During the waiting period of two months within the Insured Individual’s coverage, no benefit shall be provided for hospital confinement resulting directly or indirectly from injury sustained or a sickness or condition which was evident or for which the Insured Individual received medical advice or treatment within six (6) months prior to the effective date of this Rider.
 

Total ProtectER

1. What is considered a medical emergency?"Emergency" shall mean the sudden, unexpected onset of illness or injury having the potential of causing immediate disability or death or requiring the immediate alleviation of severe pain and discomfort.
2. What are sample illnesses and accidents covered by Total ProtectER? Total ProtectER covers diseases that include, but are not limited to:
   • Acute Bronchitis
   • Acute gastroenteritis with dehydration
   • Acute tonsillopharyngitis with moderate dehydration
   • Acute Sinusitis
   • Acute tonsillopharyngitis
   • Acute Upper Respiratory Tract Infection
   • Amoebiasis
   • Cellulitis
   • Dengue Fever
   • Acute Pneumonia
   • Typhoid Fever
   • Urinary Tract Infection
   • SVI (systemic viral infection) with fever
   • Measles with high-grade fever
   • Chicken pox with complications
   • Leptospirosis
   • Polio
   • Cholera
   • Diphtheria
   • Pertussis
   • Tetanus
   • Rabies
   • Meningitis
   • Chikungunya
   • Malaria
   • Anaphylactic Shock
   • Acute Appendicitis
   • Acute Gastritis
   Total ProtectER covers accidents that include, but are not limited to:
   • Accidents, excluding Cerebrovascular (Stroke)
   • Fracture, new
   • Burns, new
   • New animal bites, including first dose of vaccines up to a maximum of Php20,000
   • Cuts, new, needing suturing
   • Sports injuries, contact and noncontact sports, excluding professional sports and high-risk sports
   • Accidental chemical poisoning
   A Member’s eligibility to emergency care benefits under the Agreement shall be based on the final medical diagnosis.
3. How can I register my Total ProtectER voucher? Upon purchase, you can register online at https://services.insularhealthcare.com.ph/. You must register a name to your prepaid health plan within 90 days from purchase date. After which, your serial code will no longer be available for register.
4. When can I start using Total ProtectER? The health voucher will be activated 10 calendar days from registration. The validity period will be indicated on your health voucher. It is valid for 12 months or up until used, whichever comes first.Example: Registration date is Day 0. If you register on August 1, your health voucher will be activated on August 12. It will then be valid from August 12, 2023, to August 11, 2024, or up until used, which ever comes first.
5. What’s the availment process? In case of emergency, go to an IHC-accredited hospital and proceed to ER. Present your IHC e-voucher and a government-issued ID. If your case is coverable, your hospitalization will be covered by your e-voucher up to the benefit limit indicated. Services that are not covered by the e-voucher can be settled directly with the hospital.
6. Can I register someone else to use the plan? How? Yes, you can. The health plan is giftable/transferable as long as it’s not yet registered. To get the prepaid health card registered to someone else, you need their details listed below:
   • Full name
   • Birth date
   • Home address
   • Email address
   • Mobile number
   Take note that after submitting the person’s information, an email will be sent to him/her notify them that you registered them under an IHC health plan. They must confirm that they allow the registration to receive the health voucher.
7. If the benefit limit is not wholly consumed, can I use the health voucher again in the future? Total ProtectER is a one-time use health voucher, which means regardless of consuming it wholly or not, it will not be valid again for use. However, you can repurchase and register it once again.
8. Can I use my voucher in other hospitals not provided on the list? IHC has more than 500-accredited hospitals and clinics Members can choose from. All vouchers will be accepted in the cited hospitals and clinics in the list provided here https://www.insularhealthcare.com.ph/our-partners/
9. Can I use my PhilHealth for extra coverage? Yes. Once there is an admission, PhilHealth coverage is required since it also covers inpatient care. However, for those who do not have PhilHealth coverage, one may just pay the PhilHealth portion of the hospital bill before discharge.
10. What conditions are not covered by Total ProtectER?Non-emergency and pre-existing conditions, congenital and maternity-related conditions, and other conditions under IHC’s General Exclusions list are not covered by this product.An illness or condition is considered pre-existing if, prior to effective date of coverage:     (a) Any professional advice or treatment was given for such illness or condition;     (b) Such illness or condition was in any way already known to the Member; or     (c) The pathogenesis of such illness or condition had already started (of which the Member may not be aware of). Non-coverable accidents include, but are not limited to: self-inflicted injuries; injuries from professional sports and high-risk sports; injuries or illnesses due to military, paramilitary, or police service; injuries from high risk activities or suffered under conditions of war; and accidents that are secondary to or contracted due to degenerative diseases such as Alzheimer’s Disease and Parkinson’s Disease.For more information, see “General Exclusions”.