CLAIMS PROCEDURES / REQUIREMENTS:
For Motor Vehicle Claims
1. Notification Loss
Claimant must notify or report to GSIS within sixty (60) calendar days from the date
of loss or discovery. Notification maybe be made initially via any acceptable means
of communication provided that a formal notification must be submitted thereafter.
2. Submission of Documentary Requirements
Claimant must submit the complete documentary requirements within forty-five (45)
calendar days from the date of notification. Submission of the documents beyond the
prescribe period will result in the denied of the claim.
3. Documentary Requirements (Acts of Nature Claims):
A. Photocopy of Certificate of Registration and Official Receipt (OR) of Car
Registration at the time of accident or loss or damage
B. Photocopy of valid Driver’s License and Official Receipt
C. Original or Certified True Copy of Police Report or Original Copy of the
Duly notarized Owner’s or Driver’s Affidavit of Accident or duly
accomplished claim form assigned by parties involved and traffic
authorities or incident report duly signed by person/s involved
D. Repair estimates:
a. One (1) estimate is from dealer/casa; or
b. At least two (2) estimates from motor shops
E. Memorandum of Receipt or Acknowledgment Receipt or Trip Ticket issued
by the concerned agency, whenever applicable; and
F. Colored pictures of the Vehicle involved showing the damaged portion with
the plate number of the vehicle (4 sides):
a. Taken at the time of the accident; or
b. If (a) is not possible, immediately after the accident.
G. Other documents that may be needed in the adjustment of claim.
4. IMPORTANT NOTICE / REMINDERS:
GSIS has no casa and non-casa motor repair shop and towing company.
The casa or non-casa motor repair shop which issued the estimate is expected to
accept and honor the Letter of Authority issued by GSIS.
Towing expense of P3,000.00, should be covered by the policy and any excess shall
be for the account of the Assured/Claimant.
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Emergency repairs to provide mobility to insured damaged vehicles is subject to
Section III: Loss or Damage paragraph No. 5 of the Policy which reads:
“The Insured may authorize the repair of the Scheduled Vehicle necessitated
by damage for which the Fund may be liable under this Policy, provided that:
a. the estimated cost of such repair does not exceed the
Authorized Repair Limit and;
b. a detailed estimate of the cost is forwarded to the Fund
without delay.”
Violation of the above-provision will result in the denial of request for reimbursement.
For claims with request for cash settlement assured shall be paid an amount based
on evaluation net of participation and loss payment reduction amount of 30% of the
repair cost of the assured’s vehicle. The assured may then cause the repair of the
vehicle using the insurance proceeds from the cash settlement.
What to Do If Your Vehicle is Caught in a Flood
The following shall serve as emergency measures for damaged motor vehicles:
A. Check battery terminal for water contamination. Remove and dry up and
reinstall.
B. Check the air filter. If soaked in water, do not try to start the engine.
Remove any trap foreign materials, such as leaves, insects, etc.
C. Check the engine oil level and condition. If the level increased and color
changed to milky white, do not start the engine.
D. Check all the other fluids’ condition. Brake and clutch fluid, power steering
fluid, engine coolant and wiper washer water.
E. Check each electrical feature. Anything that does not operate the way they
are supposed to is a sign of electrical trouble:
• Power locks
• Power windows
• Power seats
• Audio and video systems
• Air conditioning
• Headlights
• Brake lights
• Rear combination lights
• Turn signal lights
• Hazard lights
• Interior lights
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For Non-Motor/Property Claims
1. Notification Loss
Claimant must notify or report to GSIS within sixty (60) calendar days from the date
of loss or discovery. Notification maybe be made initially via any acceptable means
of communication provided that a formal notification must be submitted thereafter
indicating the following details:
• Policy Number
• Date of Loss
• Nature of Loss
• Assured’s Contact details
.
2. Submission of Documentary Requirements
Claimant must submit the complete documentary requirements within thirty (30)
calendar days from the date of notification pursuant to Office Order No. 00:464-19
dated November 27, 2019. Submission of the documents beyond the prescribe
period will result in the denial of the claim.
3. Documentary Requirements:
A. Fire Insurance Policy with Typhoon and Flood Endorsement
For Building
• Repair Estimate
• Photographs of the damaged property
• Building plan/Sketch with dimension
For Contents
• Same as above
• Inventory of damaged and undamaged contents with date and cost of
acquisition
• List of damaged contents with repair/restoration cost
• Photographs of damaged contents
B. Special Property Floater (SPF)
• Repair Estimate
• Photographs of the damaged property
• Police Report/ Driver’s Affidavit
• Acquisition documents
• Copy of Memorandum of Receipt
C. Contractor’s All Risk (CAR)
• Copy of Formal Notice of Claim
• Copy of Duly accomplished Non-Waiver Agreement Forms
• Copy of Notification of Loss for Contractors All Risks Insurance
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• Copy of the Insured’s Claim
• Copy of Bill of Quantities
• Copy of Contract Agreement
• Copy of the Original Plan of the Contract
• Copy of Notice of Award
• Copy of Notice to Proceed; and
• Copy of PERT-CPM
D. Electronic Equipment Insurance (EEI)
• Duly accomplished and signed Non-Waiver Agreement;
• Duly accomplished and signed Notification of Loss or Damage for EEI;
• Duly accomplished and signed Sworn Statement in Proof of Loss;
• Incident Report
• Field Service Provider Report taken after the incident; and
• Photographs taken after the incident.
E. Personal Accident (PA)
Claims Requirements for Medical Reimbursement under ONLI Policy
• Notice of Claim (brief description of the accident)
• Copy of Statement of account (if hospitalized)
• Copy of Hospital Records (Clinical Abstract, Laboratory, X-ray
Results, etc.)
• Original copy of Medical Certificate
• Original copy Official Receipts for medical expenses incurred
• Original copy Doctor’s Prescription (for over the counter medicines)
• Photo/s of bodily injuries
• If accident is NOT VEHICULAR:
Affidavit on the circumstances of the Accident (Notarized) with
attached photocopy of valid ID with signature & picture
Affidavit of Two Disinterested Witness (Notarized) with attached
photocopy of valid IDs with signature & picture
• If accident is VEHICULAR: Original copy of Police/Traffic
Investigation Report
Optional (if available):
a) Copy of GSIS Official Receipt and Policy Contract
b) Copy of Vaccination Schedule
Claims Requirements for Death Benefits under ONLI Policy
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(Accidental Death/Dismemberment, Medical Reimbursement & Bereavement
Assistance)
• Notice of Claim (brief description of the accident)
• Original copy of Certificate of Legal Heirs from the assured’s
Human Resources Dept.
• Original/Certified True Copy Police/Traffic Investigation Report
• Original copy of Death Certificate (certified by PSA)
• Statement of account (if hospitalized)
• Hospital/Clinical/Laboratory Records
• Original copy of Official Receipts for medical expenses incurred
• Photos of bodily injury/incident
• If deceased is MARRIED :
a) Original copy of PSA Marriage Certificate
b) Original copy of PSA Birth Certificates of Children (if
beneficiary is minor)
c) Original copy of Affidavit of Guardianship (if beneficiary is
minor)
• If deceased is SINGLE :
a) Original copy of Birth Certificate of Insured (PSA)
b) Original copy of Marriage Certificate of Parents (PSA)
Optional (if available):
• Copy of GSIS Official Receipt and Policy Contract
• Extrajudicial Affidavit & Waiver of Rights
• Special Power of Attorney
• Autopsy Report
Claims Requirements for Medical Reimbursement under GPAI Policy
• Notice of Claim (brief description of the accident)
• Original copy of Endorsement Letter for the claim by Head of Office of
the Insured person
• Copy of GPAI Policy & attached List of the Personnel Insured
• Copy of Statement of account (if hospitalized)
• Copy of Hospital Records (Clinical Abstract, Laboratory, X-ray Results,
etc.)
• Original copy of Medical Certificate
• Original copy Official Receipts for medical expenses incurred
• Original copy Doctor’s Prescription (for over the counter medicines)
• Photo/s of bodily injuries
• If accident is NOT VEHICULAR:
Affidavit on the circumstances of the Accident (Notarized)
with attached photocopy of valid ID with signature & picture
Affidavit of Two Disinterested Witness (Notarized) with
attached photocopy of valid IDs with signature & picture
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• If accident is VEHICULAR: Original copy of Police/Traffic Investigation
Report
Optional (if available):
• Copy of GSIS Official Receipt and Policy Contract
• Copy of Vaccination Schedule
Claims Requirements for Death Benefits under GPAI Policy
(Accidental Death/Dismemberment, Medical Reimbursement &
Bereavement Assistance)
• Notice of Claim (brief description of the accident)
• Original copy of Endorsement of Claim by Head of Office of the Insured
Person
• Original copy of Certificate of Employment prior to death/Service
Record
• Original copy of Certificate of Legal Heirs from the assured’s Human
Resources Dept.
• Original copy of Police/Traffic Investigation Report
• Original copy of Death Certificate (certified by PSA)
• Statement of account (if hospitalized)
• Hospital/Clinical/Laboratory Records
• Original copy of Official Receipts for medical expenses incurred
• Notarized Affidavit of Guardianship (if beneficiary is minor)
• Photos of bodily injury/incident
• If deceased is MARRIED :
a) Original copy of PSA Marriage Certificate w/ copy of valid ID of
Spouse
b) Original copy of PSA Birth Certificates of Children w/ copy of
their valid ID
• If deceased is SINGLE :
a) Original copy of Birth Certificate of insured (PSA)
b) Original copy of Marriage Certificate of Parents (PSA)
• If deceased is SINGLE and Parents are also deceased :
b) Original copy of Birth Certificate of the Siblings (PSA)
c) Original copy of Barangay Certifications of the Siblings with
attached photocopy of their valid ID’s
Optional (if available):
• Copy of GSIS OR Premium (Policy Contract)
• Extrajudicial Affidavit & Waiver of Rights
• Special Power of Attorney
• Autopsy Report
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4. IMPORTANT NOTICE / REMINDERS:
For Non-Motor/Property Claims, the Branch Office or the Insurance Group will
immediately deploy its accredited independent adjuster to conduct site inspection
upon receipt of the notification.
For damaged properties, Assureds are encouraged to utilize loss mitigation
measures and to prevent further damage and injury to the public. Pictures of the
damaged properties must be taken from all angles to pinpoint the damage/s and
report immediately to the above-listed GSIS offices.
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