ONE PUHUNAN KAPAMILYA LIFE PLAN POC NO.
: OPHNGA271P4O20411011-1
BRANCH: PHP 500.00
PLUS
OPH-NGA ONE PUHUNAN PROTEKTAHANAN POLICY NO.: (FLI) YR20210102 | (FGEN) YR20210102
NAME OF INSURED NAME OF BENEFICIARY START DATE EXPIRY DATE
Lea Lavandero Salvador Lavandero 05/30/2025 11/30/2025
LOCATION OF RISK Fire Policy Number
Zone 2Sitio Tampac Sua Camaligan Camarines Sur Region V(bicol Region), Camaligan, F01NGA271P4O20411011-1
Camarines Sur
SCHEDULE OF BENEFITS
FORTUNE LIFE
Principal Spouse Parents Children/Siblings
LIFE/NATURAL PHP 50,000.00 PHP 20,000.00 PHP 10,000.00 PHP 10,000.00
DEATH
ACCIDENTAL DEATH PHP 50,000.00 PHP 20,000.00 PHP 10,000.00 PHP 10,000.00
& DISMEMBERMENT
ACCIDENTAL PHP 5,000.00 PHP 2,000.00 PHP 1,000.00 PHP 1,000.00
MEDICAL
REIMBURSEMENT
BURIAL ASSISTANCE PHP 5,000.00 PHP 2,000.00 PHP 1,000.00 PHP 1,000.00
BENEFIT / INSTANT
ABULOY
TERMINAL ILLNESS PHP 25,000.00 PHP 10,000.00 PHP 5,000.00 PHP 5,000.00
BENEFIT
FORTUNE GEN
Accidental Death PHP 5,000.00 PHP 0.00 PHP 0.00 PHP 0.00
Fire Cash Assistance PHP 30,000.00 PHP 0.00 PHP 0.00 PHP 0.00
DEPENDENTS
SPOUSE/PARENTS CHILDREN/SIBLINGS
Salvador Lavandero 10/10/1962
NOTICE OF CLAIM
Step 1. First Notice of Claim
- The Insured/Beneficiary shall file First Notice of Claim to the Company as soon as practicable but in any event within five
(5) days of their becoming aware of any circumstances which may give rise to a claim hereunder.
Step 2. Submission of Documents
- The Insured/Beneficiary must submit all original copies of the required documents within thirty (30) days for fast evaluation
of the claim.
DISCLAIMER
This collection slip is proof of payment for your insurance policy and not the Certificate of Cover (COC). If you require a copy of
your COC or the Master Policy (for group insurance policies), you may request a copy thereof from the institution where you
have paid for this insurance policy.
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CUSTOMER'S NAME AND SIGNATURE
