This rider may be availed under the Group Yearly Renewable Term Plan (if attached to AD&D Rider) and Group Personal Accident Policy.

If Sun Life Philippines receives Notice and Proof of Claim that an Employee while insured:

1. sustains loss from accidental bodily injury as evidenced by an external and visible contusion or wound except in the case of drowning or internal injuries shown by a medical examination or autopsy, and resulting directly and independently of all other causes; and
2. receives treatment commencing within 30 days from the date of such accident from a qualified Physician or while confined in a licensed Hospital; and
3. incurs expenses for medical, hospital or surgical treatment of such bodily injury only;

Sun Life Philippines shall reimburse the actual, necessary, reasonable and customary expenses which the Employee may have incurred for no more than fifty two (52) weeks after the injury up to the maximum amounts specified in the Amount of Insurance, subject to the Exclusions and other provisions of the Policy.

Coordination of Benefits
This policy shall not cover hospital confinement, services, supplies, treatment or any other medical care which are furnished or for which benefits are payable under any other in force policy or Plan, or under any extension of benefits provisions of any other such policy or Plan which has been canceled; provided that, if the benefits payable under such other policy or Plan are less than the total expenses incurred by the Employee, Sun Life Philippines shall reimburse an amount up to the benefits provided under this Policy. In no event, however, shall the total payments from this Policy and such other policy or Plan* exceed the incurred expenses of the insured Employee.

The following are considered Plans:

1. this or any other policy or plan, contract for group insurance benefits,
2. any group insurance, hospital, or medical service organization plan,
3. any other service or prepayment plan arranged through any employer, union, employee benefit or professional association, or
4. any government sponsored plan or statute providing similar benefits.

 

Contact us to know more about Group Insurance.