Most accidents can be prevented. But even with the greatest care, accidents can and do happen when least expected. With the Pro Family Insurance Plan you and your dependents can avail of benefits to take care of accident related expenses.

Eligibility
To be eligible for insurance coverage, individuals must be permanent residents of the Philippines and they must satisfy the following age requirements:

• Principal Insured - 18 to 64 years of age
• Spouse - 18 to 64 years of age
• Children - 2 weeks but under 21 years of age
• Parents - up to 64 years old

Simplified Enrollment
All one needs to be covered is to complete the Information Sheet and submit it to Sun Life Philippines together with the premium for the chosen plan package.

Description
The Group Policy provides insurance against loss from accidental bodily injury as evidenced by a visible contusion or wound except in the case of drowning or internal injury revealed by a medical examination or an autopsy resulting directly and independently of all other causes sustained by any Member during the effectivity of this coverage.

Personal Accident (PA) Insurance
If injuries result in any one of the following losses, and such losses occur within 180 days from the date of accident, Sun Life shall pay, subject to the Exclusions, the corresponding percentage of the Personal Accident insurance for:

Loss of	%
Entire sight of both eyes	100%
Both hands or both feet	100%
One hand and foot	100%
Either hand or foot and sight of one eye	100%
Hand, foot or sight of one eye	50%

"Loss" as above used with reference to hand or foot means complete severance at or above the wrist or ankle respectively, and as used with reference to eyes, means total and irrecoverable loss of sight. If the Member shall sustain more than one of such losses as a result of one accident, payment of the amounts shown above shall be made only for that one loss for which the largest amount is payable. Losses sustained as a result of any subsequent accident shall be considered for payment separately from and independently of other losses sustained in a previous accident. The aggregate amount of all percentages payable under the Accidental Dismemberment Benefit with respect to any one or more accidents shall not exceed 100%.

The amount of benefit payable for loss of life arising from independent, unrelated accident shall always be 100% of the Amount of Insurance regardless of the amount(s) paid under the Accidental Dismemberment Benefit.

If a Member has suffered the loss of one hand, one foot or sight of one eye prior to the Effective date of his insurance, the benefit of any subsequent loss of one hand, one foot or sight of one eye shall be one-half of the Amount of Insurance.

Medical Reimbursement
If a Member while insured sustains accidental bodily injury, and

1. Receives treatment commencing within 30 days from the date of such accident from a qualified Physician or while confined in a Hospital; and
2. 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 Member 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 and this Medical Reimbursement Benefit.

This Medical Reimbursement shall not cover hospital confinement, services, supplies, treatment or any other medical care for which benefits are payable under any other in-force Medical Reimbursement benefits of Sun Life Philippines within which the insured Member is covered unless the benefits payable under the said benefit/s are not sufficient to cover the claim applied for. In such event, Sun Life shall reimburse an amount up to the benefits provided under this Medical Reimbursement benefit. However, the total payments from this Reimbursement and all other Medical Reimbursement benefits of Sun Life shall not exceed the actual allowable medical expenses incurred by the insured Member.

Hospital shall mean any private or government institution legally constituted locally and operated hospital or clinic duly registered with the Bureau of Medical Services, Department of Health, and located within the Philippines. Physician shall mean a legally licensed physician or surgeon duly registered and practicing within the scope of his profession. A Physician cannot be the Member; or the brother, sister, parent, spouse or child of the Member, unless approved by Sun Life Philippines.

Plan Packages
The Pro-Family Plan is a yearly renewable Personal Accident program designed to provide indemnity for accident-related loss of life and dismemberment. There are several plan packages available to address various situations and needs:

1. Package I - Principal, Spouse and Dependent Children
2. Package II - Principal and Dependent Children
3. Package III - Principal and Dependent Parents
4. Package IV - Principal, Dependent Parents and Dependent Children

Each package has 4 plans available: Plan 500, Plan 1000, Plan 1500 and Plan 2000.

Maximum Amount of Insurance
The maximum aggregate amount of insurance on any one life for:

Rider	Amount
Accidental Death & Dismemberment:	Ps 2,000,0000.00
Medical Reimbursement:	Ps 200,000.00

on all Pro Family plans bought with Sun Life Philippines. Sun Life Philippines shall not be liable for claims in excess of the maximum amount of insurance. The liability of Sun Life shall be limited to the return of premiums collected for the whole plan package.

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No Evidence of Insurability Required
Insurance coverage is given without need of undergoing costly and tedious medical examinations.

One Year Coverage
Effectivity is on the date the fully accomplished Information Sheet is stamped received at the Group Insurance Dept. of Sun Life Philippines located at 15/F, Tower II, The Enterprise Center, 6766 Ayala Avenue Corner Paseo De Roxas,Makati City. Coverage shall be for one year from the Effective Date.

Exclusions

1. Persons belonging to the following occupations: non-commercial aviators, construction workers, detectives, divers, professional drivers, explosives makers, firemen, loggers, miners, military men, policemen, para-military personnel, sailors, secret service personnel, security guards and underground workers.
2. Death or Dismemberment or any loss caused directly or indirectly, wholly or partially, by;
   1. bodily or mental infirmity or disease of any kind, hernia, ptomaines, bacterial or viral infection other than infection occurring simultaneously with and in consequence of an accidental cut or wound; or
   2. suicide or attempted suicide while sane or insane, or self-inflicted injuries; or
   3. committing or attempting to commit any crime, felony or other illegal act; or
   4. homicide; or
   5. pregnancy, childbirth, miscarriage or any complications thereof; or
   6. poison, carbon monoxide or drug overdose; or
   7. war (declared or undeclared), insurrection, riots, rebellion, civil commotion or hostile action of armed forces; or
   8. entering, operating or servicing, ascending or descending from or with any aerial or submarine device or conveyance except while the Member is riding as a fare paying passenger in an aircraft operated by a commercial passenger airline or a scheduled air service over an established route; or
   9. while engaging in hunting, motor-cycling or pillion riding, mountaineering which necessitates the use of ropes or piton, racing of any kind other than on foot; hang gliding, ice or winter sports, water ski-jumping and tricks, yachting beyond five kilometers of a coastline, underwater activities involving the use of underwater apparatus or using woodworking machinery driven by mechanical power other than portable tools applied by hand and used solely for private purposes without reward.

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Note: This page contains only the important features of the plan. Please refer to the policy contract for a more detailed description of the coverage.

 

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