QuestionsQuestions (INSURANCE COMMISSION)
The Guidelines state that the State intends to provide full protection to labor, including OFWs, and ensure coverage under Section 37-A of RA 8042 (as amended by RA 10022). Compulsory insurance is distinct because it is imbued with public interest and is meant specifically to protect OFWs and their families through mandatory coverage rather than private, voluntary contracting terms.
It requires liberal construction in favor of the insured OFW; all ambiguities in the insurance contract are construed against the insurer and resolved in favor of coverage.
Each migrant worker to be deployed by a recruitment/manning agency shall be covered by a compulsory insurance contract secured at no cost to the worker. Seafarers already covered by entities providing indemnity cover to the vessel follow POEA rules and the POEA standard employment contract, subject to the Guidelines’ application to principals/shipowners that obtained insurance from local insurance companies.
Insurance companies are disqualified if their directors, partners, officers, employees, or agents have relatives within the fourth civil degree who work or have interest in any licensed recruitment/manning agency or in any government agency involved in the overseas employment program.
The insurer must be a reputable IC-licensed life, non-life, or composite insurance company existing and operational at least five (5) years, with net worth of at least PHP 500,000,000 based on audited financial statements for the immediately preceding year, with a current year Certificate of Authority and an IC-approved standard policy.
It limits which type of insurance company may write particular coverages. Natural death with supplementary accidental death and PTD benefits is for life companies only, while PTD, repatriation, subsistence, money claims, compassionate visit, medical evacuation, and medical repatriation are for non-life companies only. Accidental death insurance may be written by both life and non-life companies.
They must have a fully computerized operation on an on-line, real-time basis, and IC must be equipped with a computerized monitoring link of all transactions including complaints, payment of benefits, and remittance of taxes. They must also have branches near POEA offices nationwide and establish 24-hour call/assistance centers with agreements with international assistance providers.
Representatives must be stationed in host countries where at least 20,000 migrant workers insured under the program are located (near POLO offices, if any); where there is more than one POLO, the number of representatives must match POLOs if insured workers reach at least 40,000 in the host country; and in other circumstances where deemed necessary by the Inter-Agency Committee.
POEA shall not issue an OEC (or equivalent clearance) if the insurance contract bears the name of an insurance company not included in the IC’s list of qualified providers. Recruitment/manning agencies must provide proof acceptable to POEA.
No government agency may direct, dictate, interfere, or influence selection of insurers by recruitment/manning agencies among accredited providers. Violation by a government official/employee may be subject to administrative penalties under laws such as the Code of Ethical Standards for Government Employees and the Anti-Graft and Corruption Law.
At year-end, DOLE and IC jointly assess performance based on reports from NLRC and POEA on interactions and experiences. They can ban/blacklist evasive or non-responsive insurers; IC can further disqualify, revoke accreditation, or impose sanctions after due process.
No policy/certificate/contract, application form, rider, clause, warranty, or endorsement used under the Act may be issued without IC approval. Unauthorized formats disqualify the provider. Policies must be uniformly labeled “COMPULSORY INSURANCE COVERAGE FOR AGENCY-HIRED MIGRANT WORKERS,” and terms like “insurance providers” and “insured migrant worker” must be used uniformly.
The policy must be signed by the President of the insurance provider and countersigned by the President of the recruitment/manning agency.
Minimum benefits include accidental death (at least US$15,000), natural death (at least US$10,000), permanent total disablement (at least US$7,500), repatriation cost, subsistence allowance (at least US$100/month for up to 6 months), money claims, compassionate visit, medical evacuation, and medical repatriation (all with detailed terms). Premiums must be clearly shown, payable by the recruitment/manning agency (never by the OFW), and must be paid in full on a cash-and-carry basis at no cost to the worker.
The insurance company must make payment within ten (10) days from filing of the notice of claim and submission of complete claim documents.
For natural/accidental death: Death Certificate or Police/Accident Report, respectively. For permanent disablement: Medical Certificate. All must be duly authenticated by Philippine foreign posts. For identifying beneficiaries: relevant civil status documents (birth certificate, marriage contract, guardianship affidavit) and other documents needed for identity.
A certification stating the reason(s) for termination of the OFW’s employment and the need for repatriation must be issued by the Philippine foreign post or POLO in the receiving country, solely for compliance with the repatriation claims procedure.