IC insurance guidelines for OFWs' compulsory cover

Policy, purpose, and interpretation rules

The State must afford full protection to labor, local and overseas, organized and unorganized, promote full employment and equality of employment opportunities, and provide adequate and timely social, economic, and legal services to Filipino migrant workers (Section 1(a), Guideline I).
The State must provide adequate protection to overseas Filipino workers (OFWs) by ensuring coverage under the compulsory insurance requirement in Section 37-A of Republic Act No. 8042, as amended (Section 1(b), Guideline I).
The mandatory OFW insurance coverage is exceptionally different and distinct from ordinary and usual insurance contracts provided by insurance providers in the Philippines (Section 1(b), Guideline I).
Insurance for OFWs is imbued with public interest, so insurance contracts must be executed and performed for the protection of OFWs and their families (Section 1(c), Guideline I).
Policy terms and conditions issued in favor of OFWs must be liberally construed in favor of the insured; all ambiguities in an insurance contract are construed against the insurer and resolved in favor of coverage (Section 2, Guideline I).
In case of doubt, policy provisions must be interpreted liberally in favor of migrant workers and in accordance with the intent of the Act, its Omnibus Rules, and these guidelines (Section 11, Guideline V).

Key definitions and covered workers

“Act” refers to Republic Act No. 8042 (Migrant Workers and Overseas Filipinos Act of 1995) as amended by Republic Acts 9422 and 10022 (Guideline II(a)).
“Certificate of Authority (CA)” refers to the license issued by the IC to an insurance company authorized to transact insurance business (Guideline II(b)).
“Composite insurance company” refers to an insurance company authorized by the IC to issue both life and non-life policies (Guideline II(c)).
“Insurance Contract” refers to an agreement where one undertakes for consideration to indemnify another against loss, damage, or liability arising from an unknown or contingent event (Guideline II(d)).
“Insurer/Insurance Provider” refers to one that makes, proposes, or provides an insurance contract (Guideline II(e)).
“Migrant Workers—Compulsory Insurance Coverage” refers to the compulsory insurance policy bought by the recruitment/manning agency from a reputable insurance company duly authorized by the IC in favor of a migrant worker with the minimum coverage under Section 37-A of the Act (Guideline II(g)).
“Omnibus Rules” refers to the Implementing Rules and Regulations (IRR) of the Act (Guideline II(i)).
Each migrant worker to be deployed by a recruitment/manning agency must be covered by a compulsory insurance contract secured at no cost to the worker (Section 3, Guideline I).

Participating insurers and eligibility limits

Only reputable private life, non-life, and composite insurance companies duly licensed by the IC, existing and operational for at least five (5) years, with net worth of at least PHP 500,000,000.00 based on audited financial statements for the immediately preceding year, with a current year Certificate of Authority, and with an IC-approved standard policy may provide migrant workers’ compulsory insurance coverage (Section 1, Guideline III).
Insurance companies whose directors, partners, officers, employees, or agents have relatives within the fourth civil degree of consanguinity or affinity working for or having interest in any licensed recruitment/manning agency or any government agency involved in the overseas employment program are disqualified from providing coverage (Section 2, Guideline III).
The disqualified personnel must disclose such interest to the IC and POEA (Section 2, Guideline III).
Writing authority limits apply:
- Life insurance companies may write: natural death insurance with supplementary accidental death and permanent total disablement benefits (Section 3, Guideline III).
- Non-life insurance companies may write: permanent total disablement; repatriation cost; subsistence allowance; money claims; compassionate visit; medical evacuation; and medical repatriation (Section 3, Guideline III).
- Accidental death insurance may be written by both life and non-life companies (Section 3, Guideline III).
- Composite insurance companies may write all listed coverages (Section 3, Guideline III).
An insurance provider must have capability for a fully computerized on-line, real-time operation of transactions, and the IC must be equipped with a computerized monitoring link of all transactions, including complaints, payment of benefits, and remittance of government taxes (Section 4(A), Guideline III).
An insurance provider must have branches near the vicinity where the POEA offices are located throughout the country (Section 4(B), Guideline III).
An insurance provider must maintain 24-hour call/assistance centers for immediate assistance and to entertain complaints and inquiries from migrant workers/beneficiaries, recruitment/manning agencies, and other stakeholders (Section 4(C), Guideline III).
Insurance providers must have an agreement with international assistance providers with access in all countries where migrant workers are located (Section 4(C), Guideline III).
Insurance providers must station in host countries their own company representatives for in-country assistance for claims servicing when required:
- In countries where at least 20,000 migrant workers insured under the program are located, representatives must be stationed near POLO offices, if any (Section 4(C)(1), Guideline III).
- In countries with more than one POLO, the number of representatives must match the number of POLOs provided that the insured migrant workers reach at least 40,000 in the host country (Section 4(C)(2), Guideline III).
- In other circumstances, presence is determined necessary by the Inter-Agency Committee created under these guidelines (Section 4(C)(3), Guideline III).

Accreditation, OEC gating, and insurer performance sanctions

The IC must furnish the POEA a list of insurance providers qualified to provide mandatory insurance coverage, and must update the list whenever inclusion or disqualification occurs (Section 1, Guideline IV).
Qualified insurance providers must be issued a certification that they are authorized to issue compulsory insurance, and the certification must be displayed prominently in their main and representative offices (Section 1, Guideline IV).
The POEA must not issue an OEC (or equivalent clearance) to an OFW if the insurance contract bears the name of an insurance company not included in the IC-qualified list furnished to the POEA (Section 1, Guideline IV).
The recruitment/manning agency has the right to choose any qualified insurance provider to insure the migrant worker it will deploy (Section 2, Guideline IV).
No government agency may direct, dictate, interfere, or influence in any way the recruitment/manning agency’s selection of an accredited insurance company for mandatory insurance; violations by government officials or employees are subject to administrative penalties under the Code of Ethical Standards for Government Employees, the Anti-Graft and Corruption Law, and other relevant laws (Section 2, Guideline IV).
The DOLE and IC must jointly assess insurance provider performance at the end of every year based on NLRC and POEA reports on interactions and experiences (Section 3, Guideline IV).
The DOLE and IC assessment authorizes banning/blacklisting providers known to be evasive or not responsive to legitimate claims of migrant workers; the DOLE must include the assessment in its year-end report to Congress (Section 3, Guideline IV).
Based on the joint assessment, the IC may ban, blacklist, disqualify, or revoke accreditation of the insurance provider (Section 3, Guideline IV).
The IC must ensure faithful execution of insurance laws and perform duties under the guidelines, and may issue rulings, instructions, circulars, orders, and decisions needed to enforce the guidelines (Section 3, Guideline IV).
The IC may impose, at its discretion, fines, and suspension or (after due hearing) removal of directors and/or officers and/or agents for willful failure/refusal to comply with or violation of guideline provisions, IC orders/instructions/regulations/rulings, or commission of irregularities, or unsafe/unsound business conduct as determined by the IC (Section 3, Guideline IV).

Policy form and insurance coverage requirements

No policy, certificate, contract, application form, rider, clause, warranty, or endorsement to be used under the Act may be issued without IC approval under Section 226 of the Insurance Code (Section 1, Guideline V).
Use of an unauthorized policy format results in the disqualification of the participating insurance provider (Section 1, Guideline V).
For control, every policy (individual, or master policy and certificate of cover) must have a special serial number (Section 1, Guideline V).
The policy must be uniformly labeled “COMPULSORY INSURANCE COVERAGE FOR AGENCY-HIRED MIGRANT WORKERS” (Section 2, Guideline V).
Insurers are uniformly called “insurance providers”; the migrant worker insured under the program is uniformly called “insured migrant worker”; relevant terms must be defined in understandable language using technical terms as little as possible (Section 2, Guideline V).
The policy must mention that enforcement of the migrant worker’s rights may reference Section 23 of RA 10022, Rule XVI of its Omnibus Rules, and these Insurance Guidelines (Section 2, Guideline V).
The insurance policy must be effective for the duration of the migrant worker’s employment contract and must cover at the minimum the benefits in Guideline VII (Section 3, Guideline V).
For group insurance, a Proof of Cover must be issued to each individual insured migrant worker and must be pre-approved by the IC (Section 3, Guideline V).
Monetary benefits must be stated as directly payable to the insured migrant worker or their beneficiaries, as the case may be (Section 3, Guideline V).
The policy must clearly state the premium rate, separately showing purely insurance premium, taxes, and other allowed charges in accordance with Guideline VIII; the policy must also state the premium is payable by the recruitment/manning agency, not by the insured migrant worker (Section 4, Guideline V).
In group insurance, the Proof of Cover must show the statement that the master policy may be viewed and printed through IC, POEA, insurance providers, and recruitment agency websites (Section 5, Guideline V).
The policy must be signed by the President of the insurance provider and countersigned by the President of the recruitment/manning agency (Section 6, Guideline V).
The incontestable and suicide clauses under the Insurance Code do not apply to compulsory life insurance coverage under the Act (Section 7, Guideline V).
Claims must be paid at the insurance provider’s home office, or in any branches or assistance centers, considering the circumstances of the insured migrant worker or beneficiary at the time of payment (Section 8, Guideline V).
The policy must provide legal remedies for disputes over non-payment or short-payment of benefits with specific reference to Guideline X, and must include the notice that the Insurance Commission has offices in Manila, Cebu, and Davao and is the government office enforcing insurance laws and assisting in insurance controversies; the POEA and POLO may assist in submitting complaints to the IC (Section 9, Guideline V).
Additional clauses introduced by the insurance provider must receive IC prior approval (Section 10, Guideline V).

Premium, underwriting, and operational records

Premium rates must be fair, reasonable, adequate, transparent, and prudent, considering estimated claims for the first year and actual loss experience for succeeding years, reasonable profit, and underwriting expenses (Section 1, Guideline VI).
Premium rates and adjustments must undergo annual review tied to loss experience and must be approved by the IC (Section 1, Guideline VI).
The applicable premium must be paid by the recruitment/manning agency responsible for deployment of the migrant worker (Section 1, Guideline VI).
The recruitment/manning agency and/or the foreign employer may not charge the premium directly or indirectly to the migrant worker in any case (Section 1, Guideline VI).
Premium rates apply only to minimum coverages under the law; higher coverages require separate IC approval (Section 1, Guideline VI).
Premium must be paid in full to the insurance provider on a cash and carry basis by the recruitment/manning agencies at no cost to the worker (Section 2, Guideline VI).
If the worker voluntarily pre-terminates employment abroad and returns to the Philippines out of free will, a proportionate return of premium must be made for the recruitment/manning agency’s benefit corresponding to the unexpired term of the insurance contract (Section 3, Guideline VI).
Underwriting must not distinguish migrant workers based on occupation, sex, or place of work (Guideline VIII).
Compulsory insurance coverage may be underwritten on an individual or group basis (Guideline VIII).
Insurers must maintain separate registers at all times for: policies/proofs of cover issued; claims register; and a production register showing amounts of retention and reinsurance distribution and respective reinsurers (Guideline VIII).
These registers must be open to inspection and examination by duly authorized representatives of the Insurance Commissioner at any time during business hours (Guideline VIII).

Minimum benefits and built-in assistance triggers

The minimum benefits include (with enumerated minimum dollar amounts and benefit triggers) (Guideline VII).
Accidental death benefit must be at least US$15,000.00, payable to the migrant worker’s beneficiaries (Section 1(a), Guideline VII).
Natural death benefit must be at least US$10,000.00, payable to the migrant worker’s beneficiaries (Section 1(b), Guideline VII).
Permanent total disablement disability benefits must be at least US$7,500.00 payable to the disabled migrant worker; permanent disabilities include:
- total complete loss of sight of both eyes;
- loss of two limbs at or above the ankles or wrists;
- permanent complete paralysis of two limbs;
- brain injury resulting to incurable imbecility or insanity (Section 1(c), Guideline VII).
All accidental/natural death/disablement liability described under the disability clause must be due to accident or by any health-related cause or sickness or ailment suffered during the duration of the migrant worker’s employment (Section 1(c), Guideline VII).
Service in the armed forces in any country or international authority, whether in peace or war, serves as the only exclusion to the limits of liability under accidental/natural death/disablement coverage under that subparagraph (Section 1(c), Guideline VII).
Repatriation cost must cover worker repatriation when employment is terminated by the employer without any valid cause, or by the employee with just cause, including transport of personal belongings (Section 1(d), Guideline VII).
For death, the insurance provider must arrange and pay for repatriation of remains and belongings and must render assistance for locating licensed funeral/mortuary/disposition facilities, completing documentation, obtaining consular services, providing death certificates, purchasing the minimally necessary casket or air transport container, transporting remains (including retrieval from the site of death) and delivery to the receiving funeral home and back to the insured worker’s residence in the Philippines or any place in the Philippines in accordance with the worker’s will, if any (Section 1(d), Guideline VII).
Repatriation cost benefits are without prejudice to Rule XIII of the Omnibus Rules, and are regardless of cost, with the primary test being complete repatriation of the worker/remains and personal belongings (Section 1(d), Guideline VII).
Subsistence allowance must be at least US$100.00 per month for a maximum of six (6) months for a migrant worker involved in a case or litigation for protection of rights in the receiving country (Section 1(e), Guideline VII).
Money claims must include coverage arising from the employer’s liability awarded or given to the worker in NLRC judgment or settlement (Section 1(f), Guideline VII).
Money claims insurance coverage must be equivalent to at least three (3) months salaries for every year of the migrant worker’s employment contract (Section 1(f), Guideline VII).
The maximum amount per month for money claims coverage is US$1,000.00 or the salary under the employment contract, whichever is lower (Section 1(f), Guideline VII).
If insurance coverage is insufficient to satisfy the amount adjudged or agreed upon, the recruitment/manning agency must pay the balance thereof (Section 1(f), Guideline VII).
Compassionate visit must be provided when a migrant worker is hospitalized and confined (or will be confined as determined by the attending physician and the insurance company physician) for at least seven (7) consecutive days; one (1) family member or requested individual is entitled to transportation cost to the major airport closest to the place of hospitalization and back to the Philippines (Section 1(g), Guideline VII).
The family member/requested individual must handle visa and travel document requirements (Section 1(g), Guideline VII).
Compassionate visit benefits are regardless of cost, with the primary test being complete transport of the visitor from and back to the Philippines (Section 1(g), Guideline VII).
Medical evacuation must be undertaken by the insurance provider when an adequate medical facility is not available proximate to the worker, as determined by the insurance company physician and a consulting physician; evacuation must occur under appropriate medical supervision using the necessary mode of transport (Section 1(h), Guideline VII).
Medical evacuation benefits are regardless of cost, with the primary test being completion of the medical evacuation (Section 1(h), Guideline VII).
Medical repatriation must be undertaken when medically necessary as determined by the insurance company physician and consulting physician; repatriation under medical supervision must occur to the worker’s residence at the time the worker is medically cleared for travel by commercial carrier (Section 1(i), Guideline VII).
If medical clearance for travel takes more than fourteen (14) days from the date of discharge from the hospital, an alternative appropriate mode of transportation (including an air ambulance) may be arranged (Section 1(i), Guideline VII).
Medical and non-medical escorts may be provided when necessary (Section 1(i), Guideline VII).
Medical repatriation is without prejudice to Rule XIII of the Omnibus Rules, and is regardless of cost, with the primary test being complete repatriation under medical supervision to the worker’s residence (Section 1(i), Guideline VII).
Assistance benefits for repatriation, evacuation, and medical repatriation plus the other assistance benefits must be performed or paid immediately by the insurance provider; advance payment by the insured migrant worker or heirs is not required and must not be demanded (Section 2, Guideline VII).
Assistance benefits must remain in force while the insured migrant worker is in the country of assignment for the duration of the policy (Section 3, Guideline VII).
Benefits under Section 1(a), (b), (c), (e), and (f) may be paid in Peso equivalent only with consent of the insured migrant worker or beneficiaries, and in no case may settlement be less than the mentioned dollar equivalent at the time of payment (Section 4, Guideline VII).

Claims procedures and document rules

For claims under Section 2 of Rule XVI of the Omnibus Rules covering subparagraphs (a), (b), (c), (d), and (e), the claimant must present to the insurance company a written notice of claim with pertinent supporting documents (Section 1, Guideline IX).
The insurance company must ascertain the truth and extent of the claim and must pay within ten (10) days from filing the notice of claim and submission of complete claim documents (Section 1, Guideline IX).
For accidental death, natural death, or permanent total disablement claims under Section 2 (a), (b), and (c), payment must be made without necessity of proving fault or negligence by the insured migrant worker, provided authenticated documents from Philippine foreign posts are presented (Section 2, Guideline IX).
Required death/disability documents include:
- Death Certificate for natural or accidental death;
- Police or Accident Report for accident;
- Medical Certificate for permanent disablement (Section 2, Guideline IX).
To identify beneficiaries, additional documents must be submitted:
- Birth Certificate if the beneficiary is a parent or a child;
- Marriage Contract if the beneficiary is the spouse;
- Affidavit of Legal Guardianship if the beneficiary is a minor;
- Other documents needed to establish identity of claimants (Section 2, Guideline IX).
For repatriation under Section 2(d) of Rule XVI, the claimant must present a certification issued by the Philippine foreign post or the POLO in the receiving country stating the reasons for termination and the need for repatriation; it is solely for compliance with the claim procedure (Section 3, Guideline IX).
For subsistence allowance under Section 2(e) of Rule XVI, a certification must be issued by the Labor Attaché or, if absent, the embassy or consular official stating the title of the case, names of the parties, and nature of the migrant worker’s cause of action (Section 4, Guideline IX).
Money claims settlement for Section 2(f) of Rule XVI follows the following sequence (Section 5, Guideline IX):
- After an NLRC decision becomes final and executory or a settlement/compromise is reached, the Labor Arbiter must issue a writ of execution mandating the recruitment/manning agency to pay within thirty (30) days from receipt, after pre-execution conference (Section 5(1), Guideline IX).
- The recruitment/manning agency must file a notice of claim with its insurance provider for the insured liability amount, attaching a certified true copy of the decision or compromise agreement (Section 5(2), Guideline IX).
- Within ten (10) days from filing the notice of claim, the insurance company must pay the recruitment/manning agency the lower of (a) the amount adjudged or agreed upon, or (b) the amount of liability insured; payment may be made direct to the OFW or migrant worker or beneficiary agreed upon; the agency must then pay the worker in full, and must pay any balance if coverage is insufficient (Section 5(3), Guideline IX).
- If the insurance company fails to pay within the ten (10) days, the recruitment/manning agency must pay within the remaining days of the thirty (30) days (Section 5(4), Guideline IX).
- If not settled within the thirty (30) days, the recruitment/manning agency’s performance bond or escrow deposit must be garnished to satisfy the migrant worker’s claim (Section 5(5), Guideline IX).
- Compulsory workman’s insurance under the Omnibus Rules does not affect the joint and several liability of the foreign employer and recruitment/manning agency under Section 10 of the Act (Section 5(6), Guideline IX).
- Lawyers for insurance companies, unless the insurers are impleaded, are prohibited from appearing before the NLRC in money claims cases under Rule VII of the Omnibus Rules (Section 5(7), Guideline IX).
The recruitment/manning agency must explain to the migrant worker before departure and at least one beneficiary the insurance coverage terms and benefits, including claims procedure, in collaboration with the insurance provider (Section 6, Guideline IX).
When filing a claim, the recruitment/manning agency must assist the migrant worker/beneficiary and ensure access to information and documents in the agency’s custody needed for the claim (Section 6, Guideline IX).

Disputes, jurisdiction, and enforcement

Any question or dispute in enforcement of any insurance policy issued under these guidelines—regardless of amount—must be brought before the IC for mediation or adjudication under the applicable Insurance Code provisions or IC circulars (Section 1, Guideline X).
The IC’s existing claims adjudication procedures apply to insurance claims disputes under these guidelines, accounting for special procedures and periods in Section 37-A of the Act and these guidelines; the IC may issue pertinent circulars (Section 1, Guideline X).
The same process applies to seafarers employed/hired by principals/shipowners who obtained insurance cover from insurance companies authorized to do business in the Philippines (Section 1, Guideline X).
The NLRC has exclusive jurisdiction to enforce its final and executory decision/resolution/order or settlement/compromise against the recruitment/manning agency/insurance provider (Section 2, Guideline X).
Seafarer claims enforcement rules apply:
- Disputes in enforcement of money claims under the seafarer standard employment contract covering minimum benefits under Section 2 Rule XVI of the Omnibus IRR must be filed before the NLRC (Section 3, Guideline X).
- For seafarers under collective bargaining agreements, cases must be submitted to voluntary arbitration (Section 3, Guideline X).
- Complaints against principals/shipowners and/or manning agents for violations of the standard employment contract or pertinent POEA rules and regulations covering minimum benefits must be filed with the POEA; erring principals/shipowners/manning agents may be meted administrative penalties under POEA rules and regulations (Section 3, Guideline X).

Reporting, oversight committee, and administrative supervision

The IC must require insurance providers to submit regular reports including: production/p