Filing a critical illness claim

1. Claimant Statement 

   Download Claimant Statement - Critical Illness

2. One (1) valid government-issued photo ID of the claimant

3. Complete Medical Records supporting the critical illness diagnosis (duly certified by the issuing hospital/institution):

   • Admission and Discharge Summary;

   • Clinical Summary and Abstract;

   • Diagnostic procedure results supporting the diagnosis (e.g. ECG, biopsy, blood test, ultrasound, MRI, any endoscopy procedure, x-ray, etc..)

   • History Sheet: Contains the chief complaint, personal and family history (past and present)

1. For cancer

   • Attending Physician’s Statement – Crisis Cover (Cancer, Terminal and Other Illnesses)

     Download Attending Physician’s Statement – Crisis Cover (Cancer, Terminal and Other Illnesses)

   • Biopsy and/or histopathology results

   • If leukemia, bone marrow diagnostic result

     
     
     

2. For stroke

   • Attending Physician’s Statement – Crisis Cover (Stroke)

     Download Attending Physician’s Statement – Crisis Cover (Stroke)

   • CT scan or MRI result/s

     
     
     

3. For heart attack

   • Attending Physician’s Statement – Crisis Cover (Heart Attack) 

     Download Attending Physician’s Statement – Crisis Cover (Heart Attack) 

   • All ECG Results and interpretations – Series

   • Cardiac enzyme – Troponin / CK-MB

   • Coronary angiogram result

   • Echocardiogram, if any

     
     
     

4. For brain tumor

   • Attending Physician’s Statement – Crisis Cover (Cancer, Terminal, or Other Illnesses)

     Download Attending Physician’s Statement – Crisis Cover (Cancer, Terminal, or Other Illnesses)

   • All CT scan/s

   • Biopsy result, if any

   • MRI result/s

   • Record of operation, if any

     
     
     

5. For renal failure

   • Attending Physician’s Statement – Crisis Cover (Renal Failure) 

     Download Attending Physician’s Statement – Crisis Cover (Renal Failure)

   • BUN

   • Creatinine

   • Dialysis record (Certified True Copy)

   • Glomerular Filtration Rate (GFR)

   • Urinary Creatinine Clearance

   • Urinary Protein Determination

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