How to process claims and other policy benefits

  1. Client accomplishes the forms and completes all documentary requirements
  2. Client submits the complete requirements to any Pru Life UK branch and Customer Service Associate (CSA) pre-screens the application
  3. Branch endorses request to head office
  4. Claims team evaluates and processes the request
  5. Checks and letters will be prepared
  6. Claims proceeds will be released via fund transfer or check

Basic documentary requirements

All documents originating overseas must be authenticated by the Philippine Consul in the respective country.

  • Claimant Statement
  • Policy Contract (consists of the Application for
  • Insurance, the Policy Data Page, the Sales Illustration
  • Form and Policy Booklet)
  • Two (2) valid identification cards of INSURED
  • Two (2) valid identification cards of POLICYOWNER
  • Two (2) valid identification cards of BENEFICIARY/IES
  • Medical records (Admission and Discharge Summary,
  • Clinical Summary and Abstract, Patient History Sheet)

Additional requirements for top types of claim

Additional requirements for other types of claim may be found in the Claimant Statement Form.

  1. Attending Physician’s Statement (accomplished by the physician who attended to the deceased)
  2. Death Certificate
  3. Birth or Baptismal Certificate of the insured
  4. Birth or Baptismal Certificate of the beneficiary
  5. Marriage contract, if beneficiary is spouse
  6. If death by external causes (accident, homicide, suicide, etc.)
  • Certified true copy of the Final Investigation report of Police Authorities or NBI
  • Original or certified true copy of Sworn Statement or Affidavits on file of at least two witnesses to the incident or
  • Affidavit of at least two persons cognizant of the circumstances surrounding the Insured’s violent death
  • Certified true copy of Medico-Legal Report/Autopsy Report, if any
  • Driver’s license and vehicle registration if the Insured was driving a vehicle at the time of death
  • Duly certified copy of the criminal Complaint filed in court, if any; or Fiscal’s Resolution, if any

Hospital Statement of Accounts (must show admission and discharge date and time)

1. Incident report for minor incident (from the insured or any witness/witnesses to the incident)
2. If major accident:

  • Certified true copy of the Final Investigation report of Police Authorities or NBI
  • Original or certified true copy of Sworn Statement or Affidavits on file of at least two witnesses to the incident or
  • Affidavit of at least two persons cognizant of the circumstances surrounding the incident
  • Certified true copy of Medico-Legal Report/Autopsy Report, if any
  • Driver’s license and vehicle registration if the Insured was driving a vehicle
  • Duly certified copy of the criminal Complaint filed in court, if any; or Fiscal’s Resolution, if any


3. Original official receipts related to the treatment of injury (expenses incurred within 30 days from the date of accident)
Photocopy of prescription

  • Attending Physician’s Statement (accomplished by oncologist)
  • Biopsy and/or Hispatology results
  • If Leukemia, Bone Marrow diagnostic result
  • Attending Physician’s Statement (accomplished by neurologist)
  • All CT scan/s
  • MRI result/s
  • Attending Physician’s Statement (accomplished by cardiologist)
  • All ECG results and interpretation - Series
  • Cardiac Enzyme – Troponin / CK-MB (present only in the body for 48-72 hrs)
  • Coronary Angiogram Result
  • Echocardiogram, if any
  • Attending Physician’s Statement (accomplished by nephrologist)
  • 24-hour urine collection result
  • Blood Urea Nitrogen (BUN)
  • Creatinine
  • Dialysis Record (Certified True Copy)
  • Attending Physician’s Statement (accomplished by neurologist)
  • All CT scan/s
  • Biopsy report, if any
  • MRI result/s
  • Record of Operation

Claim via Partner Hospital

*The claim may be filed by the policyholder/insured or the next of kin if the insured is physically incapacitated.

St. Luke’s Medical Center

  • Two (2) valid identification cards of the INSURED
  • Two (2) valid identification cards of the POLICYOWNER
  • Attending Physician’s Statement;
  • Claimant Statement; and
  • Partner Hospital Claim Form (This form authorizes St. Luke’s Medical Center to release to Pru Life UK the client’s medical records on the critical illness claim. It also gives St. Luke’s Medical Center the right to accept the claim proceeds and apply the same as payment for the client’s hospital bills.)
  • You may go directly to St. Luke’s Medical Center if your complete medical records are with the hospital. You don’t have to visit a Pru Life UK office or seek an agent’s assistance during your claim process.
  • Up to 20% discount on packaged treatments for the following critical illness conditions: cancer, stroke, heart attack, renal failure, and brain tumor.
  • 10% discount on all hospital services (excluding doctors’ fees). This is regardless of whether your claim is approved or not.
  • Special assistance available onsite at the International Patients’ Lounge where all transactions will be processed.
  • You will receive timely updates on your claims application status.

Frequently Asked Questions

Clients who are making a claim against any of the following plans (rider or stand-alone):

  • Crisis Cover Benefit (CCB)
  • Life Care Benefit (LCB)
  • Multiple Life Care Plus (MLCP)
  • Life Care Advance Plus (LCAP)
  • Life Care Plus (LCP)
  • PruWellness

The claim requirements are streamlined for the client’s convenience. Only the following will be required to make a claim:

  • Two (2) valid identification cards of INSURED
  • Two (2) valid identification cards of POLICYOWNER
  • Claimant Statement
  • Attending Physician’s Statement (APS)
  • Partner Hospital Claim Form

The partner hospital claim form serves two purposes:

  • It explicitly gives Pru Life UK the right to access the client’s medical records in the custody of the partner hospital.
  • It allows the client to nominate the portion of the proceeds to be allocated to the hospital.

Clients may apply for a critical illness claim through the following channels:

  • Partner hospital through the International Patients Lounge (IPL). Only clients whose complete medical records are with St. Luke’s Medical Center may use this route.
  • Pru Life UK Business Centers.

 

The target processing time will be the same – 7 to 24 days depending on the completeness of requirements and complexity of the case.

Pru Life UK will coordinate directly with the partner hospital for the client’s medical records.

Policyowners will be given updates for each milestone of the claim process. Follow-ups may also be sent to [email protected]

Pru Life UK shall send an e-mail notification and a formal letter to inform the client about the results of the claim.

Pru Life UK will refund to the client proceeds in excess of the hospital bills.

Back to Top