CONTRIBUTION AND LEGAL DEPENDENTS
Upon payment of the first Php 15.00 weekly contribution for life insurance, a member and her legal dependents have life insurance coverage, the amount of which depends on the length of membership.
- The legal dependents of a legally married member are the following:
- the legal spouse;
- all biological and/or legally adopted children who are single and 14-day to 21 years old;
- all biological and/or legally adopted children who are single and more than 21 years old but disabled and incapacitated to work;
- If a member is single without children, legal dependents are parents 60 years old and above.
- If a member is single with children, legal dependents are the children as described in 1.b. and 1.c. and not the parents.
In case of death of the member or any of her legal dependent, the beneficiary will be indemnified according to the Table of CARD MBA Life Insurance Benefits.
- Applicants must be at least 18 years old but not more than sixty five (65) years old as of the enrollment date.
- He or she must be an active member or employee of micro finance institutions and other organized groups accredited by CARD MBA:
i. CARD, Inc.;
ii. CARD Bank, Inc.;
iii. CARD SME Bank, Inc.;
iv. CARD MRI Rizal Bank, Inc;
v. CARD-Business Development Foundation Inc.;
vi. All other institutions of CARD MRI;
vii. Organized groups under the Build-Operate-And-Transfer (BOAT) Program of CARD MBA.
- Application for membership in CARD MBA must be filled out in the prescribed form.
- Any willful misstatement in the application that would render a person eligible for insurance when he/she would otherwise be ineligible shall be sufficient cause for the cancellation of one’s membership in CARD MBA at any time such misstatement is known. CARD MBA will only refund all contributions paid by the disqualified member.
To maintain low contribution and to safeguard the association’s funds, CARD MBA will not be liable for any loss (death, disability, hospital confinement) occurring during the first year of membership or within one (1) year from the date of last reinstatement. However, if death or total and permanent disability of member or spouse is caused by a pre-existing condition, two thousand pesos (PhP 2,000.00) will be given.
In case of reinstatement, when a member or any of her legal dependent dies or becomes totally and permanently disabled after one (1) year of waiting period, the length of membership will be based on his/her original date of membership and not on the date of reinstatement.
Any member who fails to pay his/her weekly contribution shall be given a grace period of forty-five (45) days from date of default to remit the contributions.
In case of death, total and permanent disability, or hospital confinement of the member or his/her legal dependent during the grace period, the balance of the contribution in arrears shall automatically be deducted from the benefits payable.
TERMINATION OF INSURANCE COVERAGE
The insurance coverage under the Certificate of Membership shall automatically terminate under the following conditions whichever comes first:
- upon death or total and permanent disability of the member;
- upon resignation from the microfinance institutions and other organized groups affiliated with CARD MBA;
- upon resignation of the member from CARD MBA;
- upon attainment of age 70 of the member;
- upon expiration of the grace period if no payment is received by then; and
- upon termination of membership with cause by CARD MBA
The legal dependent’s coverage is co-terminus with the member’s coverage. Termination of coverage shall be without prejudice to any claim arising prior to such termination.
- Membership may be reactivated provided the member is in good health as certified by a competent physician and as long as the member’s equity value or cash value has not yet been paid. The reinstatement shall take effect upon payment of the required weekly contributions in arrears with interest at the rate of five per cent (5%) per annum.
- Reinstatement can only be performed within a period of three (3) years from the date of lapse. After the three year period, the membership will be cancelled.
- If the member cannot afford to pay all the contributions in arrears, she may pay only one weekly contribution and his/her membership will be reactivated. But the number of days she was in arrears will be deducted in computing the effective number of years of his/her membership.
- The member and his/her legal dependents shall once again undergo one (1) year waiting period from the date of reinstatement.
- Upon death of the member, the designated beneficiary/ies will be indemnified in accordance with the Table of CARD MBA Life Insurance Benefits.
- Upon death of the member’s legal spouse, or any of the member’s single and biological and/or legally adopted children, two weeks old but not more than 21 years old; or biological children over 21 years old, single who is disabled and incapacitated to work, or legal parent of a single (unmarried) member 60 years old and above, the member will receive the life insurance benefits according to the Table of CARD MBA Life Insurance Benefits.
- Pre-existing condition is a condition in which the member or the member’s legal dependent received treatment or has consulted a physician for medical treatment or has been taking medications for twelve (12) months prior to the effective date of membership or twelve (12) months prior to the date of last reinstatement.
- The following sickness shall be considered pre-existing, with or without knowledge of the member, the legal dependent or the beneficiaries, unless sufficient evidence was presented proving that the sickness is acquired after the effective date of membership or date of last reinstatement:
2.2 All tumors involving any body organ or system
2.5 Recurrent tonsillitis
2.6 Pathological abnormalities of the nasal septum and turbinates
2.9 Sinus condition requiring surgery
2.11 Liver cirrhosis
2.13 Anal fistulae
2.15 Calculi of the urinary system
2.16 Gastric or duodenal ulcer
2.17 Hallux valgus
2.18 All tumors of the skin, muscular tissue, breastbone or malignancies of the blood
2.19 Diabetes mellitus
2.21 Collagen disease
2.22 Cardio-vascular disease
2.23 Hormonal dysfunction
Accidental Death Benefits
Upon death of a member due to accident, the designated beneficiary will be indemnified in accordance with the Table of CARD MBA Life Insurance Benefits.
- Accident is defined as a loss as a direct result, independently and exclusively of all other causes, of bodily injury effected solely by external, violent and accidental means of which, except in the case of drowning or if internal injury revealed by an autopsy, there is evidence of a visible contusion or wound on the exterior of the body occurring within one hundred eighty (180) days from date of such injury. (See Mga Dahilan ng Pagkamatay na Hindi Maituturing na Aksidente)
The following causes of death shall not be considered accidental in nature:
2.1 Suicide or any attempt thereat while sane or insane, or any intentionally self-inflicted injury;
2.2 Provoked murder or assault or any attempt thereat;
2.3 Ingested poison, gas or fumes voluntarily or involuntarily taken;
2.4 Accident occurring while or because the Insured is under the influence of alcohol or any unprescribed drug;
2.5 Participation in any brawl or committing any crime or felony;
2.6 While the Insured is serving in the armed forces of any country, or international authority, whether in war or in peace, or while performing his/her job in military or paramilitary services such as police, security guard, barangay officials or as a part of an anti-riot squad;
2.7 Acts of God or Natural Calamities, other than lightning, all losses caused by natural calamities such as but not limited to typhoon, earthquake, landslide, tsunami, tornado, volcanic eruption and the likes shall not be considered accidents;
2.8 War, invasion, act of foreign enemy or warlike operation (whether declared or undeclared), mutiny, strikes, demonstrations, riots, civil commotion, conspiracy, military takeover, state of siege, or any weapon or instrument employing atomic fission or radioactive force whether in time of peace or war; and
2.9 Any loss as a result of medical malpractice.
Vehicular Accident shall refer to any unintended collision of one motorized vehicle with another, a stationary object, or person, resulting in injuries, death and/or loss of property.
There shall be no additional benefit if any of the legal dependent’s cause of death is accidental in nature.
Total and Permanent Disability Benefit
Total and permanent disability (TPD) shall mean disability caused by bodily injury or disease which prevents the member or his/her legal dependents from engaging in any gainful activity and must continue uninterruptedly for at least six (6) months.
There are two types of TPD coverage:
- Disability with dismemberment – The loss of arms or both legs, of one arm and one leg, or of both eyes, shall be considered total and permanent disability. Loss of both arms and both legs shall mean dismemberment by amputation of the entire hand or foot; with respect to eyes, entire and irrevocable loss of sight.
This type TPD can be settled immediately upon submission of complete claims documents and upon approval by the Board of Awards. The amount of benefits will be based on the Table of CARD MBA Life Insurance Benefits.
- Disability without dismemberment – If a member or his/her legal dependent becomes sick or meets an accident without dismemberment resulting to complete inability to engage in any gainful employment and becomes bedridden, s/he can be considered as total and permanently disabled if after six (6) months the health condition has not improved. After such confirmation of a competent doctor, s/he will receive benefits according to the Table of CARD MBA Life Insurance Benefits.
Motor Vehicular Accident Hospitalization Benefits
In case an eligible member or the member’s legal spouse is hospitalized due to vehicular accident occurring after the date of membership and resulting in confinement for at least 24 hours for treatment by a qualified physician, CARD MBA will reimburse the actual medical expenses incurred within six (6) months from the date of accident for such treatment such as hospital charges and nurses fees up to a maximum of ten thousand pesos (Php10,000.00) per married couple. They shall no longer be entitled to this benefit once the maximum benefit of Php10,000.00 has been paid.
Refund of Contributions
All members will be entitled to refund of contribution, depending on their length of membership at the time of death/TPD/resignation/termination:
50% of all contributions made to Life Insurance, regardless of the length of membership plus interest at a rate to be determined by the Board of Trustees in a quarterly basis but in no case less than the prevailing savings deposit rate of the commercial bank.
All benefits availed of prior to the termination of the COM shall not be deducted from the refund of contributions.
Reminder: A member who had received her refund of contribution will be treated as a new member, and will be covered by 1-year contestability period, should the member decide to return to CARD MBA.
Table 4. Mga Dahilan ng Pagkamatay na Hindi Maituturing na Aksidente Talaan ng Benepisyo
Talaan ng Benepisyo