Document text
[Date]
[Insurer name]
Attention: Claims Department and Consumer Assistance Team
[Address]
Sent by: [Delivery method]
Re: Policy No. [Policy number], claim for loss of [Date of loss]
Dear Sir or Madam:
I am the insured under the policy above. You received my proof of loss on [Date proof received]. My claim is for PHP [Amount claimed].
[Number] days have passed since then. [Choose one: The amount of the loss has not been agreed. / The amount of the loss was agreed on [Date agreed].]
Under Section 249 of the Insurance Code, as amended by R.A. 10607, a loss for which an insurer is liable must be paid within 30 days after proof of loss is received and the loss is ascertained by agreement or arbitration. If it is not ascertained within 60 days after that receipt, it must be paid within 90 days after that receipt.
Within [Number of days] days of receiving this letter, please either pay PHP [Amount claimed] or tell me in writing why you have not paid. If you consider my proof of loss incomplete, please state exactly what is missing.
Please also treat this letter as a complaint under your consumer assistance process.
I reserve my rights under the Insurance Code, including interest and other amounts under Sections 249 and 250.
If this is not resolved, I may ask the Insurance Commission for assistance or take other steps open to me.
Sincerely,
[Your name]
[Mobile and email]
Enclosed: [Policy copy, proof of loss, proof of receipt, other papers]
For you: not part of the letter, remove this page
– Before you send, work out your date. Amount agreed: 30 days. Not agreed within 60 days of receipt: day 90 after the insurer received your proof of loss. Before that date your insurer may still be in time. You can still write, but do not say it is late.
– Life policy maturing by death: use this instead of the Section 249 paragraph: “Under Section 248 of the Insurance Code, as amended by R.A. 10607, the proceeds of a policy maturing by death must be paid within 60 days after presentation of the claim and filing of the proof of death.”
– Your deadline in this letter is a request. The law sets no time to answer it.
– Late payment: interest at twice the ceiling set by the Monetary Board, unless the refusal is based on the ground that the claim is fraudulent (Secs. 248, 249).
– Not paying in time is prima facie evidence of unreasonable delay. In a case, attorney’s fees and expenses can follow (Sec. 250).
– Time to sue: a policy cannot give you under 1 year from when the cause of action accrues (Sec. 63). The Supreme Court counts it from the insurer’s rejection, and asking it to reconsider does not stop the clock. Check your policy.
– Insurance Commission: an Assistance Form or a complaint letter, by mail, in person or to publicassistance@insurance.gov.ph, with the policy copy, any denial letter and your papers. Mediation there is free and optional.
– Formal claim: a Statement of Claims (up to ₱1,000,000) or a verified complaint, with a certificate of non-forum shopping and a docket fee. The Commission decides claims up to ₱5,000,000, and filing there bars a court case on the same matter (Sec. 439).
– Compulsory motor cover (CTPL) has its own rules: up to ₱30,000 per person without proving fault, written notice within 6 months of the accident, and any case within 1 year of denial (Secs. 391, 397; IMC 2024-01).
– Claim only what is true: presenting a fraudulent claim is an offence (Sec. 251). Sending this letter does not guarantee payment. Your policy and the facts decide your case.
Source: Insurance Code as amended by R.A. 10607, Secs. 63, 90, 92, 248–251, 391, 397, 439, lawphil.net; G.R. 257086 (2025); IMC 2023-01, IMC 2024-01; Insurance Commission Citizen’s Charter 2026, Assistance Form Rev. 4. bsp.gov.ph did not open, so the interest rate is not stated. Checked 02.11.2026. Not legal advice.