Document text
[DATE]
VIA [PERSONAL DELIVERY WITH RECEIVING COPY / REGISTERED MAIL WITH RETURN CARD / E-MAIL TO THE CLAIMS ADDRESS]
The Claims Department
[NAME OF INSURANCE COMPANY]
[ADDRESS]
Subject: Death claim — Policy No. [NUMBER], insured [FULL NAME OF INSURED], died [DATE OF DEATH]
Dear Sir/Madam:
I am writing to inform you that [FULL NAME OF INSURED], insured under Policy No. [NUMBER] [AND GROUP / CERTIFICATE NO. [NUMBER]], died on [DATE OF DEATH] at [PLACE]. I am [THE BENEFICIARY NAMED IN THE POLICY / ONE OF THE BENEFICIARIES / THE LEGAL HEIR / THE AUTHORIZED REPRESENTATIVE OF THE BENEFICIARIES], and I hereby present the claim for the proceeds of the policy.
Enclosed are the following:
1. Claimant’s statement on your form, signed;
2. Certified copy of the death certificate (PSA / Local Civil Registry);
3. [ATTENDING PHYSICIAN’S STATEMENT / MEDICAL CERTIFICATE];
4. [POLICE REPORT — if the death was due to an accident];
5. Original policy [OR AFFIDAVIT OF LOSS OF THE POLICY];
6. Valid IDs of the beneficiaries and proof of relationship ([MARRIAGE / BIRTH CERTIFICATES]);
7. [AFFIDAVIT OF LEGAL HEIRS — if no beneficiary is named or the named beneficiary has died];
8. [OTHER DOCUMENTS].
Please acknowledge receipt of this claim in writing, stating the date you received it, and let me know within [SEVEN (7)] days if you need any other document, so that I can provide it promptly.
Under Section 248 of the Insurance Code, as amended, the proceeds of a policy maturing by the death of the insured are to be paid within sixty (60) days after presentation of the claim and filing of the proof of death. I request payment by [BANK TRANSFER TO [ACCOUNT NAME, BANK, ACCOUNT NUMBER] / CHECK PAYABLE TO [NAME]].
You may reach me at [MOBILE NUMBER] and [E-MAIL]. Thank you for your assistance.
Very truly yours,
______________________________ [FULL NAME OF CLAIMANT] [RELATIONSHIP TO THE INSURED] [ADDRESS]
RECEIVED BY (insurer): ____________________ Date and time: __________
FOLLOW-UP — IF NOT PAID WITHIN 60 DAYS
Send only after the 60 days have passed
[DATE]
The Claims Department
[NAME OF INSURANCE COMPANY]
[ADDRESS]
Subject: Request for payment — death claim under Policy No. [NUMBER], presented on [DATE OF CLAIM]
Dear Sir/Madam:
On [DATE OF CLAIM] I presented the death claim under Policy No. [NUMBER] with the proof of death of [FULL NAME OF INSURED], as shown by your receiving copy [AND YOUR ACKNOWLEDGMENT DATED [DATE]]. [I SUBMITTED THE ADDITIONAL DOCUMENTS YOU REQUESTED ON [DATE].] More than sixty (60) days have passed and the claim has not been paid [and I have not received any written explanation].
I respectfully request payment of the proceeds within [FIFTEEN (15)] days from receipt of this letter. Under Section 248 of the Insurance Code, failure to pay within sixty (60) days entitles the beneficiary to interest on the proceeds for the period of delay at twice the ceiling prescribed by the Monetary Board, unless the claim is fraudulent; Section 250 also provides for damages when payment is unreasonably withheld.
If there is a reason for the delay, please explain it in writing and list exactly what is still needed. If the matter remains unresolved, I intend to bring it to the Insurance Commission.
Very truly yours,
______________________________ [FULL NAME OF CLAIMANT] [MOBILE NUMBER] · [E-MAIL]
NOTES — delete this page before sending
• Insurance Code (PD 612 as amended by RA 10607): Sec. 248 — 60 days after presentation of the claim and filing of proof of death; interest at twice the Monetary Board ceiling for the delay unless the claim is fraudulent. Sec. 250 — damages, attorney’s fees and interest if payment is unreasonably denied or withheld. Sec. 439 — the Insurance Commission adjudicates claims up to ₱5,000,000.
• Count the 60 days from the day the insurer received the complete claim and proof of death. Keep the receiving copy.
• Contestability: within the first two years of a policy the insurer may investigate misrepresentation; a denial on that ground needs a lawyer’s review.
• Before sending the follow-up or any complaint, have a lawyer review the facts and the interest you claim.
Field labels in [SQUARE BRACKETS, CAPITALS] must be completed or deleted. Alternatives are separated by a slash. © Layers (layers.md), licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Template and deadlines for information only — check your own case with the agency or insurer, and have documents with legal effect reviewed by a lawyer. Not legal advice.
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Template — check your case with the agency; review by a lawyer. Not legal advice. © Layers (layers.md) · CC BY 4.0