Frequently Asked Questions

All regular, full-time and actively at work employees who are at least 18 years old and no more than 65 years old are eligible members.

The amount of Life Insurance cover is determined by the employer. Cover may be a fixed amount or multiples of monthly basic salary

No, as the amount of cover is determined by the employer and should be consistent with the other levels in the company.

No, as this is a term life insurance or purely protection thus, no cash or loan values are accumulated.

No Evidence Limit (NEL), also called Free Cover Limit, is the maximum amount of insurance cover for a member which no evidence of insurability is required to be accepted in the policy.

If the amount of cover is beyond the NEL, the amount in excess will be subject to underwriting. Evidence of insurability, such as submission of an accomplished Medical Health Questionnaire or undergoing medical examination, will be evaluated by Generali’s Medical Director to determine if the member may be accepted as a standard or substandard risk, or to postpone or decline the amount of cover beyond the NEL.

The additional amount of cover beyond the NEL shall take effect on the date of approval of Generali’s Medical Director.

In case a member is unable to comply with the evidence of insurability, the obligation of Generali is limited to the current amount of cover that has been approved.

Generali will shoulder the medical examination expenses as long as it is done in one of Generali’s accredited clinics.

In case a member requests for repeat/additional tests, these shall be for the account of the member.

All causes of death are covered.

For suicide cases, if a member commits suicide within one year from the date of issue/reinstatement of his insurance, provided however, that the employee is then sane, Generali’s liability is just the return of premiums for the period mentioned.

A member remains covered as long as they continue to be employed with their employer and remains to be eligible.

You can no longer continue coverage under the Group Life Insurance as coverage is co-terminus with the employment.

However, each member has the privilege to convert his life insurance into an ordinary life insurance policy without showing evidence of insurability within 31 days from the date of separation. Furthermore, amount of cover should not be more than the latest coverage under the group policy and there are no riders to be attached to an ordinary individual insurance plan.

An insured member shall have the right to designate anybody, not disqualified by law, as his beneficiary or beneficiaries

The beneficiary/ies will receive the death benefit within 14 working days from Generali’s receipt of complete claim documents

All regular, full-time and actively at work employees who are at least 18 years old and no more than 65 years old are eligible.

Eligible dependents of above eligible employees may also be enrolled in the plan. If premium is to be paid by the employer, 100% of the dependents should be enrolled. If premiums will be shared between employee and employer, a minimum of 75% participation of eligible employees should enroll their dependents.

The amount of Medical Insurance cover is determined by the employer.

No, as the amount of cover is determined by the employer and should be consistent with the amounts set for other levels in the company.

Any illness which is proven to be related or is a complication of an illness shall share the same benefit limit as its root disease.

You may check the list of doctors and their schedules here OR you may call our Alarm Center

Since the Doctors’ lists and/or schedules are updated regularly by our Providers, it is not advisable to provide members a copy of the doctors’ list. However, you may check the most updated list of doctors and their schedules here OR you may call our Alarm Center.

Generali will reimburse the actual customary, reasonable expenses had member availed services with an accredited doctor, up to the limits of the plan.

You may request for doctor accreditation by writing us through your HR. The doctor may be accredited upon compliance to the Generali credentialing criteria, when approved by our medical coordinator and if he/she is amenable to the payment terms & conditions of our contract.

The member may occupy a room category higher than his R&B limit. Please note that because of socialized pricing in hospitals, staying in a more expensive room will also make the other services more expensive. As a result, the member may incur excess amounts over his plan limits and such excess amounts will have to be paid prior to discharge from the hospital.

If a member is treated in a non-accredited hospital, Generali will reimburse the actual, customary, and reasonable expenses had member availed of services in an accredited hospital with an accredited doctor, subject to the limits of the plan.

It is the member’s responsibility to file the Philhealth form. If you fail to file it, you will shoulder the amount corresponding to your Philhealth benefit.

Injuries sustained in vehicular accidents and other medico-legal cases (shooting, stabbing et al) are not automatically covered. The member needs to submit a police report and other pertinent documents subject to our evaluation. Generali will not cover your medical expenses if it is proven that the injury is sustained due to causes that are exclusions/limitations of the plan (i.e. while in violation of any law).

Submission of the duly accomplished Generali claim form and other requirements is within 90 days from the date of discharge from the hospital or from the date of treatment. Generali will process and send the reimbursement to the employee within 14 working days from receipt of complete claim documents.

The membership card serves as member identification during availment with our Providers (hospitals, clinics and doctors), which is required to validate if member is eligible for coverage. Once the membership card is swiped in the POS terminal, it will generate a print-out called LOE (Letter of Eligibility).

If a member loses his network card, he may coordinate with his employer’s HR representative for the card replacement. Generali will replace the card subject to a fee of Ph100.

A member’s medical plan is co-terminus with his stay in the company. The member should surrender his card and his dependents’ card, if applicable, before separation/resignation as part of the clearance requirement.

The Alarm Center (AC) is the call center servicing arm of the Generali Provider Network headed by a Doctor and manned by agents who are registered nurses or paramedical staff. They are responsible in assisting the members during a medical availment.

You may send your feedback or concern through your employer. For urgent concerns, the member may call or send us a message through Generali’s Alarm Center 24/7 Personalized Service Medical Hotline Nos. for immediate assistance. Contact details are also indicated at the back of the network cards. The member should give complete information so that Generali can address the matter as quickly as possible.

A member remains covered as long as he continues to be employed with his employer and remains eligible.

You can no longer continue coverage under the Group Medical Insurance as coverage is co-terminus with your employment.