Solidarity in the time of COVID-19 -- MS Supplement

IC urges insurance firms to cover COVID-19 cases

The Insurance Commission urged all insurance companies, mutual benefit associations and health maintenance organizations to extend the coverage of their insurance policies and HMO agreements to customers infected with COVID-19 and related conditions.

Insurance Commissioner Dennis Funa issued a circular urging insurance companies, MBAs and HMOs to waive provisions in their respective contracts and agreements such as waiting periods, healthcare access to non-affiliated networks and exclusion of pandemic or epidemic, among others.

Funa said this request was made considering that these provisions might become barriers to healthcare access and treatment.

He, however, said the implementation of the request addressed to the insurance and HMO industries was on a “voluntary basis to be decided upon by each company on the basis of their respective financial standing.”

Funa earlier issued a circular allowing life insurance companies to launch initiatives that aim to provide additional benefits or free insurance coverage to customers affected by COVID-19 without the need of prior approval from the Insurance Commission. 

Under the Insurance Code, all insurance contracts/policies or any clause, warranty or endorsement attached to a contract/policy should be issued unless the same has been approved by the commissioner.

Funa said considering the gravity of the COVID-19 situation, there was a need to expedite the approval of initiatives designed to provide additional layer of protection to the insuring public to address the immediate need of those affected by COVID-19 and to inspire consumer confidence in the life insurance industry.

He said while there was no need for prior approval from the IC, insurance companies were required to ensure that the initiative would not be used to induce prospective clients or existing policyholders into purchasing a new product from the company.

Funa said that while prior approval of these initiatives was not required, the IC could require companies to recall the same if, at any time after review, there was a finding of violation of or non-compliance with the Insurance Code and pertinent issuances of the IC and without prejudice to the imposition of applicable penalties.

He said to ease the financial burden of the insuring public and to ensure continuous coverage for those affected by COVID-19, all insurance companies, pre-need companies and HMOs should extend a grace period of at least 30 days for the payment of premiums/contributions, installments and/or membership fee that remained unpaid during the period from March 15 to April 13, 2020 or up to a later date deemed appropriate by the respective companies.

Topics: Insurance Commission , insurance companies , mutual benefit associations , health maintenance organizations , coronavirus disease 2019 , COVID-19
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