AXA Hospital Assist

Hospital Assist is a microinsurance package from AXA. It provides financial protection and health benefits to help cover unexpected medical and life events, such as hospitalization, surgery, accidents, or death.

 

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Coverage of Hospital Assist

  • Term Life Insurance: Pays a benefit if the insured passes away due to an accident or illness except in case of suicide within one (1) year from the later of the Member’s effective date or the date of last reinstatement, if any, of his/her individual insurance coverage.
  • Personal Accident: Pays a benefit if the insured passes away or gets permanently disabled due to an accident.
  • Daily Hospital Income Benefit: Pays a benefit per day in the event the insured gets confined in a hospital for at least two consecutive nights due to an illness or an accident.
  • Lump Sum Surgical Benefit: Pays a lump sum benefit if the insured undergoes a necessary operation while confined in the hospital for at least two nights.

 

Eligibility

  • Must be 18 to 64 years old.
  • Must be a fully verified GCash user.
  • Only one policy per person; you cannot purchase for someone else.

 

Exclusions and Limitations

AXA shall not provide cover and not be liable to pay any claim or provide any benefit hereunder to the extent that the provision of such cover, payment of such claim, or provision of such benefit would expose AXA to any sanction, prohibition or restriction under United Nations resolutions or the trade or economic sanctions, laws or regulations of the European Union, United Kingdom or United States of America.

For Daily Hospital Income (DHI) benefit

This benefit will not be paid if hospital confinement is caused by:

  1. Suicide or self-inflicted injuries;
  2. Active war, active terrorism, or riots; or,
  3. Illegal or criminal acts committed by the Member punishable under the Revised Penal Code, as amended, (Act No. 3815) or special penal laws; or
  4. Happens within the 15-day Waiting period. Waiting period is defined as the length of time after the later of the initial Effective Date of insurance or the Date of Reinstatement of insurance, which no benefits are payable.

 

For Surgical benefit

This benefit will not be paid if the operation is caused by the following or fall under the following surgeries:

  1. Suicide or self-inflicted injuries;
  2. Active war, active terrorism, or riots; or,
  3. Illegal or criminal acts committed by the Member punishable under the Revised Penal Code, as amended, (Act No. 3815) or special penal laws;
  4. Surgeries for injuries resulting from the Member's attempt to commit an unlawful act or any offense punishable by law, whether by imprisonment or fine;
  5. Outpatient surgeries; or,
  6. Plastic or cosmetic surgery that is not associated with an accident or illness or is not associated with the follow-up to previous surgery due to a disease, and this surgery is without medical necessity that threatens the health and life of the Member.

 

For Term Life benefit

This benefit will not be paid if the insured passed away due to suicide within one (1) year from the later of the effective date or the date of last reinstatement, if any.

For Accidental Death and Disablement benefit

This benefit will not be paid if the death or disablement is caused by:

  1. Suicide or self-inflicted injuries;
  2. Active war, active terrorism, or riots; or,
  3. Illegal or criminal acts committed by the Member punishable under the Revised Penal Code, as amended, (Act No. 3815) or special penal laws.

 

 

How to Enroll in Hospital Assist

  1. Open the GCash app and tap GInsure.
  2. Select the Health category and choose AXA Hospital Assist.
  3. Provide consent for information collection by tapping Agree.
  4. Enter your personal details and proceed to get a quote.
  5. Select the desired product tier and tap Avail.
  6. Review your details and the terms & conditions, then tap SUSUNOD: PAYMENT.
  7. After payment, you will receive your policy number and a welcome SMS/email from AXA Philippines.

Insurance coverage starts on the date of initial payment and is effective for one year, regardless of payment mode. You can view the details of your policy in your insurance certificate. Go to the enrollment confirmation page and tap “Request copy of COI”.

To update your beneficiary information, please fill out this form.

 

Claims

Note: If a claim was filed within the 45-day grace period, the claim will not be processed until outstanding premiums are paid.

Claim Requirements

DHI Benefit
  1. Valid ID of GCash member
  2. Proof of Bank/GCash/Paymaya account
  3. Itemized Hospital Statement of account/Hospital document which states: 
    • Start date of confinement
    • Discharge date
    • Diagnosis
    • Type of hospital stay (e.g. regular room or ICU)
    • You may need to submit a Hospital SOA as well as a Medical certificate if these details are not all found in the Hospital SOA.
       
Lump Sum Surgical Benefit
  1. Valid ID of GCash member
  2. Proof of Bank/GCash/Paymaya account
  3. Itemized Hospital Statement of account/ Hospital document which states:
    • Start date of confinement
    • Discharge date
    • Diagnosis
    • Type of hospital stay (e.g. regular room or IC)
  4. Proof of Operation/ Surgical Abstract

The Lump Sum Surgical benefit must be filed separately from the DHI benefit 
 

Personal Accident
  1. Valid ID of GCash member
  2. Proof of Bank/GCash/Paymaya account
  3. Police investigation report

 

Life Insurance (Death) Benefit
  1. Valid ID of Beneficiary
  2. Proof of Bank/GCash/Paymaya account
  3. PSA Copy or Civil Registered copy of Death Certificate of insured member
  4. Police investigation report, if death was due to an accident
  5. Medical Records, if death was due to an illness
  6. Proof of relationship
    • Marriage contract – if the Beneficiary is the spouse of the Insured member
    • Birth certificate of the Insured – if the Beneficiary is the parent of the Insured member
    • Birth certificate of the Beneficiary – if the Beneficiary is the child of the Insured member

 

How to file for a claim

  1. On the GInsure page, tap the MyGInsure tab, and select the AXA product purchased.
  2. Enter your mobile number/OTP to verify.
  3. Tap My Policies and select the policy and benefit that you want to claim.      
  4. Answer the information needed and tap Submit.      
  5. An email informing you of your successful claim submission as well as your claim details will be seen on your registered email address.
  6. You/Your beneficiary will receive an SMS notification from AXA PH once a decision has been made. If approved, your claim will be paid within 10 business days through your nominated bank account or GCash upon receipt of the complete claim requirements by AXA. Information about additional documents to be submitted will be requested from you by AXA through SMS or email.

 

Cancellations

You should cancel your policy within 15 days from the insurance effective date to receive a refund. After 15 days from policy's effective date, you may still cancel, but no refund shall be received.

To cancel your policy:

  1. Go to the MyGInsure page in GInsure and tap the AXA policy you want to cancel.
  2. Tap My Policies and tap “CANCEL POLICY” on the policy that you want to cancel.
  3. Answer all the necessary information.
  4. After you submit your information, your policy is CANCELLED. Refund will be automatically credited to your GCash account, given that the policy is within the 15-day free look period from your policy's effectivity date.

 

Contact

If you have questions about your policy, filing of claims, or status of claims filed, please fill out the Customer Help Form. The customer servicing partner, InsuranceKo, will get back to you via SMS or phone call within 7 days. Office hours: 8:00AM to 5:00PM, Monday to Friday.

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