Wednesday, December 30, 2009

6th International Microinsurance Conference to be held in Manila, November 2010

For more information, click on this link

National Strategy

Republic of the Philippines
National Strategy for MICROINSURANCE
_______________________________________

A. Background

The Philippine Medium Term Development Plan (MTDP) recognizes the role of government to put appropriate safety nets and risk protection for the poor. “The poor and marginalized groups in the Philippines face various risks – temporary and permanent loss of employment, inability to cope with abrupt changes in the prices of basic commodities, illness and physical injury, violence and the lack of peace and order, old age, etc. Occasionally, they are confronted with shocks arising from natural disasters and abrupt swings in the macro economy. . . Protecting the poor and vulnerable groups is imperative in winning the battle against poverty within the decade.” (MTDP 2001-2010, chapter 13). One way to do this is to ensure that the poor are given access to financial services in general, and insurance in particular.

In line with its policy thrust of rationalizing public spending for social services and less government intervention in activities that could best be implemented by the private sector, the government issued the National Strategy for Microfinance in 1997, which further supports the following key policy direction espoused in the MTDP: “Inefficient or regressive spending and subsidies are being phased out and instead, markets are made to work better for poor people.” (MTDP 2001-2010, chapter 13). To do this, the MTDP also clearly highlights the need to “Develop mechanisms to involve the private sector actively in the provision of services and other assistance to the poverty areas identified by government using innovative and sustainable models available both locally and internationally.”

Recognizing the importance of appropriate risk protection for the poor, the government through the Department of Finance-National Credit Council (NCC), and in coordination with the Insurance Commission (IC) and other regulatory authorities [Bangko Sentral ng Pilipinas (BSP), Securities and Exchange Commission (SEC) and the Cooperative Development Authority (CDA)] as well as the private sector engaged in the provision of insurance products and services, initiated the formulation of a National Strategy to develop an insurance market for the poor.

Consistent with the vision and key strategies espoused in the National Strategy for Microfinance that was issued in 1997 , the National Strategy for Microinsurance defines the objective, the roles of the various stakeholders and the key strategies to be pursued in enhancing access to insurance of the poor. It also discusses health insurance for the poor in the context of social protection. Strategies to encourage complementation of the products of PhilHealth by the private sector are also discussed. It also provides directions towards mainstreaming informal insurance and insurance-like activities and the promotion of public awareness and financial literacy.

B. Vision and Objective: Appropriate Risk Protection for the Poor

The National Strategy for Microfinance articulated the vision “to have a viable and sustainable private micro (financial) market with the government providing a supportive and appropriate policy environment to the market.” Along this line, the market for financial products and services that provides appropriate risk protection for the poor (i.e. microinsurance ) will be developed.
The objective is to provide the poor increased access to microinsurance products and services. This will be achieved through the adoption and implementation of the following key policy strategies:

a. Increased participation of the private sector in the provision of microinsurance services;

b. Establishment of an appropriate policy and regulatory environment for the safe and sound provision of microinsurance by the private sector;

c. Mainstreaming of informal insurance, insurance-like, and other similar activities/schemes; and

d. Institutionalization of financial literacy (learning/education) that will highlight the importance of microinsurance, the applicable rules and regulations, the duties and responsibilities of the providers, and the rights of the insured.

C. Key Stakeholders

The development of an insurance market for the poor requires the participation of all key stakeholders from both the government and the private sector. To ensure that the objective of increased access of the poor for risk protection is attained, it is imperative for key stakeholders to focus on roles where they have distinct and comparative advantage. Their respective roles are as follows:

a. Government

Government shall support and encourage the participation of private insurance providers in offering appropriate risk protection to the poor. Government instrumentalities shall focus on the following:

i. Policy and Regulatory Agencies

1. Provide the enabling policy and regulatory environment to encourage private sector participation in the delivery of Microinsurance products and services;

2. Establish appropriate policy and regulatory measures supportive of financial inclusion; and

3. Identify options and develop guidelines for mainstreaming informal insurance and insurance-like schemes.

ii. Other National Agencies and Instrumentalities

1. Establish networks and linkages with microinsurance providers for the effective and efficient delivery of microinsurance to their constituents; and

2. Provide basic support services such as infrastructure, health services, education and maintenance of peace and order to mitigate the poor’s exposure to risks.

iii. Local Government Units (LGUs)

1. Encourage and collaborate with the private sector on the provision of microinsurance to their local constituents; and

2. Establish support mechanisms (linkages, information and public assistance desks, financial literacy campaigns, etc.) that will increase public awareness and access to microinsurance products and services by the poor.

iv. Social Insurance Providers

1. Make available to the poor social protection from risks that are not normally covered by the private sector;

2. Collaborate with LGUs and other concerned government agencies in providing subsidies in the provision of social microinsurance to identified indigents deserving of the subsidies; and

3. Develop mechanisms to partner with private insurance providers in lowering out-of-pocket expenses for health insurance of the poor.

b. Insurance and insurance-like providers

Private insurance and insurance-like providers shall take the lead role in directly providing microinsurance products and services to the poor. These are the life and non-life insurance companies, Cooperative Insurance Societies (CIS), Insurance/Service Cooperatives, Mutual Benefit Associations (MBAs), pre-need companies and Health Maintenance Organizations (HMOs). They shall:

i. Provide sound and viable microinsurance products and services;

ii. Engage in sustainable operations following principles of good governance, prudential standards and appropriate regulations;

iii. Develop simple, affordable and innovative microinsurance products and services tailor fitted to the needs of the poor;

iv. Complement social insurance products and services provided by government-run social insurance providers; and

v. Increase outreach at the least cost through partnership and networking with community based organizations, Microfinance Institutions (MFIs), social insurance providers, LGUs and other concerned government agencies.

c. Intermediaries

Intermediaries refer to entities or individuals such as brokers and agents that shall facilitate the provision of insurance services by licensed insurance providers. Brokers act on behalf of the clients in the purchase of insurance products while agents, on the other hand, act on behalf of the insurance companies in the solicitation of insurance business. Intermediaries shall:

i. Provide appropriate and reliable delivery and support mechanisms to facilitate microinsurance transactions including claims;

ii. Increase outreach at the least cost and most efficient manner; and

iii. Actively engage in information dissemination and educational activities that will increase the awareness of the poor on the benefits and risk-protection features of specific microinsurance products and services.

d. Support institutions

Support institutions shall provide the necessary support services and assistance to build the capacity of key stakeholders in microinsurance. These institutions shall include the following: academic and research entities, Business Process Outsourcing (BPO) companies, training and technical assistance service providers, networks and associations, media, foundations and other service providers. Support institutions shall:

i. Promote public awareness and education;

ii. Provide technical assistance, capacity building and training programs for providers, government institutions and other stakeholders;

iii. Conduct policy and market research, business development studies and advocacies; and

iv. Develop appropriate business solutions for efficient delivery of Microinsurance products and services.

e. Development partners

Development partners are international organizations, be it publicly or privately owned, and individuals of good reputation that support the development thrusts of the government. Development partners shall:

i. Support financial inclusion policy and regulatory initiatives of the Government, including local government units, that will encourage and strengthen private sector participation, and at the same time protect the poor from unsafe and fraudulent insurance schemes. Such support and assistance shall include building capacities of government entities in formulating and implementing appropriate prudential requirements and standards, and in promoting public-private sector collaboration in social insurance schemes;

ii. Assist in setting up and institutionalizing an information database at the local and national levels that will be used for the development of microinsurance products; and

iii. Provide technical assistance to the private sector on products development, distribution channel innovations, training and capacity building, financial literacy, information campaign, knowledge management, impact assessment, and operating systems and procedures enhancement.

D. The Strategies to be pursued

To realize the objective of providing poor households and microenterprises greater access to microinsurance products and services, the following specific strategies shall be pursued:

a. Provision of an appropriate policy and regulatory environment that is conducive to the effective and efficient functioning of the private microinsurance market. Such environment shall be established to encourage increased private sector participation in the provision of microinsurance products and services. This shall be done by:

i. Formulating prudential requirements and guidelines appropriate for delivery of microinsurance products and services;

ii. Establishing performance standards that will guide the operations of microinsurance providers;

iii. Developing policies and guidelines for the private sector to complement products and services of social insurance programs of Government such as the Philippine Health Insurance Corporation (PhilHealth) and the Philippine Crop Insurance Corporation (PCIC),; and

iv. Providing regulatory space for innovative electronic payment systems and infrastructures to improve efficiency and to lower the cost of transactions in the delivery of microinsurance products and services.

b. Mainstreaming informal insurance. Informal schemes refer to in-house insurance schemes developed and implemented by entities that do not have any license from the Insurance Commission nor any other appropriate regulatory body. To ensure the safe and sound provision of microinsurance products and services, entities engaged in the provision of informal insurance activities (i.e. doing self-insurance) shall be required to formalize such activities within a specified period of time. Government shall:

i. Provide the following options for formalization.

1. Partnership with formal insurance providers and intermediaries through the purchase of individual/group insurance policies either directly from an insurance provider or through an intermediary;

2. Becoming a duly licensed agent or broker;

3. Joining a Mutual Benefit Association (MBA) or a Cooperative Insurance Provider. Cooperatives may apply as members in an existing Cooperative Insurance Society, while individuals may apply as members in an MBA or in an Insurance/Service Cooperative engaged in insurance business.

4. Setting up of any of the following licensed Insurance Entities:

a. Life or Non-life insurance company;
b. Mutual Benefit Association; or
c. Cooperative Insurance Society or as an Insurance/Service Cooperative that is engaged in insurance business.


ii. Provide clear rules and guidelines on collaboration and exchange of information among government regulatory bodies to ensure that informal insurance schemes are under the coverage of the regulatory environment within a specified period of time.

iii. Provide appropriate support systems to formalization through:

1. Information dissemination and advocacy campaign on policies and guidelines to formalization by the concerned regulatory bodies in collaboration with appropriate stakeholders;

2. Capacity building and training for microinsurance providers by support institutions with the assistance of development partners with specific focus on the following:

a. Development of products that will meet the needs of the clients; and

b. Provision of enhanced benefits, business opportunities and/or assured protection to entities mainstreaming their informal insurance activities.

c. Institutionalization of Financial Literacy. Public awareness and education campaign on the importance of microinsurance shall be carried out among key stakeholders. This shall focus on the following: appropriate risk protection; microinsurance policies and regulations; duties and responsibilities of providers; and rights and benefits of clients. The target audience for financial literacy on microinsurance shall include the following:

1. Legislators
2. National and local government officials
3. Insurance and insurance-like providers
4. Intermediaries
5. Wholesale and retail Micro Finance Institutions
6. Existing and potential clients/consumers
7. International development/donor agencies
8. Support institutions


Financial Literacy on microinsurance shall be pursued by:

1. Using tri-media that include print, radio and television;

2. Building capacities of key stakeholders in ensuring the safe and sound provision of microinsurance products and services through the conduct of seminars, conferences, trainings and workshops including exposure visits;

3. Institutionalizing activities on financial literacy within major stakeholders;

4. Establishing networks and linkages between and among support institutions engaged in the financial literacy campaign; and/or

5. Establishing a critical mass of advocates on financial literacy in both the government and the private sector;

A national framework on Financial Literacy for Microinsurance shall be formulated. The framework shall provide the key policies and strategies to be pursued, measures to be adopted as well as the activities to be implemented to ensure that both the microinsurance providers and clients understand their respective roles, rights and responsibilities and that the latter are given appropriate protection.
In a study entitled Making Insurance Markets Work for the Poor: Microinsurance Policy Regulation and Supervision – Philippines Case Study, it was reported that as of 2006, the microinsurance market in the country covers an estimated 2.9 million adults (about 5.4 percent of the adult population), almost half of which (41 percent), are provided by the informal market. Informal micro insurance market is comprised of registered and unregistered institutions that provide insurance, insurance-like, and other similar products and services to the poor without any license from the concerned regulatory authority.
Social insurance programs such as those administered and implemented by PhilHealth, Government Service Insurance System (GSIS), and Social Security System (SSS), even when provided to the same clients (i.e. the poor) are not covered in this framework.

Regulatory Framework

Regulatory Framework

for Microinsurance

1. Background

The development of the Philippine Microfinance Industry proved that the provision of formal financial services, particularly savings and credit, to the poor is a viable and sustainable activity. A large number of private financial institutions, notably rural, cooperative and thrift banks, cooperatives and non-government organizations, including commercial banks acting as wholesaler of microfinance funds, are now actively engaged in providing the poor greater access to micro credit to finance their livelihood and small business activities. This development presented a vast opportunity for the poor to improve their lives, increase their income and build on their assets. However, it has been realized that micro credit does not protect the low-income from unforeseen and unfortunate events that may adversely affect their livelihood, lives and families.

The poor, compared to the other sectors, greatly needs risk protection against death, injury and illness, loss of property, and other contingent events. Without any risk protection, the poor are very vulnerable and susceptible to unforeseen circumstances that will prevent them and their dependents from improving their lives and overcoming poverty once it happens.

The government, private sector insurance providers (including other entities providing insurance-like and other similar products and services) and microfinance institutions (MFIs) are becoming increasingly aware of the need for additional financial services for the poor, i.e. insurance products for risk protection that are timely, reliable, dependable, affordable and accessible. To attain this objective, current delivery mechanisms of insurance products will have to be improved at the least cost while microinsurance products will have to be developed to be affordable. These will entail innovations and improvements on the varied insurance modalities, delivery channels and schemes to meet this end while at the same time protecting the disadvantaged against unreasonable, fraudulent and unscrupulous acts.

This framework outlines the government’s policy thrusts and direction for the establishment of a policy and regulatory environment that will encourage, enhance and facilitate the safe and sound provision of microinsurance products and services by the private sector. It will also identify and promote a system that will protect the rights and privileges of those who are insured. Ultimately, trust and confidence on the insurance industry and other providers of insurance-like and other similar products as a whole will be enhanced.

2. The Vision: Appropriate Risk Protection for the Poor

The National Strategy for Microfinance articulated the vision “… to have a viable and sustainable private micro (financial) market with the government providing a supportive and appropriate policy environment to the market. The objective is to provide access to financial services (microinsurance included) to the majority of the poor households and microenterprises”.

In accordance with this, a viable and sustainable private insurance market for the poor is envisioned. This will be achieved using the following key strategies:

2.1. Increased participation of the private sector in the provision of microinsurance services;

2.2. Establishment of an appropriate policy and regulatory environment for the safe and sound provision of microinsurance by the private sector;

2.3. Mainstreaming of existing informal insurance, insurance-like, and other similar activities/schemes: and

2.4. Institutionalization of financial literacy (learning/education) program that will highlight the importance of microinsurance, the applicable rules and regulations, the duties and responsibilities of the providers, and the consumer rights of the insured.

3. The Scope of the Regulatory Framework

This regulatory framework covers the provision of insurance, insurance-like and other similar activities as may be defined by the concerned regulatory bodies that cover the risk protection needs of the poor by the private sector. It does not cover social insurance schemes and risk protection programs administered and implemented by government[1].

4. The Objective of the Regulatory Framework

This framework will provide a policy and regulatory environment that will facilitate the participation of the private sector in providing risk protection for the poor and ensure that the rights and privileges of the insured poor will be protected and promptly acted upon. The framework also gives insurance providers flexibility to put in place the necessary safeguards against fraudulent and scrupulous claims.

Specific regulatory concerns will be addressed to attain this objective and, given a huge informal market for microinsurance,[2] it will provide a formalization path for existing informal providers to transform themselves into formal microinsurance providers.

5. What is Microinsurance

The term “microinsurance” refers to the insurance, insurance-like and other similar business activity of providing specific products and services that meet the needs of the poor [3] for risk protection and relief against distress, misfortune or contingent event. Since microinsurance products and services are intended to meet the risk protection needs of the low-income sector, affordability of premium payments is a major consideration. To ensure this, the nature and features of a microinsurance product is defined in this framework to minimize and limit underwriting risks[4].

Microinsurance is therefore defined as follows[5]:

5.1. Microinsurance is an activity providing specific insurance, insurance-like and other similar products and services that meet the needs of the low-income sector for risk protection and relief against distress, misfortune and other contingent events. This shall include all forms of insurance, insurance–like and other similar activities, as may be defined by concerned regulatory bodies, with the following features:

5.1.1 Premiums, contributions, fees or charges are collected/deducted prior to the occurrence of a contingent event; and

5.1.2 Guaranteed benefits are provided upon occurrence of a contingent event.

5.2. Microinsurance product is a financial product or service that meets the risk protection needs of the poor where:

5.2.1. The amount of premiums, contributions, fees or charges, computed on a daily basis, does not exceed five (5) percent of the current daily minimum wage rate for non-agricultural workers in Metro Manila[6]; and

5.2.2. The maximum sum of guaranteed benefits is not more than 500 times the daily minimum wage rate for non-agricultural workers in Metro Manila[7].

5.3. All microinsurance contracts shall clearly state the benefits and terms of coverage. In this regard, all microinsurance providers shall ensure the following:

5.3.1. The contract provisions can be easily understood by the insured and printed in English and/or Pilipino ;

5.3.2. The documentation requirements are simple; and

5.3.3. The manner and frequency of collection of premiums, contributions, fees or charges coincide with the cash flows of the insured and are not onerous.

5.4. The key features of a microinsurance contract are provided for in Appendix 1 of this Framework.

5.5. The regulatory authorities shall issue appropriate circulars prescribing the features of microinsurance products and simplified microinsurance contracts. Existing documentary requirements shall likewise be reviewed and revised when needed to make sure that the requirements are applicable to the low-income sector.

6. Who Can Provide Microinsurance Contracts

6.1 Insurance, insurance-like, and other similar activities that satisfy the conditions set forth in Section 5 and providing a microinsurance product shall only be undertaken by entities registered and licensed by appropriate government regulatory bodies. These entities shall include but are not limited to any of the following:

6.1.1 Commercial Life Insurance Companies

6.1.2 Commercial Non-life Insurance Companies

6.1.3 Mutual Benefit Associations

6.1.4 Cooperative Insurance Societies

6.1.5 Pre-need Companies

6.1.6 Health Maintenance Organizations

6.2 These entities may offer bundled microinsurance products (e.g. life, non-life insurance, health maintenance and/or pre-need products) provided that:

6.2.1 The bundled product only includes microinsurance products.

6.2.2 The contract specifies that the lead microinsurance provider shall assume the liability for the bundled microinsurance products or services.

6.3 Mutual Benefit Associations (MBAs) are only allowed to provide insurance coverage to their members and their immediate family members as provided for in Item IA of Appendix 1. The Cooperative Insurance Societies can only serve the insurance needs of their primary cooperative member-owners, their individual members and their immediate family members as also provided for in Item IA of Appendix 1. Both entities are not allowed to transact insurance business with the general public.

6.4 Cooperative Insurance Societies (CIS) are not allowed to serve the insurance needs of other cooperatives that are not member-owners of the CIS. A CIS serving the insurance needs of non-member cooperatives and the general public shall be required to get a commercial insurance license from the Insurance Commission.

6.5 All entities providing microinsurance, as defined and described in Section 5, that are not licensed by the appropriate regulatory body but are still going to provide microinsurance products shall formalize their operations within one (1) year from the issuance of the appropriate circular by the concerned regulatory authority, using the following options:

6.5.1 Partner with licensed microinsurance providers as enumerated in Section 6.1;

6.5.2 Buy a microinsurance product through a licensed agent or broker; or

6.5.3 Join an existing MBA or CIS.

6.6 Entities may also opt to organize their own microinsurance entity, in which case they shall secure appropriate license within two (2) years from the issuance of the appropriate circular by the concerned regulatory authority.

Government regulatory bodies shall collaborate and exchange information to ensure that informal insurance and insurance-like activities are under the coverage of the regulatory environment in order to minimize regulatory arbitrage among regulated entities.

7 What is Required of Microinsurance Providers

7.1 Prudential Requirements

7.1.1 All entities registered and licensed to provide microinsurance products as indicated in Section 6.1 shall comply with the prudential requirements of the concerned regulatory authority.

7.1.2 Regulatory requirements for products approval, solvency, capitalization/guaranty fund, net worth, investments and reserves shall be complied with by all entities providing microinsurance products.

7.1.3 Considering the limited risks associated with microinsurance, concerned regulatory authorities shall create a special regulatory space for microinsurance providers as follows:

7.1.3.1 Lower guaranty fund requirement for MBAs wholly engaged in microinsurance.Guaranty fund requirement for these entities shall be lower than what is required for regular MBAs. The guaranty fund shall, however, be fully funded by the members;

7.1.3.2 Lower capitalization requirement for Commercial Insurance Companies and Cooperative Insurance Societies wholly engaged in microinsurance. Capitalization requirements shall not be lower than fifty percent (50%) of what is required for domestic insurance companies;

7.1.3.3 Expanded admitted assets for entities engaged in microinsurance. The Insurance Commission shall prescribe additional admitted assets arising from the premiums collected from the sale of the microinsurance products. These additional admitted assets shall be considered in the computation of the margin of solvency.;

7.1.3.4 Appropriate Risk-Based Capital (RBC) framework for entities providing microinsurance products only.

7.2 Market Conduct Requirements

7.2.1 Payment and Settlement of Claims. All entities providing microinsurance products shall process and settle claims within 10 working days from receipt of complete required documents. Submission of the required documents through electronic means shall be accepted as provided for in the E-commerce law.

7.2.2 Documentary Requirements. The microinsurance provider shall accept substitute documents for settlement of claims. Concerned regulatory authorities shall issue appropriate circulars providing for the minimum documentary requirements.

7.2.3 Filing of Complaints. Complaints related to microinsurance contracts shall be acted upon by the concerned regulatory authorities.

7.2.3.1 Complaints involving microinsurance benefits shall be acted upon within 5 working days upon filing of a complaint and a resolution shall be made within 45 working days from the time the case is submitted for final resolution. Alternative dispute resolution mechanisms as mutually agreed upon by the parties concerned, may be utilized in the speedy resolution of microinsurance cases.

7.2.3.2 Other types of complaints shall be acted upon based on the nature of the complaint and the internal policies of the concerned regulatory authorities.

7.2.4 Know Your Client (KYC) Requirement. All microinsurance providers shall comply with the KYC requirements. For microinsurance clients, the application form containing the required minimum client information together with a photo-bearing ID or a substitute document is sufficient. Appendix 2 provides a sample list of valid IDs.

7.2.5 Governance Requirements - Existing requirements for good governance of concerned regulatory authorities shall be applied to all entities providing microinsurance products. Disclosure of microinsurance and insurance-like activities shall be required.

8 Who Can Sell Microinsurance Products

8.1 Only providers, agents and brokers licensed by the concerned regulatory authority shall be allowed to sell microinsurance products.

8.2 To facilitate distribution of microinsurance products, a microinsurance agent/broker shall be licensed to sell only microinsurance products. A microinsurance agent/broker shall not be required to take the regular licensure examination. Instead, he/she shall undergo an approved microinsurance training program and pass a qualifying examination at the end of the program. The concerned regulatory authority shall prescribe the training requirements for microinsurance agents/brokers.

8.3 Regular agents/brokers shall be allowed to sell microinsurance products and services.

8.4 Institutions engaged in microfinance activities may apply and be licensed as microinsurance agents/brokers, provided the license shall only cover the solicitation of microinsurance products.

Primary cooperatives may apply and be licensed as microinsurance agents/brokers provided the cooperative agent/broker sells only microinsurance products to its individual members.

8.5 Microinsurance Brokers shall be required a paid-up capital equivalent to half of what is required for regular brokers.

9 Performance Standards

A set of performance standards shall be established by concerned regulatory authorities to ensure the efficient and effective delivery of appropriate microinsurance products and the viability, growth, and development of the microinsurance industry. It shall, among others, consist of performance indicators covering areas such as solvency and stability, efficiency, governance, understanding of the product, risk management and outreach.

10 Financial Literacy (Learning/Education) for Microinsurance

To ensure that both the provider and the client understand their roles and responsibilities in risk protection, the concerned regulatory authorities in coordination with the Department of Finance (DOF), the National Anti-Poverty Commission (NAPC) and key stakeholders shall conduct financial literacy trainings, seminars and workshops on microinsurance. Separate modules on financial (microinsurance) literacy (learning/education) shall each be developed for providers and clients. Financial literacy (learning/education) modules for providers shall focus on their responsibilities to clients, and the various prudential, market conduct and good governance requirements while the module for clients shall focus on their rights and responsibilities as insured.

Appendix 1

Key Features of a Microinsurance Contract

I. The following features are applicable to life and non-life microinsurance contracts:

A. Coverage - A microinsurance contract shall cover the insured, and at his/her option, may include his/her immediate family (i.e. his/her spouse, children , and in the case of single persons, his/her parents and siblings ); and his/her assets;

B. Period of Cover – The term of the microinsurance contract shall be determined by the provider and shall depend on type of coverage;

C. Risk and Contingent Events Covered- A microinsurance contract may cover any of the following:

1. Death (may be bundled with memorial plan, mortuary or burial benefits );

2. Accident and illness;

3. Fire and other extended perils;

4. Calamities/disasters/catastrophic events (e.g. typhoon, earthquake, infestation, volcanic eruption, flooding and other convulsions of nature);

5. Casualty (e.g. personal accident, motor vehicle, and money security and payroll robbery); and

6. Other contingent events as may be determined by the concerned regulator

D. Terms and Conditions - A microinsurance contract shall clearly state the face amount, benefits and terms of insurance coverage. Contract provisions shall be clearly stated in simple terms. The manner and frequency of premium collections shall, if possible, coincide with the cash flow of the insured and may be collected daily, weekly, monthly, quarterly, semi-annually, and annually whichever is applicable.

E. Effectivity - A microinsurance contract becomes immediately effective only upon full payment of the first premium, contribution, fees or charges.

F. Claims Settlement - Claims for a microinsurance contract must be settled within 10 working days upon receipt of complete documents by the provider.

G. Dispute Resolution - Disputes related to microinsurance contract shall be settled initially through alternative dispute resolution mechanisms.

II. The following apply to life microinsurance contracts only:

A. Grace Period- During the effectivity of the contract, the insured is entitled to a maximum grace period of 45 calendar days from due date of premium/contribution payment.

B. Contestability – The contestability period for a microinsurance contract shall be one (1) year.

C. Suicide Clause - The provider shall be liable if the insured commits suicide after one (1) year from the effective date or date of last reinstatement of the contract. Suicide committed in the state of insanity will be compensable regardless of the date of commission. Where suicide is not compensable, the liability of the provider will be limited to the return of premiums.

III. In the case of non-life microinsurance contract, the provider shall send notices to the microinsurance clients at least 45 calendar days prior to expiration of the contract. Such notice shall include in clear terms whether the contract may or may not be renewed and any changes to be made thereon, if renewed.

Appendix 2

Sample List of Valid Identification Cards

(Know Your Client Requirement)

Clients who engage in insurance, insurance-like and similar activities for the first time shall be required to present the original and submit a clear copy of at least one (1) valid photo-bearing identification document issued by an official authority.

The term “official authority” shall refer to any of the following:

  1. Government of the Republic of the Philippines;
  2. Government political subdivisions and instrumentalities
  3. Government-owned and/or controlled corporations (GOCCs);
  4. Private entities or institutions registered with, supervised or regulated either by the Bangko Sentral ng Pilipinas (BSP), Securities and Exchange Commission (SEC) or Insurance Commission (IC)

Valid IDs include the following:

  1. Passport
  2. Driver’s license
  3. Professional Regulation Commission (PRC) ID
  4. National Bureau of Investigation (NBI) Clearance
  5. Police Clearance
  6. Postal ID
  7. Voter’s ID
  8. Barangay Certification
  9. Government Service Insurance System (GSIS) e-Card
  10. Social Security System Card (SSS) Card
  11. Senior Citizen Card
  12. Overseas Workers Welfare Administration (OWWA) ID
  13. OFW ID
  14. Seaman’s Book
  15. Alien Certification of Registration/Immigrant Certificate of Registration
  16. Government Office and GOCC ID
  17. Certification from the National Council for the Welfare of Disabled Persons (NCWDP)
  18. Department of Social Welfare and Development (DSWD) Certification
  19. Integrated Bar of the Philippines ID
  20. Company IDs issued by private entities or institutions registered with, supervised or regulated either by the BSP, SEC or IC
  21. Affidavit of two disinterested parties


[1] Social insurance programs such as those administered and implemented by PhilHealth, Government Service Insurance System (GSIS), and Social Security System (SSS), even when provided to the same clients (i.e. the poor) are not covered in this framework.

[2] In a study entitled Making Insurance Markets Work for the Poor: Microinsurance Policy Regulation and Supervision – Philippines Case Study, it was reported that as of 2006, the microinsurance market in the country covers an estimated 2.9 million adults (about 5.4 percent of the adult population), almost half of which (41 percent), are provided by the informal market. Informal micro insurance market is comprised of registered and unregistered institutions that provide insurance, insurance-like, and other similar products and services to the poor without any license from the concerned regulatory authority.

[3] This also refers to and is used interchangeably with low income, disadvantaged, marginalized or the less privileged sectors of society.

[4] When underwriting risks are low, regulatory requirements may be kept to a minimum making it possible for a greater number of market players (small ones included) to provide the needed risk protection for the poor.

[5] The new definition of microinsurance is based on the definition provided for in Insurance Memorandum Circular (IMC) No. 9-2006. The Technical Working Group on Microinsurance reviewed and revised the definition of microinsurance product to consider developments in the market for risk protection among the poor.

[6] The five percent (5%) ceiling for premium for microinsurance considers improved efficiency in the Insurance Industry resulting from better and improved mortality rates and technology, and the increased number of insured thereby spreading risks to a greater number and lowering costs of insurance delivery.

[7] The maximum coverage can provide 16.5 months (500 days) of lost income resulting from any unforeseen or contingent event happening to the insured. This is deemed sufficient to augment the needs of the family of the insured. This insurance coverage can be provided with the maximum 5% ceiling.