PreparedCARD Lite Coverages

Thank you for purchasing the Western Guaranty Corporation PreparedCARD Lite!

Once activated, this card will allow the Registered Bearer a one-time-use of only one of the following benefits*

  • Up to Php 20,000 Emergency Room coverage from a nationwide network of hospitals powered by InLife Healthcare
  • Up to Php 16,000 Emergency Room reimbursement coverage for non InLife accredited hospitals
  • Up to Php 5,000 benefit from
    • Fire and Lightning Property Damage
    • Death Due to Accident
    • Permanent Disability Due to Accident
  • Up to Php 1,000 benefit from
    • Earthquake Damage
    • Bereavement Assistance for Death due to other than Accident

Enrollment

Before availing the benefits for the WGC PreparedCARD Lite, the holder must first register the Card via SMS. There will be a 72-hour “grace period” before the Card gets activated. The effectivity date of the Card will be sent via SMS after a successful registration.

 

To register, first scratch off the gray area at the back of the PreparedCARD Lite to reveal the PIN Number and Activation Code.

Then text the following information to the number 0919 062 4139

WGC < 12 digit PIN No> / < 5 digit Activation > / < First Name > / < Middle Initial > / < Last Name > / < Birthdate mmddyyyy> / < Gender M or F > / < Civil Status M or S > / < Home Address >

      Example – WGC 123456789012/12345/JUAN/D/CRUZ/01011970/M/S/123 SANTOS ST., Q.C

If successful, an SMS will be received showing the Effectivity Date and Expiration Date of the Card. If there is an error with the sent SMS, a message showing the error in the sent message will be received.

Once successful, the Card will be active after 72 hours. The benefits will be available for 1 year after registration or when a coverage of the Card has been used, whichever comes first.

 

Claiming of the Coverage

Availing the benefits of the PreparedCARD Lite is simple.

For the Emergency Room Benefit –

  • Present the following to the Emergency Room Reception of any of the nationwide accredited hospitals of the InLife Healthcare Services
    • WGC PreparedCARD Lite (Active and Registered to the Bearer)
    • Valid Government-issued ID

The PreparedCARD Lite will be surrendered to the InLife Representative

When availing the benefits other than the Emergency Room Coverage (this includes reimbursements for emergency room services from non-Inlife accredited hospital)

  • Present the following original documents to any of the Western Guaranty Corporation offices within 30 days from the occurrence
    • WGC PreparedCARD Lite (Active and Registered to the Bearer)
    • Valid Government-issued ID
    • Written notice of claim
    • Incident Report
    • Birth / Death Certificate (NSO)
    • Bureau of Fire Protection Report / Certificate (For Fire & Lightning)
    • Barangay Certificate of Fire Loss
    • Photos of Fire Loss showing affected property
    • In case the PreparedCARD Lite holder is unable to claim, the next of kin will need to provide additional documents
      • Birth / Death Certificate of the Card owner
      • Proof of relation of the Claimant Representative

 

 EMERGENCY CARE SERVICES OF YOUR PreparedCARD Lite

  • Professional fee(s) of attending physician(s)
  • Emergency Room Fees
  • Medicines used for immediate relief & during treatment
  • Whole blood/human blood product transfusions
  • Oxygen/I.V. fluids
  • X-ray, laboratory tests & other diagnostic examinations directly related to the emergency management of the patient
  • Anti-rabies vaccine, anti-venom (1st dose)
  • Anti-tetanus vaccine
  • Ambulance service (per conduction) from point of accident to any hospital

 

DEFINITION OF QUALIFIED EMERGENCY CONDITIONS / SITUATIONS

Emergencies shall refer to the sudden and unexpected onset of illness or injury which at the time of occurrence reasonable appears to have potential of causing immediate, permanent disability or death; or which requires the immediate alleviation of severe pain and discomfort.

 

QUALIFIED EMERGENCY CONDITIONS / SITUATIONS

Defined to be existing when a delay in treatment of a patient would lead to significant increase in the threat to life, or to the potential loss of a body part; and/or shall include any of the following warning signs (based on American College of Emergency Physician parameters):

  • Bleeding that will not stop
  • Breathing problems (difficulty of breathing, shortness of breath)
  • Sudden changes in mental status (such as unusual behavior, confusion, difficulty arousing)
  • Chest pains
  • Choking
  • Coughing up or vomiting blood
  • Syncope (fainting) or loss of consciousness
  • Sudden onset head and/or spine injury
  • Severe or persistent vomiting
  • Sudden injury due to motor vehicle accidents, burns, smoke inhalation, near drowning, a deep
  • large wound etc.
  • Sudden and severe pain anywhere in the body
  • Sudden dizziness, weakness, or change in vision
  • Introduction in vitro, and/or direct bodily exposure to poisonous and/or toxic substances
  • Sudden and severe abdominal pain or pressure

 

GENERAL EXCLUSIONS

Unless specified, this product shall not cover the following:

EXCLUSIONS SECONDARY TO SELF-CULPABILITY

  1. Injury and its complications resulting from self-inflicted injuries including: attempted suicide or self-destruction, whether sane or insane infections as a result of tattoos, piercing on any body part aside from the ears, whether self-inflicted or done by a third party
  2. Disabilities, injuries, or illnesses resulting from domestic violence; Healthcare Provider may rely on the Police or Doctor’s report to evaluate such claim.
  3. Injuries or illnesses attributable to the individual’s own misconduct , gross negligence, vicious or immoral habit, including:
  • unauthorized use of prohibited and regulated drugs
  • alcoholic liquor intake
  • direct or indirect participation in the commission of a crime
  • violation of a law or ordinance
  • unnecessary exposure to imminent danger, Healthcare Provider may rely on the Police or Doctor’s report to evaluate such claim.
  1. Injuries or illnesses caused directly or indirectly by engaging in any risky sport or hazardous activity such as but not limited to handling firecrackers and explosives, scuba diving, boxing, mountain climbing, surfing, water-skiing, yachting, parachuting, drag racing, target shooting, motor sports, winter sports, skydiving, use of wood-working machinery
  2. Illnesses resulting from exposure to ionizing radiation of any source
  3. Injuries resulting from direct participation in any act of war and in state of civil, military, or political unrest (i.e. riots, strikes)
  4. Injuries or illnesses resulting from any combat-related activity or from participation in any political, police, investigative, firefighting activities while in military service
  5. Injuries resulting from conducting murder, assault, homicide or any attempt thereof, including injuries occasioned by provocation of the member

 

DIAGNOSTIC/THERAPEUTIC PROCEDURES AND MEDICATIONS NOT COVERED

  1. Routine physical examinations required for obtaining or continuing insurance, schooling, government licensing, health permit, travel documents, and other similar purposes, including routine PE for employment (i.e. pre-employment PE, Annual PE) unless otherwise specified in the Schedule of Benefits
  2. All screening tests, including tests for Hepatitis screening and PPD skin test
  3. Aesthetic, cosmetic, and reconstructive surgery or any consultation and treatment for beautification purposes, including varicose vein treatment (i.e. sclerotherapy, Endovenous Laser Therapy (ELT)), except if necessary to treat a functional defect due to accidental injury within the initial confinement
  4. Treatment involving new diagnostic and therapeutic modalities such as but not limited to LASIK, PET scan, physical therapy modalities (i.e. shockwave therapy, cold laser therapy, targeted radiofrequency, etc.)
  5. Experimental and/or investigational medical procedures and its complications
  6. Cost of intravenous immunoglobulin (IVIG), hyperalimentation, multivitamins and nutritional/food/herbal supplements, and vaccines for immunization, unless otherwise specified in the Schedule of Benefits
  7. Outpatient medicine and take-home medicine except chemotherapy medicine and medicine administered during an emergency treatment
  8. Cost of blood donor screening
  9. Circumcision (except for treatment of phimosis), sex transformation, artificial insemination, sterilization of either sex or reversal of such, and diagnosis, treatment and procedures related to fertility or infertility
  10. Procedures for desensitization for hypersensitivity, including allergy testing, unless otherwise specified in the Schedule of Benefits
  11. Hormone replacement therapy (HRT) for pre-menopausal or menopausal men/women or any other treatment for menstrual syndrome or menopausal syndrome
  12. Acupuncture, chirotherapy, and other forms of alternative medicine and their complications
  13. Cost incurred in the process of organ donation and transplantation, and its complications, if the member is the donor in such procedure/s

 

DISEASES/ILLNESSES NOT COVERED

  1. Psychiatric and/or psychological illnesses and conditions including but not limited to anxiety disorders (i.e. stress-related anxiety or anxiety attacks), psychotic disorders, bipolar disorders, depressive disorders, and personality disorders
  2. Neurodevelopmental disorders including but not limited to :
  • Intellectual Disability (previously called mental retardation)
  • Communication disorders (i.e. speech sound disorder)
  • Autism Spectrum disorder (i.e. Asperger’s disorder)
  • Attention-Deficit/Hyperactivity Disorder (ADHD)
  • Specific learning disorders
  • Motor disorders (i.e. tic disorders, Tourette’s disorder)
  • Cerebral Palsy, Epilepsy, Down syndrome, etc.
  1. Congenital, genetic, hereditary diseases, and their complications, except if congenital benefits are covered as indicated in the Schedule of Benefits
  2. Neonatal illnesses resulting from complications of pregnancy and delivery of the newborn infant
  3. Maternity care and all other conditions related to and/or resulting from pregnancy and delivery including its complications, except if maternity benefits are covered as indicated in the Schedule of Benefits
  4. Obesity and its treatment including but not limited to bariatric surgery, liposuction, weight reduction programs, etc.
  5. Sleep Disorders and Eating Disorders
  6. Error of refraction, including diagnostic procedures and treatment, except consultation
  7. Chronic Dermatoses such as:
  • Chronic Idiopathic and/or Psychogenic Dermatoses (i.e. acne, alopecia areata, psychogenic purpura, rosacea, chronic urticaria)
  • Primary Psychiatric Dermatologic disorders (i.e. bromosiderophobia, delusion of parasitosis, dysmorphophobia, factitial dermatitis, trichotillomania)
  • Autoimmune and Hormonal Dermatoses (i.e. ichthyosis, psoriasis, vitiligo, atopic dermatitis, seborrheic dermatitis
  1. Demyelinating diseases of the nervous system (i.e. multiple sclerosis), Autoimmune neurologic disorders (i.e. myasthenia gravis, Guillain Barre syndrome), and Neurodegenerative diseases (i.e. Alzheimer’s disease, Parkinson’s disease)
  2. Sexually transmitted infections (STIs) including but not limited to condyloma acuminata, genital warts, gonorrhea, chlamydia, molluscum contagiosum, syphilis, trichomoniasis, etc.
  3. HIV infection, AIDS, and their complications; Suspected HIV infection (subject to medical evaluation by the Healthcare Provider or unless proven otherwise by member through submission of a valid negative HIV test result)
  4. Dental-related condition or illnesses, including its complications (i.e. maxillary sinusitis of odontogenic origin), except if dental benefits are covered as indicated in the Schedule of Benefits
  5. Injuries or illnesses attributable to third party liabilities, if Member refuses to execute a Deed of Subrogation and Reimbursement
  6. Diseases that are declared epidemic or pandemic by the Department of Health, World Health Organization, or any recognized health authority (i.e. Avian flu, Meningococcemia, etc.)
  7. Pre-existing medical conditions or illnesses unless otherwise specified in the Schedule of Benefits

MISCELLANEOUS EXCLUSIONS

  1. Custodial, domiciliary, convalescent and intermediate care
  2. Professional fees for medico-legal cases; Professional fees of assistant surgeons except when the service of an assistant surgeon is medically necessary, subject to the approval of the Healthcare Provider
  3. Benefits covered by PhilHealth and all other government funded healthcare entitlements as provided for by law
  4. Charges for non-medical services such as those of private duty nurses or physicians; charges for non-medical amenities such as telephone, radio, television, refrigerator, extra bed/ beddings, toiletries and the like unless these are included in the Member’s room and board accommodation
  5. Purchase or use of durable medical equipment such as but not limited to oxygen dispensing unit, except if rented while confined at the hospital
  6. Cost of corrective/prosthetic appliances, artificial aids, surgically implanted external devices, orthopedic hardware, and hearing aids and its fitting
  7. Cost of hospital confinement wherein the Member went home against medical advise (HAMA), or was discharged against medical advise (DAMA), or has absconded, including succeeding availments for the same illness, subject to the approval of the Healthcare Provider

FIRE &/or LIGHTNING

  1. This insurance does not cover any loss or damage occasioned by or through or in consequence, directly or indirectly, of any of the following occurrences, namely:
  • War, invasion, act of foreign enemy, hostilities or warlike operations (whether war be declared or not), civil war.
  • Mutiny, riot, military or popular rising, insurrection, rebellion, revolution, military or usurped power.
  1. Unless otherwise expressly stated in the policy, this insurance does not cover:
  • Coal, against loss or damage occasioned by its own spontaneous combustion.
  • The Company will pay to the Insured the amount of insurance as stipulated in the policy due to loss or damage caused by fire and/or lightning against his properties and belongings.
  • The Insured shall give immediate written notice to the Company at the time of any loss or damage to his properties and within thirty (30) days after the loss, the Insured shall submit to the Company a Proof of Loss, signed and sworn to by the Insured and a Certificate of Loss from the local government with jurisdiction therein.
  • The Company shall not be liable upon this policy so far as it relates to the property affected by any misdescription, misrepresentation or omission.

SECTION II – ACCIDENT / DEATH INSURANCE

  1. This insurance does not cover death, occasioned by or happening through:
  • War, invasion, act of foreign enemy, hostilities or warlike operations (whether war be declared or not), civil war.
  • Mutiny, riot, military or popular rising, insurrection, rebellion, revolution, military or usurped power.
  • Suicide or attempted suicide (whether felonious or not, sane or insane), hernia, alcoholism, intoxication, drugs, intentional self-injury, insanity.
  • Death caused by murder or provoked assault or any attempt thereat.
  • Death, consequent upon the Insured engaging in the making of explosives or upon being engaged as a custodian of explosives.
  • Death, consequent upon the Insured’s commission of or attempt to commit a felony as consequent upon the Insured’s being engaged in the illegal occupation or performing an unlawful act.
  • Pre-existing illness, pregnancy and childbirth.

 

  1. Total Permanent Disability shall mean:
  • Loss of the limbs;
  • Loss of both hands;
  • Loss of both feet;
  • Total loss of sight of both eyes;
  • Accident resulting in being permanently bedridden;
  • Any other injury causing total permanent disability.
  1. Indemnity for loss of life due to accident or sickness shall be payable in accordance with the beneficiary designation. No assignment of the benefits of this policy shall be binding upon the Company unless until the original or a duplicate is filed with the Company.
  2. The age eligibility for the Insured shall be at least fifteen (15) years old at the time of coverage and shall not be renewable after the end of the period of insurance when the Insured attains the age of sixty five (65) years.
  3. In case of death of the Insured, the claimant (beneficiary) shall submit any or all of the following documents:
  • Birth and Death Certificate of the Insured;
  • Copy of Confirmation of Coverage (COC);
  • Police Report or Affidavit of Incident;
  • Marriage Contract (if applicable);
  • Birth Certificate of beneficiary.

 

CONDITIONS APPLICABLE TO ALL SECTIONS

  1. This policy including any renewal thereof and/or any endorsement thereon is not in force until the premium has been fully paid to and duly receipted by the Company in the manner provided herein.
  • No payment in respect of any premium shall be deemed to be payment to the Company unless a printed form of receipt for the same signed by an Official or duly appointed Agent of the Company shall have been given to the Insured,    except when such printed receipt is not available at the time of payment and the Company or its representative accepts the premium in which case a provisional receipt other than the printed form may be issued in lieu thereof.
  • Any supplementary agreement seeking to amend this condition prepared by the agent, broker or Company official, shall be deemed invalid and of no effect.
  1. Unless otherwise expressly stated in the policy, this insurance does not cover:
  • Earthquake, volcanic eruption or other convulsion of nature.
  • Flood, typhoon, hurricane, tornado, cyclone or other atmospheric disturbance.
  • Insured is engaged in hazardous work like policeman, soldier, fireman, etc.
  1. This policy shall not be cancelled by the Company except upon prior notice thereof to the Insured and no notice of cancellation shall be effective unless it is based on the occurrence, after the effective date of the policy, of one or more of the following:
  • Non-payment of premium;
  • Conviction of a crime;
  • Discovery of fraud or material misrepresentation;
  • Discovery of willful or reckless acts of omissions.
  1. The insurance contract shall begin and end at 12:00 noon on the dates mentioned in the policy.This policy contract shall terminate only in the event of any claim settlement or upon expiry as mentioned in the Policy Schedule, whichever comes first. In case of Group Insurance, the individual Insured shall be automatically deleted in the Master Policy.
  2. If any claim under this policy shall be in any respect fraudulent, or if any fraudulent means or devices are used by the Insured or any one acting on his behalf to obtain any benefit under this policy, or if the loss or damage be occasioned by the willful act or with the connivance of the Insured, all benefits under this policy shall be forfeited.
  3. The amount of any loss or damage for which the Company may be liable under this policy, shall be paid within ten (10) days after all the necessary documents are received by the Company.
  4. In case there are terms and conditions that are contrary to this policy and any appropriate existing Philippine laws or rules and regulations of the Insurance Commission, it will be automatically amended to conform to such laws.

 

 

Emergency Hotlines

The following are the contact information in case of emergency or clarification regarding the WGC PreparedCARD Lite –

InLife Insular Healthcare

www.insularhealthcare.com.ph

 24/7 Call Center Hotline

+632 817 7857

Medical Information Center

+632 813 0131 Local 8307, 8310, 8332 to 8334, 8359

Mobile Number

+63917 886 1167

Toll free Hotline Number

1-800-108177-857

 

Western Guaranty Corporation

PreparedCARD Lite Hotline

+632 241 7401 Local 358