Downloadable Forms

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Policy Values Transaction

Forms needed to withdraw dividends and apply for a policy loan.
Dividend Withdrawal Form
Policy Loan Agreement
Request to Deposit Policy Proceeds
Request for Policy Information (For Non-VUL and VUL Policies)
Request to Release Check Policy Documents to Representative or Agent

Policy Amendment Forms

Forms required for policy amendment and reissuance of policy contract.
Application for Reinstatement or Policy Change
Instruction for Transfer of Ownership
Instruction for Policy Assignment
Life Insurance Trust Agreement
Notice of Death of Policy Owner with Contingent Owner
Lost or Damaged Policy Affidavit with Discharge of Policy
Request for Policy Change Form
Request for Change in Mode of Payment
Request for the Issuance of a Replacement of Lost or Damaged Insurance Policy
Instruction for Cancellation of Assignment
Application for Addition of Rider (For Non-VUL Policies)
Application for Removal Reduction of Extra Premium on account of Occupation form
Instruction on Transfer of Ownership To A Contingent Owner While Insured is a Minor (Absolute Assignment for New I-Peso Pro Earn Plan)

VUL Transaction

Forms for Variable product investment transactions.
Wealth Series Application for Fund Switch and Premium Redirection
I-Dollar Asian Gems Application for Fund Withdrawal
Regular-Pay Wealth Series Application for Increase-Decrease in Sum Insured
Regular-Pay Wealth Series Increase-Decrease in Reg Premium
VUL Application For Cooling Off
Wealth Series Application for Fund Withdrawal
VUL Application for Rider Addition/Cancellation/Amendment
VUL Application for Top-Up
Client Suitability Assesment Form For Bancassurance
Client Suitability Assesment Form For Direct Agency
Client Acknowledgement and Waiver Form
Additional Terms and Conditions for Income-Paying Funds

Maturity and Recapture Transaction

Forms needed for either policy maturity benefit claim or maturity recapture.
Maturity Benefit Claim Form
Maturity Benefit Payment and Recapture Form
Additional Requirements for Recapture

Death and Disability/Hospitalization Claim

Forms required for death claim, disability and hospitalization benefits.
Attending Physician's Statement
Claimant's Statement Form
Death Notice
I-Heal Hospital’s Certification Form II
Hospitalization Claim Form
I-Heal Insured Statement Accident Form I
I-Heal Insured Statement Sickness Form I
I-Shield Claimant Statement Form I-B
I-Shield Hospital Certification Form II
I-Shield Insured Statement Form I-A
I-Shield Physicians Statement Form III
Insured Statement Disability Claim
Insured Statement for Dread Disease Claims
Neurological Evaluation Form
I-Heal Physician's Statement Accident Form III
I-Heal Physician's Statement Sickness Form III
Physician Statement-Disability Claim
I-Heal Surgeon's Certification Form IV
Death Claim Payment Receipt and Release

Identity Validation

Forms for updating of basic personal information and for validation purposes.
Beneficiary Information Form (Multiple Beneficiary)
Customer Information Update Form
FATCA Requirement
Supplemental Form - Regulatory
Signature Affirmation Form
Special Power of Attorney
Entity Information Form
Declaration of Policyholder Born in the United States of America But not a US Citizen

Payment Channels

Forms for enrolling under a specific premium payment facility.
Application for Easy Pay Plus Fund(Premium Deposit Fund) Form
Authorization for Automatic Charging Option (ACO) Form
Authorization for Automatic Debit Arrangement
ADA Form (BDO)
ADA Form (BPI)
Application for Easy Payment Option (EPOn)
Authorization for Automatic Debit Arrangement (ADA) for Top-up Premiums
BANCA ADA Direct Credit to Bank Account Request Form


Forms required for minor Policy owner/ Beneficiary
Affidavit of Actual Custody
Affidavit of Parental Authority
Affidavit of Substitute Parental Authority

Group Insurance

Forms for Online Application of Group Insurance
Employee Census
Customer Info Update
Individual Application form
Specimen Signature form
Authorized Representative Form
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