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Gold Edition
OPERATIONS MANUAL
PNP Welfare Benefit Claims
NAPOLCOM |PNP WELFARE BENEFIT CLAIMS 2
OPERATIONS MANUAL Gold Edition
Contents
APPEALS ------ 31
APPEALS ------ 31
AUTOMATIC REVIEW ------ 31
APPENDICES/REFERENCES ------ 41
MEMORANDUM CIRCULAR NO. 2015-002 ------ 41
FURTHER AMENDING MEMORANDUM
CIRCULAR NO. 95-001, AS AMENDED BY
NAPOLCOM MEMORANDUM CIRCULAR
NO. 95-023, ON THE COVERAGE OF THE
WORD GRANTEE IN SECTION 1 (b)
THEREOF
MEMORANDUM CIRCULAR NO. 2015-001 ------ 43
AMENDING ITEM F, SECTION 1 OF
NAPOLCOM MEMORANDUM CIRCULAR
NO. 95-011, ENTITLED, “PRESCRIBING
THE RULES AND REGULATIONS IN THE
IMPLEMENTATION OF THE NAPOLCOM
SCHOLARSHIP PROGRAM FOR
SURVIVING CHILDREN OF DECEASED
AND/OR PERMANENTLY
INCAPACITATED PNP PERSONNEL,
UNDER R.A. NO. 6963 AND NAPOLCOM
RESOLUTION NO. 94-047”
MEMORANDUM CIRCULAR NO. 2013-003 ------ 47
AMENDING SECTIONS 6 AND 7 OF RULE
IV OF NAPOLCOM MEMORANDUM
CIRCULAR NO. 2011-009 ENTITLED
NAPOLCOM |PNP WELFARE BENEFIT CLAIMS 6
OPERATIONS MANUAL Gold Edition
“REVISED RULES GOVERNING THE
INVESTIGATION AND ADJUDICATION
OF BENEFIT CLAIMS OF UNIFORMED
MEMBERS OF THE PHILIPPINE
NATIONAL POLICE (PNP)”
MEMORANDUM CIRCULAR NO. 2011-009 ------ 50
REVISED RULES GOVERNING THE
INVESTIGATION AND ADJUDICATION
OF BENEFIT CLAIMS OF UNIFORMED
MEMBERS OF THE PHILIPPINE
NATIONAL POLICE (PNP)
MEMORANDUM CIRCULAR NO. 2000-005 ------ 71
RULES AND REGULATIONSGOVERNING
THE INVESTIGATION AND
ADJUDICATION OF BENEFIT CLAIMS OF
UNIFORMED MEMBERS OF THE
PHILIPPINE NATIONAL POLICE (PNP)
MEMORANDUM CIRCULAR NO. 1995-011 ------ 83
PRESCRIBING THE RULES AND
REGULATIONS IN THE
IMPLEMENTATION OF THE NAPOLCOM
SCHOLARSHIP PROGRAM FOR
SURVIVING CHILDREN OF DECEASED
AND/OR PERMANENTLY
INCAPACITATED PNP PERSONNEL,
UNDER R.A. 6963 AND NAPOLCOM
RESOLUTION NO. 94-047
RESOLUTION NO. 1994-047 ------ 90
ESTABLISHING THE NAPOLCOM
SCHOLARSHIP PROGRAM FOR
SURVIVING CHILDREN OF PNP
MEMBERS
These benefits are granted after the compensability of the claim for
such welfare benefits are determined and/or established by
sufficient proofs to be service-connected. The claimants are
required to comply with all the requirements prescribed by law such
as the submission of pertinent documents required thereto.
WHAT IS DEATH?
a) Surviving spouse;
d) Surviving parents;
1) Surviving spouse;
4) Surviving parents;
NOTICE
OCCUPATIONAL DISEASES:
1) Skin cancer
2) Cataract leading to blindness
3) Rabies
4) Tuberculosis and its complications
5) Poisoning
a) Heat stroke
b) Frostbite/Freezing
a) CVA embolism
b) CVA thrombosis
c) CVA thrombo-embolism
d) CVA hemorrhage
9) Cardiovascular diseases
10) Pneumonia
a) Viral Pneumonia
b) Bacterial Pneumonia
a) Death
b) Loss of limb/s or its functions
c) Blindness
d) Deafness
NON-OCCUPATIONAL DISEASES:
1) Viral hepatitis
2) Cancer of the liver
3) Cancer of the lungs
4) Cancer of the pancreas
5) Cancer of the stomach and intestine
6) Liver cirrhosis and its complications
a) Medical
b) Surgical
c) Hospital
1) Accommodation
d) Supplies
Hospital Room tare shall not exceed Php 1,500.00 per day
except in the following cases:
MEDICINES
MEDICAL RE-EXAMINATION
PAYMENT OF CLAIMS
MISCELLANEOUS PROVISION
PRESCRIPTIVE PERIOD
TRANSFER OF VENUE
APPEALS
APPEALS
AUTOMATIC REVIEW
SCHOOL LEVEL
1) Kindergarten
2) Grades 1 to 6 (Elementary Education)
3) Grades 7 to 12 ( Secondary Education)
4) Vocational
5) College level
A. Initial Application
B. Renewal Application
f. Latest 2” x 2” ID picture.
The LAS within fifteen (15) days from receipt of the records,
shall evaluate the same, prepare and submit the
corresponding Memorandum/Resolution to the VCEO for
approval of payment.
ACADEMIC SUBJECTS
WEIGHTED AVERAGE
SHIFTING OF COURSE
DROPPING OF SUBJECTS
COMPLETION
DEFERMENT
LIMITATIONS
Any grantee who has been expelled from the school for
valid cause shall lose his scholarship privilege.
ANTI-GOVERNMENT ACTIVITIES
Issued this 13th day of April, 2015, at Quezon City, Metro Manila,
Philippines.
Attested by:
Xxx
f. “School Level” – refers to the following:
1) Kindergarten
2) Grades 1 to 6 (Elementary Education)
3) Grades 7 to 12 (Secondary Education)
4) Vocational
5) College Level
Xxx
Attested by:
RULE I
TITLE AND CONSTRUCTION
RULE II
DEFINITION OF TERMS
RULE III
GROUNDS FOR COMPENSABILITY
RULE IV
INVESTIGATION AND ADJUDICATION OF APPLICATION FOR
TOTAL PERMANENT PHYSICAL DISABILITY BENEFITS
(b) All other PNP members assigned with the Police regional
Offices shall submit their individual APPLICATION LETTER FOR TPPD
to the Regional Personnel and Human resource Development
Divisions (RPHRDD)
RULE V
INVESTIGATION AND ADJUDICATION OF CLAIM FOR DEATH
BENEFITS
a) Surviving spouse;
d) Surviving parents;
RULE IV
BENEFITS AND BENEFICIARIES
1) Surviving spouse;
4) Surviving parents;
RULE VII
LIST OF COMPENSABLE ILLNESS/DISEASE LEADING TO THE
DEATH OR TOTAL PERMANENT PHYSICAL DISABILITY
1) Skin cancer
3) Rabies
5) Poisoning
a) Heat stroke
b) Frostbite/Freezing
a) CVA embolism
b) CVA thrombosis
c) CVA thrombo-embolism
d) CVA hemorrhage
9) Cardiovascular diseases
10) Pneumonia
Viral Pneumonia
Bacterial Pneumonia
a) Death
b) Loss of limb/s or its functions
c) Blindness
d) Deafness
1. Viral hepatitis
2. Cancer of the liver
3. Cancer of the lungs
4. Cancer of the pancreas
5. Cancer of the stomach and intestine
6. Liver cirrhosis and its complications
RULE VIII
SCOPE OF MEDICAL ATTENDANCE AND HOSPITALIZATION
BENEFITS
a) Medical
c) Hospital
1) Accommodation
2) Ambulance and operating room service
3) Clinical laboratory service
4) Diagnostic services/procedures as may be necessary to
diagnose or effect a cure
d) Supplies
RULE IX
RULES ON THE PAYMENT AND/OR REIMBURSEMENT
OF REASONABLE MEDICAL EXPENSES
RULE X
GROUNDS FOR DENIAL OF THE CLAIM AND LIABILITY
OF CLAIMANTS OR THEIR REPRESENTATIVE
RULE XII
MISCELLANEOUS PROVISIONS
Attested by:
RULE I
Title and Construction
RULE II
Definition of Terms
RULE III
GROUND FOR COMPENSABILITY AND DOCUMENTARY
REQUIREMENTS
a. The PNP member must have been injured at the place where
his work requires him to be and must have been performing
his official functions;
RULE IV
COMMENCEMENT OF PROCEEDINGS
a. Surviving spouse;
b. Surviving dependent legitimate children;
c. Non-dependent legitimate children and illegitimate children;
d. Surviving parent;
e. Surviving brothers and sisters;
RULE V
BENEFITS AND BENEFICIARIES
1. Surviving spouse
2. Surviving dependent legitimate children
3. Non-dependent legitimate children and illegitimate children
4. Surviving parents
5. Surviving brothers and sisters (PD 1184)
b) If a deceased PNP member during his lifetime contracted a
second marriage after the death of his first spouse, the
surviving dependent legitimate children of the first
marriage, if any, shall be entitled to a proportionate share
of the benefits applying suppletorily the provision of Article
888 of the New Civil Code which states that “legitimate,
illegitimate children and descendants consists of one-half of
the hereditary estate of the father and mother. The latter
may freely dispose of the remaining half, subject to the
rights of illegitimate children and of the surviving spouse as
hereinafter provided.”
a. Medical
a. Professional attendance and treatment
b. Consultative Professional Fees (Medical)
b. Surgical
a. Surgical operation or intervention, after-care and follow-up
b. Consultative Professional Fees (Surgical)
c. Hospital
a. Accommodation and subsistence
b. Ambulance and operating room services
c. Clinical laboratory service
d. Diagnostic services/procedure as may be necessary to
diagnose or effect a cure.
d. Supplies
a. Drugs, medication or medical supplies
b. Any other goods or supplies prescribed for medical
diagnose, care or treatment
RULE VII
RULES FOR PAYMENT AND/OR REIMBURSEMENT OF
REASONABLE MEDICAL EXPENSES
RULE VIII
LIABILITY
c. By notorious negligence.
a. Letter application;
b. Certified true copy of the Napolcom Adjudication Award;
c. Birth Certificate of the applicant duly authenticated by the
Local Civil Registrar;
d. Two (2) Certificates of Good Moral Character;
e. Report Cards, Diploma, Transcript of Records, National
Elementary Achievement Test (NEAT) or National Secondary
Assessment Test (NSAT) result, if applicable, and Enrollment
Assessment Receipt.
b. The LAS within fifteen (15) days from receipt of the records,
shall evaluate the same and prepare and submit the
corresponding Memorandum/Resolution to the VCEO for final
disposition.
a. The tuition fee shall not be more than the following amount
per school year:
Any grantee who has been expelled from the school for valid
cause shall lose his scholarship privilege.
Attested by:
Attested by:
Step Service/Office/
Procedure
Number Unit
1 Central a. Receives, classifies, records and
Receiving, assigns sequence number in the
Records Section Document Tracking System (DTS)
Personnel and
Administrative
Service (PAS)
7th floor