PRUHealth FamLove

March 2022 | Product Management

 Despite the increasing interest and knowledge of
Filipinos about insurance products, the Philippines
remains to be an underpenetrated market
when it comes to individual insurance.

1.69%*
contribution of the insurance
sector to the national economy
as of Sep 2019

*Premium volume as a share of gross domestic product (GDP)

Confidential
Source: https://business.inquirer.net/298179/covid-19-claims-show-low-insurance-
2
penetration-in-ph-say-life-insurers
Barriers to purchasing
insurance product

64 % E,MIN,RURAL
ABC,NCL, 60 and above

No budget/not enough money 55.5

million Filipinos

25 %
25 % do not have insurance based on
the 2019 Financial Inclusion
Survey conducted by the
Not needed ABC, MMA,NCL, 15-19, URBAN
SL, VIS, MIN, RURAL
Expensive ABC1, SL
Bangko Sentral ng Pilipinas

8 %
8%
Slow return of ABC, SL
MIN
Lack of trust in C2, SL
MIN
insurance service providers
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With Pru Life UK’s newest health
product PRUHealth FamLove we
are making it possible for Filipinos
to insure not only themselves but
their family members as well in
the most affordable and
convenient way.

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PRUHealth FamLove
PRUHealth FamLove

Product Features

Product classification Health and protection

Product type Yearly renewable term

Up to age 85 of the Main

Benefit term Life Insured
(renewable up to age 84)

Currency Philippine Peso

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 PRUHealth FamLove

Product Features

Minimum sum assured 500,000

Maximum sum assured 1,000,000 (for SIO)

Minimum and Policyowner and Main Insured

(same person)
maximum entry ages 20 – 60 years old

Policy applications within the above-mentioned range are subject to Simplified

Issuance. Other financial-related underwriting guidelines apply.
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PRUHealth FamLove
Core Benefits
For Main Life Insured
Death Benefit
100% of the policy sum
assured (SA) less any
Moderate CI Benefit claim
once the Main Life Insured
(LI) dies
Once this benefit is claimed,
the policy will terminate.
Any Family Extension Benefit (FEB) payout, if applicable, will reduce the death and critical illness benefit of the Main Life Insured.
Critical Illness (CI) Benefit
Moderate CI Benefit
50% of the policy’s SA will
be paid once the Main LI is
diagnosed with any of the
covered Moderate CI
conditions.
This benefit is taken from
the policy SA, therefore,
reduces the benefit amount
payable on Severe CI or
death. The policy continues
but at a lower coverage
amount.
This benefit is payable only
once and will terminate
upon payment of the claim.
Severe CI Benefit
100% of the policy’s SA will
be paid once the Main LI is
diagnosed with any of the
covered Severe CI less
any Moderate CI Benefit
claim.
This benefit is taken from
the policy SA.
Since the benefit amount is
equal to 100% of the policy
SA, the policy terminates
once this benefit has been
claimed.
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PRUHealth FamLove

Core Benefits Sample benefits payout

For Main Life Insured
Scenario 1
Core Benefits Benefit
Amount Upon claiming the Death Benefit, we will pay 100% of the
Main Life Insured policy SA. Afterwards, the policy terminates.
Death Benefit 1,000,000
Critical Illness Benefit 1,000,000 Death Benefit
Moderate CI Benefit 500,000
Severe CI Benefit 1,000,000

Scenario 2
Moderate CI Benefit claim - we will pay 50% of the
policy SA. The policy will continue at a lower SA equal
to policy SA less the Moderate CI Benefit paid. Moderate
CI Benefit terminates.
Scenario 3
Severe CI Benefit claim - we will pay 100% of the
policy SA. Afterwards, the policy terminates. This
assumes that there is no Moderate CI Benefit claim.

500,000 Moderate CI 500,000 remaining policy SA 1,000,000 Severe CI

(Severe CI or Death)

Severe CI Benefit claim (after Moderate CI Benefit

claim) - we will pay the remaining 50% of the
policy SA. Afterwards, the policy terminates.

500,000 Moderate CI 500,000 Severe CI

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PRUHealth FamLove

Product Packages

mySelf myPartner myChild* myFamily* myParent

Family ▪ Main Life ▪ Main Life ▪ Main Life ▪ Main Life ▪ Main Life
composition Insured only Insured Insured Insured Insured
▪ Spouse/ Life ▪ Children ▪ Spouse/ Life ▪ Parents
Partner Partner
▪ Children

Maximum
1
number of lives 2 3 4 3
insured

*Main Insured may elect up to two (2) children as Other Life Insured.
Simplified Issuance will also be applied to other life insureds.
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PRUHealth FamLove

Additional Core Benefit

For packages with other life insureds

Family Extension Benefit (FEB)

Fixed FEB Sum Assured Package(s)

Main LI may extend the coverage of Moderate and Severe CI 50% of policy SA myPartner
to up to 3 qualified family members depending on the chosen myChild
myFamily
package.
25% of the policy SA myParent

+ Sample FEB benefits payable

Eligible entry Policy SA: 1,000,000 Package: myFamily FEB SA: 500,000
Family relationship Benefit Term
age
Spouse or Life
20 – 60 Up to age 85
Partner
Biological or adopted
15 days to 21 Up to age 22
children
Moderate CI Severe CI
Parents Benefit Benefit
(either or both
parents are only
allowed to enroll at
45 – 70 Up to age 85 250,000 500,000
50% of the FEB SA 100% of the FEB SA
policy inception)

These benefits will be deducted from the policy SA once claimed.

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PRUHealth FamLove

Additional Core Benefit

Family Extension Benefit (FEB)

Who can be elected as other Life Insureds?

Apart from having the option to elect members
of a traditional family such as father, mother,
spouse, daughter and son…

The Main LI has the liberty to elect a same-sex

partner, common-law partner, and adopted
children as Life Insureds.

Important Notes:
▪ Insurable interest must be established for same sex or common
law partners to be covered.
▪ Only same sex or common law partners who have no legal
impediment to marry may be included as insured under the policy.

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PRUHealth FamLove

Additional Core Benefit

Family Extension Benefit (FEB)

▪ Once any of the other Life Insured files a claim for

Moderate CI, the FEB SA decreases by 50% while the
remaining benefit amount continues to be claimable.

▪ The FEB will terminate upon payment of the death

benefit or Severe CI benefit to the Main LI or when
the total benefit amount for FEB has been claimed
even if other Life Insured(s), if any, have not filed for
a claim.

▪ If all other life insureds have exceeded the eligible

coverage age or if the Main LI has reached age 85,
whichever is earlier, FEB will terminate.

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 Event 1: Main Life Insured was diagnosed
Benefits payout if with with and claimed for Moderate CI Benefit -
Family Extension Benefit 500K
The policy will continue at a lower sum assured equal
Example 1: myFamily Package to original SA less the Moderate CI Benefit paid.
Event 2: Life Insured 2 was diagnosed
with and claimed for FEB Severe CI
Benefit - 500K
Since the FEB Severe CI claim of 500K will use up the
remaining policy’s SA, the policy will terminate.

Revised Policy SA = 1M – 500K = 500,000 Revised Policy SA = 500K – 500K = 0

Core Benefits Benefit Amount (policy terminates)
Main Life Insured Husband - Main Life Insured
Death Benefit 1,000,000
Critical Illness Benefit Death 500,000 Death 0
Moderate CI Benefit 500,000
Moderate 500,000 Moderate 500,000
Severe CI Benefit 1,000,000 CI Benefit claimed CI Benefit claimed

Other Life Insured(s) Severe Severe

500,000 CI Benefit 0
Family Extension Benefit 500,000 CI Benefit

Moderate CI Benefit 250,000

FEB SA = Remains at 500K Revised FEB SA = 500K – 500K = 0
Severe CI Benefit 500,000
(benefit terminates)
Wife - Life Insured 2
Important Notes:
1. FEB SA is a shareable benefit among Moderate Moderate
250,000 CI Benefit 0
other life insured(s) CI Benefit
2. FEB SA depletes every time there is Severe
Severe 500,000
a claim coming from any of the 500,000 CI Benefit claimed
other life insured(s). It also depletes CI Benefit
the policy SA.
3. FEB SA will terminate if any of the
other life insured(s) claims the FEB Child 1 - Life Insured 3
Severe CI Benefit, or the Main LI
claims the Severe CI or Death Moderate Moderate
benefit. CI Benefit 250,000 CI Benefit 0

Severe Severe
500,000 CI Benefit 0
CI Benefit Confidential 14
Benefits payout if with Event 1: Life Insured 2 was diagnosed with
and claimed for Moderate CI Benefit - 125K
Family Extension Benefit
The policy will continue at a lower sum assured equal to
original policy SA less the FEB Moderate CI Benefit paid. The
Example 2: myParent Package FEB SA will also be reduced by the FEB Moderate CI claim.
Event 2: Life Insured 3 was diagnosed with
and claimed for FEB Severe CI Benefit - 125K
Since the FEB Moderate CI claim of 125K will use up the
remaining FEB SA, this benefit will terminate. The policy will
continue at a lower sum assured less the FEB Severe CI claim.

Revised Policy SA = 1M – 125K = 875K Revised Policy SA = 875K – 125K = 750K

Core Benefits Benefit Amount
Main Life Insured Daughter - Main Life Insured
Death Benefit 1,000,000
Critical Illness Benefit Death 875,000 Death 750,000
Moderate CI Benefit 500,000 Moderate
Moderate 437,500 375,000
Severe CI Benefit 1,000,000 CI Benefit CI Benefit
Other Life Insured(s) Severe Severe
CI Benefit 875,000 CI Benefit 750,000
Family Extension Benefit 250,000
Moderate CI Benefit 125,000
Severe CI Benefit 250,000 Revised FEB SA = 250K – 125K = 125K Revised FEB SA = 125K – 125K = 0
(benefit terminates)
Father - Life Insured 2
Important Notes:
1. FEB SA is a shareable benefit among
Moderate 125,000 Moderate 125,000
other life insured(s)
CI Benefit claimed CI Benefit claimed
2. FEB SA depletes every time there is
a claim coming from any of the Severe Severe
other life insured(s). It also depletes 125,000 0
CI Benefit CI Benefit
the policy SA.
3. FEB SA will terminate if any of the
other life insured(s) claims the FEB Mother - Life Insured 3
Severe CI Benefit, or the Main LI
claims the Severe CI or Death Moderate Moderate
benefit. CI Benefit 62,500 CI Benefit 0
Severe Severe 125,000
CI Benefit 125,000 CI Benefit claimed
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PRUHealth FamLove

Other Benefits and Features

Life Event Portability

Booster of Cover

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 PRUHealth FamLove

Other Benefits
Life Event Booster (LEB)*

▪ Allows Main LI to avail of increase in policy SA upon
occurrence of any of the eligible life events, without
underwriting but within allowable limits. It will be
payable upon death or diagnosis of Moderate or Severe
CI.
▪ Eligible life events are:
▪ Can be availed multiple times if there is occurrence of
eligible life events.
▪ Allowable increase in SA is 25% of the policy SA**.
▪ The premium rate will be payable based on the increased
SA and attained age and gender of the Main LI.

▪ Main LI may apply for the benefit

▪ within 3 months from occurrence of eligible life
event
▪ if they are below age 50 during the occurrence of
eligible events
▪ there are no previous claims under the policy
Change in marital Addition of new child,
status whether newborn or
(whether to married or widowed, adopted
annulled/divorced***)

* Documents to verify occurrence of eligible life events will be required prior to processing this transaction.
**Subject to the applicable maximum amount payable per life. Confidential 17
***For Filipinos, a divorce validly procured abroad may be recognized if the divorce is confirmed or recognized by Philippine courts.
PRUHealth FamLove

Other Benefits
Life Event Booster (LEB)

Sample benefit increase

via LEB Core Benefits Benefit Amount Benefit Amount
before LEB after LEB
Life Event: Main Life Insured
Addition of child of the Main
Life Insured Death Benefit 1,000,000 1,250,000
Original policy SA: Critical Illness Benefit
1,000,000 Moderate CI Benefit 500,000 625,000
▪ After availing LEB, the policy Severe CI Benefit 1,000,000 1,250,000
SA will increase by 25% (fixed
percentage) - 1,250,000 Other Life Insured(s)

▪ The Death Benefit, Moderate

Family Extension Benefit 500,000 625,000
and Severe CI Benefits will Moderate CI Benefit 250,000 312,500
increase by the same
proportion. Severe CI Benefit 500,000 625,000
▪ The Main LI is not required to
upgrade his/her product
package to include additional
life insured.
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Family Extension and
Life Event Booster Benefit
Example 3: myFamily Package
Event 1: Main Insured had another child, added
him as Life Insured 3, and availed the LEB.
The policy SA will increase by 25%. The Death Benefit,
Moderate and Severe CI Benefits, and FEB SA will increase by
the same proportion.
Revised Policy SA = 1M + 250K = 1.25M
Event 2: Life Insured 4 was diagnosed with and
claimed for FEB Severe CI Benefit - 625K
Since the FEB Severe CI claim of 625K will use up the FEB SA,
this benefit will terminate. The policy will continue at a lower
sum assured less the FEB Severe CI claim.
Revised Policy SA = 1.25M – 625K = 625K

Core Benefits Benefit Amount Husband - Main Life Insured

Main Life Insured Death 1,250,000 Death 625,000
Death Benefit 1,000,000
Moderate Moderate
CI Benefit 625,000 CI Benefit 312,500
Critical Illness Benefit
Moderate CI Benefit 500,000 Severe Severe
1,250,000 625,000
CI Benefit CI Benefit
Severe CI Benefit 1,000,000
Other Life Insured(s) – Wife and Child 1 Revised FEB SA = 500K + 125K = 625K Revised FEB SA = 625K - 625K = 0
(benefit terminates)
Family Extension Benefit 500,000
Wife - Life Insured 2
Moderate CI Benefit 250,000 Moderate Moderate
CI Benefit 312,500 CI Benefit 0
Severe CI Benefit 500,000
Severe Severe
625,000 0
CI Benefit CI Benefit

Child 1 - Life Insured 3

Moderate Moderate
312,500 0
CI Benefit CI Benefit
Severe Severe
625,000 0
CI Benefit CI Benefit

Child 2 - Life Insured 4

Moderate Moderate
312,500 0
CI Benefit CI Benefit
Severe Severe 625,000
625,000 19
CI Benefit CI Benefit Confidential
claimed
PRUHealth FamLove
Other Features
Portability of Cover
▪ If the Main LI passes away or claims the Severe CI
Benefit while the spouse is insured under FEB, the
spouse has the option to take up a new policy with the
same SA that the spouse had (as part of the FEB,
excluding any increase due to LEB).
▪ Premiums for the new policy will be based on the
spouse's age and gender at the time of election.
▪ No underwriting is required provided that the
spouse has no previous claim under the policy.
▪ To apply, the spouse would need to fill out Special
Instructions under Major Amendment section of the
Policy Amendment Request Form (PARF).
▪ Any insured children will continue to be insured under
the new policy’s FEB (up to 50% of the new SA)
provided that the children to be insured have no
previous claim.
▪ New family members can be added under FEB (up to 3
family members), but they will be subject to SIO
underwriting.
▪ The spouse must elect this option within 3 months
from the PO’s date of death or diagnosis of severe
critical illness.
▪ In case the spouse already filed for a claim under the
original policy, he/she will no longer be eligible to avail
of this benefit.
▪ Parents of the PO are NOT eligible for this feature.
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Portability of Cover Event 1: Main Life Insured died. Event 2: The spouse has availed of
Portability of Cover for herself and her child

The policy will terminate upon death of the main

life insured.
Example 4: myFamily Package New Policy SA = 500K
Revised Policy SA = 1M – 1M = 0 (equal to Original FEB SA)
Core Benefits Benefit Amount (policy terminates)
Main Life Insured Husband - Main Life Insured Wife - Main Life Insured
Death Benefit 1,000,000
Critical Illness Benefit Death 1,000,000 Death 500,000
claimed
Moderate CI Benefit 500,000
Moderate Moderate
Severe CI Benefit 1,000,000 0 CI Benefit 250,000
CI Benefit
Other Life Insured(s) Severe Severe
0 CI Benefit
500,000
Family Extension Benefit 500,000 CI Benefit

Moderate CI Benefit 250,000

Revised FEB SA = 500K – 500K = 0 New FEB SA = 250K
Severe CI Benefit 500,000 (benefit terminates) (equal to 50% of new policy SA)

Wife - Life Insured 2

Child 1 - Life Insured 2
Moderate
CI Benefit 0 Moderate
125,000
Severe CI Benefit
CI Benefit 0 Severe
250,000
CI Benefit
Child 1 - Life Insured 3

Moderate 0
CI Benefit
Severe
0
CI Benefit Confidential 21
PRUHealth FamLove

Annual Premium Samples

Policy SA: mySelf myPartner myChild myFamily myParent

1,000,000 Main Insured +
Main Insured +
Main Insured Main Insured + Spouse / Life Main Insured +
Spouse/
Only Up to 2 Children Partner + Up to 2 Parents
Male Life Partner
Up to 2 Children
Age 20 15,655 18,353 19,285 21,983 27,394
Age 30 17,120 20,168 20,750 23,798 34,749
Age 40 22,095 26,655 25,723 30,283 53,714
Age 50 32,405 41,518 36,033 45,145 78,385
Age 60 62,845 74,008 66,475 77,638 129,325*
Female
Age 20 15,600 18,040 19,230 21,670 27,339
Age 30 16,615 20,168 20,245 23,798 34,244
Age 40 22,770 29,120 26,398 32,748 54,389
Age 50 31,270 41,120 34,898 44,748 77,250
Age 60 44,595 65,545 48,225 69,175 111,075*

*For renewal premium only

Note: Premiums illustrated above are inclusive of PhP 400 policy fee. Applicable modal factors for non-annual modes will apply.
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Target Segments
Despite the differences in
profile, needs and priorities…

there’s a PRUHealth FamLove

product package for them.

Confidential 24
For every family that’s different,
We DO protection the same,
We DO family for all.

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Meet our target customers
GINA
Profile
▪ 25 years old
▪ Single and not in a relationship
▪ Living independently
Priorities
▪ Live healthy to be able to enjoy life
▪ Build career in the advertising industry
▪ Save up and be prepared in case
something unfortunate happens in the
future
▪ Be able to support her needs and wants
and not depend on parents
Her story
Appropriate
Once upon a time, there was a 25-year-old
lady named Gina. She works as a junior
product package
officer in an advertising agency. She lives
comfortably in a condominium unit near her
office.
One day, her friend was diagnosed with
breast cancer. Her friend told her about the
expensive cost of treatment and how it
mySelf
depleted her savings.
Because of that, Gina realized that her HMO ▪ Main Life
will not pay all her expenses if she gets Insured only
struck with cancer.
Until finally, she decided to get an insurance
product that will cover her expenses in case
she gets sick.
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Meet our target customers

His story
Appropriate
Once upon a time, there was a 32-year-old
boy named Marco. He’s a member of the product package
LGBTQ community and works in the BPO
industry.
MARCO
He is currently living with his partner, and
Profile
they've been together for 5 years.
▪ 32 years old
▪ An LGBTQIA+ member One day, they found out that a friend of
▪ With same-sex partner them who also has a partner died of myPartner
Leukemia.
Priorities
▪ Be healthy as close friend got diagnosed Their friend told them that he wanted to get ▪ Main Life
with critical illness an insurance cover for his partner when he Insured
▪ Build career in the BPO industry was healthy but cannot find a company that ▪ Spouse/ Life
▪ Be financially equipped for whatever may will allow him to get cover for his partner. Partner
happen to him, his family and partner in
the future Because of that, Marco decided to get a
policy for him and his partner.

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Meet our target customers

Her story
Appropriate
Once upon a time, there was a single mom
named Helen. She has an online selling product package
HELEN business for clothes and bags.
Profile
One day, one of her valued customer
▪ 37 years old chatted with her and told her that her kid,
▪ Previously married but got annulled who is 7 got hospitalized due to heart
recently attack.
▪ With a 4-year-old daughter
Priorities Her customer mentioned the high cost that myChild*
they incurred during the hospitalization, and
▪ To provide her child a good future and this led her to borrow money from friends
ensure that she provides everything that and family members. She suffered from
▪ Main Life
they need even without the help of her anxiety and depression because of this. Insured
ex-husband ▪ Children
▪ Continue to build a stable career Due to that, Helen decided that she needs
to get an insurance cover for her and her 4-
year-old daughter.

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Meet our target customers

ALBERT
Profile
▪ 42 years old
▪ Happily married for 8 years
▪ With 2 daughters – 6 years old
(biological) and 1 year old (adopted)
▪ Wife decided to be stay-at-home to take
care of kids
Priorities
▪ To provide the needs of his family and
give his children good education and
future
▪ Continue to build a stable career in the
banking industry
His story
Appropriate
Once upon a time, there was a family man
named Albert. He holds an executive product package
position in a multi-national company. He
has 2 beautiful daughters and a wife who is
a stay-at-home mom.
One day, he learned that his boss' wife died
due to kidney failure. Before dying, she
went through a kidney transplant and spent
a lot on the transplant and medication. To
myFamily
make matters worst, he also learned that
his boss' son was also suffering from kidney ▪ Main Life
failure. Insured
▪ Spouse/ Life
Because of that, he decided to buy an
Partner
insurance plan that will cover his whole
family. ▪ Children

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Meet our target customers
MARIA
Profile
▪ 36 years old
▪ Single but in a relationship
▪ Only child
▪ Still living with retired parents
Priorities
▪ Prepare for future healthcare needs of
her parents in case they get sick
▪ Ensure that they are well taken care of
in case something happens to her
▪ Have a stable job so that she can
provide for her and her family’s needs
Her story
Once upon a time, there was a girl named
Appropriate
Maria. She is in her 30's but is still single product package
and living with her parents. She currently
works as a Manager in a bank.
She lived a comfortable life during her
childhood. Her parents sent her to good
schools and was living the best life.
Due to the pandemic, her parent's myParent
restaurant business shut down. Though her
parents have money for retirement, their ▪ Main Life
money might not be enough to cover
sudden medical bills.
Insured
▪ Parents
Because of this, Maria realized that for her
to show gratitude to her parents she bought
an insurance plan that will cover her and
her parents.
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More about PRUHealth FamLove
PRUHealth FamLove

Commission Schedule

Annual Semi-Annual Quarterly Monthly

Year 1 30% 27.5% 25% 25%

Year 2 10%

Year 3
onwards 5%
(perpetual)

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PRUHealth FamLove
Application and Underwriting
Guidelines

Application submission Via PRUOne only

New application form to be

Application form used solely for this product to
be uploaded in PRUOne

500K to 1M SA:
Simplified issuance
Underwriting
Higher than 1M SA:
Full underwriting (separate
launch)

Multiple policies Main LI allowed to have

multiple policies

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PRUHealth FamLove

Underwriting Guidelines
All locations within the Philippines except Basilan, Maguindanao, Shariff
Location Kabunsuan, Sulu, Marawi, and Tawi - Tawi

Existing underwriting rules on acceptable at standard apply. Please see

Occupation attached file on the Appendix section.

Relationship of Father, Mother, Daughter, Son, Spouse, Same Sex Partner, Common-
PO, Main LI to Other LI(s) Law Partner

Relationship of
Father, Mother, Sister, Brother, Daughter, Son, Spouse, Same Sex Partner,
beneficiary to Main
Life Insured Common-Law Partner, Grandfather, Grandmother, Niece or Nephew

Beneficial owner Not allowed for January 2022 release

High-risk flag Application will not proceed if considered a high-risk client

Agents must not outright decline application of clients with HIV-related declaration(s) per IC CL 2017-11. Confidential 34
They can submit it to HO for further evaluation.
PRUHealth FamLove
Application and Underwriting
Guidelines
▪ Certificate of No Marriage (CENOMAR)
issued by the Philippine Statistical
Authority OR Government issued
Additional requirements if
Consularized Certificate of Union if married
same sex partner is added
abroad
as Life Insured
Any of the following:
▪ Proof that the relationship between the
same sex partners has existed for 5
years or more (e.g., statement of joint
bank account(s), certificate of residency
issued by Barangay, etc.)

▪ Certificate of No Marriage (CENOMAR)

issued by the Philippine Statistical
Authority of the common law partner and
the Main Life Insured
Additional requirements
if common law partner is Any of the following:
added as Life Insured ▪ Proof that the relationship between the
same sex partners has existed for 5
years or more (e.g., statement of joint
bank account(s), certificate of residency
issued by Barangay, etc.)

Additional requirements if Adoption document as proof that a child is

for adopted children legally adopted
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PRUHealth FamLove

Underwriting Guidelines
Questions for Simplified Issuance

Have you ever been diagnosed with, receiving

treatment or medical advice, or been investigated
for any of the following conditions: High blood
pressure, Diabetes, Stroke, Chest pain, Heart
disease; Kidney, Liver, Lung or Endocrine disease;
Brain or Nervous system disease, Musculoskeletal
disorders; Cancer, Tumour Growth; Any Disability
including Eye and ENT; immunodeficiency disease
including HIV/AIDS?

In the past 2 years, have you been hospitalized

for more than five (5) consecutive days or taken
medication for longer than two (2) weeks or
undergone any form of surgery?

Same underwriting applies to other Life Insureds.

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PRUHealth FamLove

Underwriting Guidelines
General rule on aggregation

+
No aggregation of SA of PRUHealth FamLove
PRUHealth FamLove policy SA policy included in aggregation
during 1st application if Main LI or other Life Insureds are
(Policy SA also not considered applying for another PLUK policy
in the NMA amount.) (increase in SA due to availment of
LEB included)

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PRUHealth FamLove

Underwriting Guidelines
General rule on aggregation

After issuance of 1st PRUHealth FamLove policy: The SA at the time a new policy is acquired by an
existing client will be included in the aggregation and NMA limit of an agent.

Example:

Policy details Date of Issuance Sum Assured

1st policy PRUHealth FamLove April 2022 1,000,000
PAA Plus base plan 1,000,000
2nd policy December 2022
Life Care Benefit 500,000
Total sum assured to be aggregated: 2,500,000

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PRUHealth FamLove

Underwriting Guidelines
Coordination of Benefits

Aggregate of Combined Riders / Benefits

Critical Illness Maximum SA Limit (PhP)
CCB and/or LCB and/or LCP
11,250,000
and/or MLCP
CCB and/or LCB and/or LCP
and/or MLCP with Late-Stage CI
15,000,000
Benefit or Severe Critical Illness
Benefit*
LCAP and Early-Stage CI Benefit
3,750,000
or Moderate CI Benefit

*Combination of CCB and/or LCB and/or LCP and/or MLCP cannot be more than 11.25 million in the 15 million total.

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PRUHealth FamLove

Free-look Period

This is a 15-day cooling-off period from

the date the PO/Main LI receives
his/her Policy Booklet during which
he/she may review the insurance
Free-look period policy.

If the client changes his/her mind,

he/she will be asked to simply
complete and submit the appropriate
form within this period and we will
refund the premium he/she paid in full.

Confidential 40
PRUHealth FamLove

Policy Renewal

If at the end of the current benefit term and

every year thereafter, the Main LI has not
reached age 85, the policy may be renewed
annually, provided that:
▪ It is renewed at the same package and policy
SA as shown in the Policy Data Page less any
accelerated benefits already paid.
▪ The attained age of the Main LI at the end of
each benefit term is not more than 85.

Automatic Coverage for the other life insured(s) will

automatically renew together with the policy,
renewability
provided that:
▪ The policy is renewed at the same FEB amount
and package as shown in the PDP less any
accelerated benefits already paid.
▪ The attained age of the other life insured(s) at
the end of each benefit term is not more than
85 for the spouse/life partner and parents or
not more than 22 for children, whichever is
later.
▪ The policy has not terminated.

Premiums on the renewed policy shall be based

on the attained age as of last birthday and
gender of the Main LI and policy SA at the date
of renewal.
Confidential 41
PRUHealth FamLove

Policy Changes

Conversion to other Allowed

available products

Change in Allowed following existing

payment mode guidelines

Change in Allowed following existing

payment method guidelines

▪ Allowed; increase in policy SA will

Increase in policy SA be subject to UW
▪ Coverage for Death, Moderate and
Severe CI, FEB will be adjusted in
proportion to the increase in policy
SA.

▪ Allowed after policy inception.

▪ Coverage for Death, Moderate and
Decrease in policy SA Severe CI, FEB will be adjusted in
proportion to the decrease in policy
SA.
Confidential 42
PRUHealth FamLove

Policy Changes

▪ Can be done within 5 years

from the due date of the
premium if Main LI and Other
Reinstatement Life Insured(s) gave
satisfactory evidence of good
health.
▪ Pay the current premium due
(based on the attained age and
gender of the Main LI upon
reinstatement) without paying
any of the overdue premiums.

▪ Allowed but should follow the

Change in product rules which will be discussed
plan/package on the next slide.

Confidential 43
PRUHealth FamLove

Change in Product Plan/Package

Allowable scenarios
1 mySelf myPartner
11 myPartner mySelf
2 mySelf myChild
12 myChild mySelf
3 mySelf myFamily
13 myParent mySelf
4 myPartner myChild
14 myFamily mySelf
5 myPartner myFamily
15 myFamily myPartner
6 myChild myFamily
16 myFamily myChild
7 myChild myPartner

8 myParent myFamily To be allowed after product launch. More details to

be shared.
Main LI and Other Life Insured(s) should meet acceptable
9 myParent myPartner
age limits and current SA is retained.

10 myParent myChild Confidential 44

PRUHealth FamLove

Claims Guidelines

▪ 90 days from effective date of

benefit or date of approval of last
Waiting period
reinstatement of the benefit
for CI Benefits ▪ Also applicable to other Life
Insureds

Survival period for CI 7 days from date of CI

Benefits under FEB condition diagnosis

▪ 2 years from the policy

and benefit’s effective date
or from the date of last
Incontestability period reinstatement, if any and
▪ For any future increase in
SA for 2 years from the
effectivity date of the
increase in SA
▪ Applicable to all life
insureds under the policy

Confidential 45
PRUHealth FamLove

Claims Guidelines

Means an illness, sickness or

condition which existed prior to the
Effectivity Date of the benefit or the
date of last reinstatement of the
Policy, whichever is later, in respect
of which the Life Insured(s):
▪ had signs or symptoms of the
illness, sickness or condition
▪ were aware, or a reasonable
Pre-existing conditions
person in your position would
have been aware
▪ sought or should have sought
advice or treatment
(conventional or alternative)
from a medical practitioner or
other allied health professional,
in circumstances where a
reasonable person in your
position would have sought such
advice or treatment; or
▪ have had medical treatment,
consultation or been prescribed
medication or therapy.
Confidential 46
PRUHealth FamLove

Claims Guidelines
▪ Pre-existing conditions related to
critical illness before the policy
inception date.
▪ Critical illness where first diagnosis
and signs and/or symptoms occur in
the waiting period.
▪ Death due to the critical illness within
the survival period*.
▪ Congenital diseases, congenital
abnormalities, and/or congenital
defects.
▪ Critical illness in the presence of an
Exclusions infection of Human Immunodeficiency
Virus (HIV) in the body of the Insured
or caused directly or indirectly by
Acquired Immune Deficiency
Syndrome (AIDS) or a disease
related to Acquired Immune
Deficiency Syndrome (AIDS), except
for conditions covered under the
HIV/AIDS SOFI category.
▪ The effects of alcohol abuse, drug
abuse or any other dependence.
▪ Any intentional self-inflicted injuries
or any other acts towards the similar
purpose, whether committed in a
sane state or not.
Confidential 47
*Only applicable to Other Life Insured(s) under FEB.
PRUHealth FamLove

Policy Replacement

A policy will be tagged as a

replacement case when another policy
of the PO/Main LI
▪ Has been rescinded
▪ Changed its status to lapse
Rules on Policy
Replacement Within one year before or after the
(Pol Rep) issuance of new coverage from the
A&H group where the PRUHealth
FamLove is categorized.

Pol Rep applies on the Main LI only

(i.e., family members are not
included)

Confidential 48
What is SOFI?
System and Organ Function Insurance

▪ Uses a different way of categorizing and defining

covered critical illnesses as it is based on bodily
system and organs.

▪ It is designed to provide payout upon occurrence of

an event which critically affect a person’s health such
as diagnosis of severe illness (cancer, heart attack,
stroke), surgery, or when any of the covered systems
or organs has been moderately or severely impaired
or needs to undergo moderate or severe surgery.

SOFI definitions are different from existing CI definitions. Confidential 49

While existing CI products are good,
the numbers game cannot be played forever.

Customers look for CI coverage to protect

themselves from the unexpected event(s) over a
long period of time.

The reality is policy provisions are set at the time

of sales and may not be able to cover ALL
sicknesses over time.

SOFI does not intend to replace existing CI list but to present an alternative to clients.

Confidential 50
PRUHealth FamLove Critical Illness Coverage

System and Organ Function Insurance

Cardiovascular System Neurological System

Hepatic System and

Respiratory System
Liver Function

All systems: Cancer,

Renal System and Disabilities, Injuries,
Kidney Function Infections

Confidential 51
PRUHealth FamLove Critical Illness Coverage

System and Organ Function Insurance

is afflicted by a need certain

Pays when covered is unable to meet a
moderate/severe surgeries to restore
system or organ is… functional level
disease function

inability to perform
Pays for non-system moderate and severe
Cancer activities of daily living
specific diseases… disabilities regardless of cause

Critical illness conditions and definitions stated in the policy booklet must be satisfied in the event of claim.
Confidential 52
PRUHealth FamLove Critical Illness Coverage

System and Organ Function Insurance

Diagnosed base severe illness Undergo a surgery (can

(e.g., cancer, heart attack,) differentiate severity level)

Comprehensive
protection

Permanent and irreversible

End stage of life
physical health condition

Confidential 53
PRUHealth FamLove Critical Illness Coverage

System and Organ Function Insurance

Sample benefit payout
Severe Impairment

100% Sum Assured

Severe Surgery

Cardiovascular
System

Moderate
Impairment

50% Sum Assured

Moderate Surgery

Confidential 54
PRUHealth FamLove
SOFI Coverage and Definitions
SOFI Categories Moderate
Cancer Early-Stage Cancer and Carcinoma in-situ
Diagnosis of one of the following:
I. Carcinoma in situ
Carcinoma in situ of the following sites: Breast,
uterus, ovary, fallopian tube, vulva, vagina,
cervix uteri, colon, rectum, penis, testis, lung,
liver, stomach, nasopharynx or bladder.
Carcinoma in situ means the focal autonomous
new growth of carcinomatous cells confined to
the cells in which it originated and has not yet
resulted in the invasion and/or destruction of
surrounding tissues. 'Invasion' means an
infiltration and/or active destruction of normal
tissue beyond the basement membrane.
II. Early Prostate Cancer
Prostate Cancer that is histologically classified
as T1N0M0 using the TNM Classification or
Prostate cancers described using another
equivalent classification.
III. Early Thyroid Cancer
Thyroid Cancer that is histologically classified
as T1N0M0 using the TNM Classification
Severe
Late-Stage Cancer
A malignant tumour positively diagnosed with
histological confirmation and characterised by the
uncontrolled growth of malignant cells with invasion
and destruction of normal tissue. The term malignant
tumour includes leukemia, lymphoma and sarcoma.
The following are excluded:
a. All tumours which are histologically classified as
pre-malignant, non-invasive, carcinoma-in-situ,
having borderline malignancy, having any degree of
malignant potential, having suspicious malignancy,
neoplasm of uncertain or unknown behaviour, or all
grades of dysplasia, squamous intraepithelial
lesions (HSIL and LSIL) and intra-epithelial
neoplasia;
b. Any non-melanoma skin carcinoma, skin confined
primary cutaneous lymphoma and
dermatofibrosarcoma protuberans unless there is
evidence of metastases to lymph nodes or beyond;
c. Malignant melanoma that has not caused invasion
beyond the epidermis;
d. All Prostate cancers histologically described as
T1N0M0 (TNM Classification) or below or Prostate
cancers of another equivalent or lesser
classification;
e. All Thyroid cancers histologically classified as
Confidential 55
T1N0M0 (TNM Classification) or below;
PRUHealth FamLove

SOFI Coverage and Definitions

SOFI Categories Moderate Severe

Cancer Early-Stage Cancer and Carcinoma in-situ Late-Stage Cancer (cont’d)

(cont’d)
a. X
b. X
c. X
d. X
e. X

f. All tumours of the Urinary Bladder histologically

IV. Early Urinary Bladder Cancer
Urinary Bladder Cancer that is histologically
classified as TaN0M0 or T1N0M0 using the TNM
Classification
V. Early Chronic Lymphocytic Leukemia
Chronic lymphocytic leukaemia (CLL) classified
as RAI Stage I or II
classified as T1N0M0 (TNM Classification) or below;
g. All Gastro-Intestinal Stromal tumours histologically
classified as Stage I or IA according to the latest
edition of the AJCC Cancer Staging Manual, or
below;
h. Chronic Lymphocytic Leukaemia less than RAI
Stage 3;
i. All tumours in the presence of HIV infection.

VI. Early Gastro-Intestinal Stromal Tumours

Early Gastro-Intestinal Stromal tumours
classified as classified as Stage I or IA
according to the latest edition of the AJCC
Cancer Staging Manual.

The diagnosis of any of the above must always be

positively diagnosed upon the basis of a microscopic
examination of the fixed tissue, supported by a
biopsy result(Histopathological report). Clinical
diagnosis does not meet this standard.

Confidential 56
PRUHealth FamLove

SOFI Coverage and Definitions

SOFI Categories Moderate Severe

Cancer Early-Stage Cancer and Carcinoma in-situ -

(cont’d)

The following are excluded:

a. Clinical diagnosis of Cervical Intraepithelial
Neoplasia (CIN) classification which reports CIN I,
CIN II, and CIN III (severe dysplasia without
carcinoma in situ)
b. Carcinoma in situ of the biliary system
c. Prostatic Intra-epithelial Neoplasia (PIN)
d. Vulvar Intra-epithelial Neoplasia (VIN)
e. Melanoma and non-melanoma carcinoma-in-situ
f. Any lesion or tumour which is histologically
described as benign, dysplasia, premalignant,
borderline malignant or of suspicious malignant
potential.
g. All tumours in the presense of Human
Immunodeficiency Virus (HIV) infection

Confidential 57
PRUHealth FamLove

SOFI Coverage and Definitions

SOFI Categories Moderate Severe

Heart Attack N/A Death of heart muscle due to ischaemia, that is evident
by at least three of the following criteria proving the
occurrence of a new heart attack:

a. History of typical chest pain;

b. New characteristic electrocardiographic changes;
with the development of any of the following: ST
elevation or depression, T wave inversion,
pathological Q waves or left bundle branch block;
c. Elevation of the cardiac biomarkers, inclusive of
CKMB above the generally accepted normal
laboratory levels or Cardiac Troponin T or I at
0.5ng/ml and above;
d. Imaging evidence of new loss of viable myocardium
or new regional wall motion abnormality. The
imaging must be done by Cardiologist.

The following are excluded:

a. Angina;
b. Heart attack of indeterminate age; and
c. A rise in cardiac biomarkers or Troponin T or I
following an intra-arterial cardiac procedure
including, but not limited to, coronary angiography
and coronary angioplasty.

Explanatory note: 0.5ng/ml = 0.5ug/L = 500pg/ml

Confidential 58
PRUHealth FamLove

SOFI Coverage and Definitions

SOFI Categories Moderate Severe
Stroke N/A A cerebrovascular incident including infarction of brain
tissue, cerebral and subarachnoid haemorrhage, cerebral
embolism and cerebral thrombosis. This diagnosis must be
supported by all of the following conditions:
a. Evidence of permanent neurological damage which
results in one of the three following deficits:
i. Total and permanent loss of motor function in
one or more limb
ii. Permanent loss of the ability to speak due to
damage to the speech center in the brain
iii. Permanent inability to perform 3 out of 6
“activities of daily living” without the
assistance of another person
b. The evidence of any of the three deficits above must
be confirmed by a neurologist at least six (6) weeks
after the event; and
c. Findings on Magnetic Resonance Imaging,
Computerised Tomography, or other reliable imaging
techniques consistent with the diagnosis of a new
stroke.

The following are excluded:

a. Transient Ischaemic Attacks and any Reversible
ischemic neurological deficit;
b. Brain damage due to an accident or external injury,
infection, vasculitis, inflammatory disease and
migraine;
c. Vascular disease affecting the eye or optic nerve; and
Ischaemic disorders of the vestibular system.
Confidential 59
PRUHealth FamLove
SOFI Coverage and Definitions
SOFI Categories Moderate
Bone Marrow Moderate Impairment
Occurrence of either of the following:
Myelodysplastic syndrome or myelofibrosis
requiring regular and permanent transfusion of
blood products for severe recurrent anemia.
Diagnosis of Myelodysplastic Syndrome (MDS) or
Myelofibrosis must be confirmed by a hematologist
as a result of marrow biopsy. The condition must
be deemed incurable and blood transfusion support
must be an indefinite requirement.
Severe haemophilia associated with spontaneous
haemorrhage and with a clotting factor VIII or
factor IX of less than one percent. Diagnosis must
be confirmed by a Specialist Doctor.
N/A
Severe
Severe Impairment
Means bone marrow failure which results in anaemia,
neutropenia, and thrombocytopenia requiring
treatment with at least one of the following:
a. Blood product transfusion
b. Marrow stimulating agents
c. Immunosuppressive agents
d. Bone marrow transplant
Severe Surgery
The actual undergoing as a recipient of a transplant
of human bone marrow using haematopoietic stem
cells which is preceded by total bone marrow
ablation.
This transplantation must have been deemed
medically necessary to treat the irreversible end-
stage failure of the bone marrow. Other stem cell
transplants are excluded.
Confidential 60
PRUHealth FamLove

SOFI Coverage and Definitions

SOFI Categories Moderate Severe
HIV / AIDS N/A Occurrence of one of the following:
• HIV infection due to a blood transfusion, provided
that all of the following conditions are met:
a. the blood transfusion was Medically Necessary;
b. the blood transfusion was received by the Life
Insured in the Philippines after Policy Effective
Date or Reinstatement Date of this Policy,
whichever is later;
c. the source of the infection is established to be
contaminated blood provided for the blood
transfusion, the origin of which can be traced
through the institution providing such
contaminated blood; and
d. the Life Insured does not suffer from
Thalassaemia Major or Haemophilia.
• Infection with HIV where it was acquired as a result
of an accident during the course of carrying out
normal occupational duties with sero-conversion to
Positive HIV antibody occurring within 6 months of
the accident. Any accident giving rise to a potential
claim must be reported to us within 30 days from
occurrence and be supported by a negative HIV
antibody test taken immediately after the accident.

Confidential 61
PRUHealth FamLove

SOFI Coverage and Definitions

SOFI Categories Moderate Severe
HIV / AIDS N/A Occurrence of one of the following:
• The clinical manifestation of AIDS (Acquired
Immuno-deficiency Syndrome) supported by the
results of a positive HIV (Human Immuno-
deficiency Virus) antibody test and a
confirmatory Western Blot test. In addition, the
Life Insured must have a CD4 cell count of less
than two hundred (200) and one or more of the
following criteria are met:
a. Weight loss of more than 10% of body
weight over a period of six (6) months or
less (wasting syndrome);
b. Kaposi Sarcoma;
c. Pneumocystis carinii Pneumonia;
d. Progressive multifocal
leukoencephalopathy;
e. Active Tuberculosis;
f. Less than one-thousand (1000)
Lymphocytes;
g. Malignant Lymphoma.

This coverage shall cease in the event of an

efficient and effective vaccine being found for the
prevention of HIV/AIDS. The benefit does not cover
sexually-transmitted HIV infection.
Confidential 62
PRUHealth FamLove
SOFI Coverage and Definitions
SOFI Categories Moderate
Cardiovascular Moderate Impairment
System Occurrence of one of the following:
a. Ejection fraction of the heart is less than or
equal to 40% as measured by
Echocardiogram, or
b. Cardiac impairment of at least class III of the
New York Heart Association (NYHA)
Classification; or
c. Cardiac impairment at Stage C of the
American College of Cardiology
Foundation/American Heart Association
(ACCF/AHA) heart failure staging system.
The state must be irreversible and present for a
continuous period of at least six (6) month, and
not be improvable by the intake of medication.
Moderate Surgery
The actual undergoing of minimally invasive
surgery to repair disease or disorder of the heart,
heart valves or coronary arteries.
All Intra-arterial and catheter-based methods are
excluded.
Severe
Severe Impairment
Occurrence of one of the following:
a. Ejection fraction of the heart is less than or
equal to 30% as measured by Echocardiogram,
or
b. Cardiac impairment of at least class IV of the
New York Heart Association (NYHA)
Classification; or
c. Cardiac impairment at Stage D of the American
College of Cardiology Foundation/American
Heart Association (ACCF/AHA) heart failure
staging system.
The state must be irreversible and present for a
continuous period of at least six (6) month, and not
be improvable by the intake of medication.
Severe Surgery
Actual undergoing of open-heart surgery (with
thoracotomy) to treat any disease or disorder of
the heart.
Angioplasty, keyhole techniques, intra-arterial
techniques or other minimally invasive techniques
are excluded.
Confidential 63
PRUHealth FamLove

SOFI Coverage and Definitions

SOFI Categories Moderate
Respiratory Moderate Impairment
System Occurrence of either of the following:
Chronic irreversible lung disease with one of the
following:
a. FEV1 of less than or equal to 40% of predicted
FEV1 (obstructive) or FVC of less than or equal
to 40% of predicted FVC (restrictive); or
b. Severe irreversible changes in pulmonary
function tests with permanent DCO <50%
(obstructive and/or restrictive); or
c. Requiring assisted ventilation with a mechanical
ventilator for a continuous period of at least 12
hours on daily basis.
Severe
Severe Impairment
Severe chronic irreversible lung disease with dyspnea at
rest and lung function test consistently showing FEV1 of
less than or equal to 30% of predicted FEV1 value and
Arterial blood gas analyses with partial oxygen
pressures of 55mmHg or less (PaO2 ≤ 55mmHg);
requiring permanent supplementary oxygen therapy as
per standard treatment guidelines for respiratory
failure.
Diagnosis must be established by a Pulmonologist or
Respiratory Specialist Doctor along with laboratory
reports

The above must have been recorded for a continuous

period of at least two (2) months.

Severe asthma with persistent status asthmaticus

that requires hospitalization and assisted ventilation
with a mechanical ventilator for a continuous period
of at least four (4) hours on the advice of a Specialist
Doctor in the relevant field. Treatment by continuous
positive airways pressure delivered by CPAP or BIPAP
mask is excluded.

Diagnosis must be established with a Pulmonologist

or Respiratory Specialist Doctor along with laboratory
reports. Confidential 64
PRUHealth FamLove

SOFI Coverage and Definitions

SOFI Categories Moderate Severe
Respiratory Syste Moderate Surgery Severe Surgery
m The actual undergoing of one of the following Actual undergoing of transplantation of a lung
surgeries: as a recipient as a result of irreversible lung
a. Complete surgical removal of one lung as failure.
a result of illness or accident.
b. Tracheostomy for the treatment of lung
disease or airway disease or as a ventilatory
support measure following major trauma or
burns. The Life Insured must have been a
patient in a designated intensive care unit
under the care of a medical specialist. The
benefit is only payable if the tracheostomy is
required to remain in place and functional for
a minimum period of three months.
c. Surgical insertion of a vena-cava filter after
there has been documented proof of
recurrent pulmonary emboli.

All surgeries must be certified to be absolutely

necessary by a Specialist Doctor in the relevant
field.

Confidential 65
PRUHealth FamLove
SOFI Coverage and Definitions
SOFI Categories Moderate
Neurological Moderate Impairment
• Diagnosis of a neuro-muscular or spinal cord disease
System resulting in neurological deficit with persistent signs of
involvement of the spinal nerve columns and the motor
centres in the brain and with spastic weakness and atrophy
of the muscles of the extremities or resulting in permanent
bowel and bladder dysfunction requiring permanent regular
self-catheterisation or a permanent urinary or bowel conduit.
• Coma requiring the use of life support systems and lasting
continuously for at least 48 hours and resulting in permanent
neurological deficit. Permanency must be diagnosed no
sooner than six (6) weeks from occurrence.
• Severe epilepsy confirmed by all of the following:
a. Diagnosis made by a Specialist Doctor in the relevant
field by the use of electroencephalography (EEG),
magnetic resonance imaging (MRI), position emission
tomography (PET) or any other appropriate
diagnostic test that is available;
b. There must be documentation of recurrent
unprovoked tonic-clonic or grand mal seizures of
more than five (5) attacks per week, and be known
to be resistant to optimal therapy as confirmed by
drug serum-level testing; and
c. The Insured must have been taking at least two (2)
prescribed antiepileptic (anticonvulsant) medications
for at least three (3) months on
d. The Insured must have been taking at least two (2)
prescribed antiepileptic (anticonvulsant) medications
for at least three (3) months on the recommendation
of a Specialist Doctor in the relevant field.
e. Febrile or absence (petit mal) seizures alone will not
satisfy the requirement of this definition.
All diagnosis must be clinically confirmed by a Specialist Doctor
in the relevant field.
Severe
Severe Impairment
Occurrence of one of the following:
a. Diagnosis of neuro-muscular disease which results in significant
muscle weakness and permanent inability to perform 3 out of 6
Activities of Daily Living. Neuro-muscular diseases covered
include motor neurone disease, multiple sclerosis, muscular
dystrophy and amyotrophic lateral sclerosis. Permanency must
be diagnosed no sooner than 6 months from occurrence.
b. Coma requiring the use of life support systems and lasting
continuously for at least 96 hours and resulting in permanent
neurological deficit. Permanency must be diagnosed no sooner
than six (6) weeks from occurrence.
c. Diagnosis of severe dementia caused by Alzheimer's disease or
irreversible organic diseases with Clinical Dementia Rating of 3
and supported by Mini Mental State Examination (“MMSE”)
score of 17 or less (out of 30) or assessed by two (2)
neuropsychometric tests performed six (6) months apart with a
battery of tests which clearly define the severity of the
impairment.
All diagnosis must be clinically confirmed by a registered medical
specialist in the relevant field.
Confidential 66
PRUHealth FamLove

SOFI Coverage and Definitions

SOFI Categories Moderate Severe
Neurological Moderate Surgery Severe Surgery
System The actual undergoing of one of the following: The actual undergoing of surgery to the skull under
a. Burr hole surgery to the skull or general anesthesia during which a craniotomy
transphenoidal surgery for the insertion of (surgical opening of skull) is performed.
shunt, to remove subdural haematoma,
abnormal growth or lesion, or repair of The following are excluded:
intracranial aneurym or arterio-venous a. Burr hole procedures
malformation. Partial removal of pituitary b. Transphenoidal procedures
microadenoma and endovascular surgery are c. Endoscopic assisted procedures or any other
specifically excluded. minimally invasive procedures
b. Endarterectomy of the carotid artery which d. Brain surgery as a result of an accident
has been necessitated as a result of at least
80% narrowing of the carotid artery as
diagnosed by an arteriography or any other
appropriate diagnostic test of similar or
higher diagnostic accuracy that is available.
Endarterectomy of blood vessels other than
the carotid artery are specifically excluded.

All surgeries must be certified to be absolutely

necessary by a Specialist Doctor in the relevant
field.

Confidential 67
PRUHealth FamLove

SOFI Coverage and Definitions

SOFI Categories Moderate Severe
Renal System and Moderate Impairment Severe Impairment
Kidney Function Chronic kidney disease with permanent impaired Severe irreversible functional impairment of the
renal function evidenced by severely reduced kidney requiring either permanent renal dialysis or
eGFR less than 30 ml/min/1.73m2 body surface kidney transplantation.
area and persisting for a period of at least 6
months.

Moderate Surgery Severe Surgery

The complete surgical removal of one kidney Actual undergoing of kidney transplant as a
necessitated by any illness or accident. The need recipient as a result of irreversible kidney failure.
for the surgical removal of the kidney must be
certified to be absolutely necessary by a
Nephrologist.

Confidential 68
PRUHealth FamLove

SOFI Coverage and Definitions

SOFI Categories Moderate
Hepatic System Moderate Impairment
and Liver Function Liver cirrhosis with a HAI-Knodell Score of 6 and
above as evident by liver biopsy. The diagnosis
must be unequivocally confirmed by a Specialist
Doctor in the relevant field and based on the
histological findings of the liver biopsy.
Severe
Severe Impairment
End stage liver failure confirmed by a Specialist
Doctor in the relevant field and fulfilling Child-Pugh
Class C and MELD score of at least 19.
Liver disease secondary to alcohol or drug abuse is
excluded.

Moderate Surgery Severe Surgery

The actual undergoing of one of the following Actual undergoing of liver transplant as a recipient
surgeries: as result of irreversible liver failure.
a. Partial hepatectomy of at least one entire
lobe of the liver that has been found
necessary as a result of illness or accident of
the Life Insured.
b. Biliary tract reconstruction surgery involving
choledochoenterostomy, necessitated by
disease or trauma of the biliary tract. Biliary
atresia is excluded.

All surgeries must be certified to be absolutely

necessary by a Specialist Doctor in the relevant
field.

Confidential 69
PRUHealth FamLove
SOFI Coverage and Definitions
SOFI Categories Moderate
Sensory System Moderate Impairment
Occurrence of one of the following:
a. Total and irreversible loss of sight in one eye or
any disease or disorder of the eyes leading to a
permanent best corrected visual acuity of 6/60 or
less on the Snellen Chart in both eyes or visual
field of ten (10) degrees or less in the better eye.
Permanency must be diagnosed no sooner than 6
months.
b. Permanent and irreversible binaural hearing loss of
at least 60 decibels in all frequencies of hearing.
Permanency must be diagnosed no sooner than 6
months.
All diagnosis must be clinically confirmed by a Specialist
Doctor in the relevant field.
Severe
Severe Impairment
Occurrence of one of the following:
a. Permanent and irreversible loss of sight in both eyes
as a result of illness or accident to the extent that
even when tested with the use of visual aids, vision is
measured at 3/60 or worse in both eyes using a
Snellen eye chart or equivalent test, or visual field of
20 degrees or less in both eyes. The blindness must
be confirmed by an ophthalmologist. Permanency
must be diagnosed no sooner than six (6) weeks.
b. Permanent and Irreversible loss of at least 80
decibels in all frequencies of hearing in both ears as a
result of illness or accident. Medical evidence in the
form of an audiometry and sound threshold tests
must be provided and certified by an Ear, Nose, and
Throat (ENT) Specialist Doctor. Permanency must be
diagnosed no sooner than 6 months.
c. Total and irreversible loss of the ability to speak as a
result of injury or disease to the vocal cords. The
inability to speak must be established for a
continuous period of 12 months. This diagnosis must
be supported by medical evidence furnished by an
Ear, Nose, Throat (ENT) Specialist Doctor. All
psychiatric related causes are excluded.
No benefit will be payable if a device, or implant could
result in the partial or total restoration of
sight/hearing/speech.
Confidential 70
PRUHealth FamLove

SOFI Coverage and Definitions

SOFI Categories Moderate Severe
Sensory System Moderate Surgery Severe Surgery
The actual undergoing of one of the following None
surgeries:
a. Receipt of a transplant of a whole cornea
due to irreversible scarring with resulting
reduced visual acuity, which cannot be
corrected with other methods.
b. Surgical cochlear implant as a result of
permanent damage to the cochlea or
auditory nerve.
c. Surgical drainage for Cavernous Sinus
Thrombosis.

All surgeries must be certified to be

absolutely necessary by a Specialist Doctor in
the relevant field.

Confidential 71
PRUHealth FamLove
SOFI Coverage and Definitions
SOFI Categories Moderate
Disabilities Moderate Impairment
Accident or illness resulting in one of the following conditions
being met:
a. If the Insured is under the age of 16 at the time of the
accident or illness, it must result in permanent and
irreversible physical impairment(s) requiring permanent
and constant daily and medical care by an adult caregiver
throughout the Insured's life.
b. If the Insured is age 16 or above at the time of the
accident or illness, the condition must cause permanent
and irreversible inability of the Insured to perform at least
2 of the 6 Activities of Daily Living without the assistance
of another person.
c. Complete and permanent loss of use of one entire limb
through paralysis persisting for at least 6 months from the
date of accident or illness.
d. Second degree (partial thickness of the skin) burns
covering at least 20% of the surface of the Life Insured's
body, or Third degree (full thickness of the skin) burns
covering at least 50% of the face of the Life Insured.
e. Osteoporosis with Fractures where all of the following
conditions are met:
i. at least a fracture of the neck of femur or two (2)
vertebral body fractures, due to or in the presence
of osteoporosis; and
ii. bone mineral density measured in at least two (2)
sites by dual- energy x-ray densitometry (DEXA)
or quantitative CT scanning is consistent with
severe osteoporosis (T-score of less than -2.5).
iii. Actual undergoing of internal fixation or
replacement of the fractured bone is required.
Moderate Surgery
None
Severe
Severe Impairment
Accident or illness resulting in one of the following conditions being
met:
a. If the Insured is under the age of 16 at the time of the
accident or illness, it must result in permanent and
irreversible physical impairment(s) requiring permanent and
constant daily and medical care in a specialized medical
facility throughout the Insured's life. Permanency must be
diagnosed no sooner than 6 months.
b. If the Insured is age 16 or above at the time of the accident
or illness, the condition must cause permanent and
irreversible inability of the Insured to perform at least 3 of
the 6 Activities of Daily Living without the assistance of
another person. Permanency must be diagnosed no sooner
than 6 months.
c. Complete and permanent loss of use of both arms or both
legs, or one arm and one leg, through severance or paralysis
persisting for at least 6 months from the date of accident or
illness.
d. Third degree or full thickness burns covering at least 20% of
the body surface area as measured by The Rule of Nines or
the Lund and Browder Body Surface Chart.
Severe Surgery
None Confidential 72
Product Comparison
 AIA Active
PRUHealth FamLove Family Care Plus Troo Health Sun Healthier Life
Joint Critical Protect

Product type Traditional Traditional Traditional Traditional Traditional

Participating N/A

Payment Term 1 year (YRT until age 85) 10 years 10 years 1 year 5 years

Premium Structure Increasing every renewal Level for 10 years Level for 10 years Increasing every renewal Level for 5 years

0 to 60 years old 18-65 years old 18-65 years old 30 days old – 60 years old 18-60 years old
(Main Insured
Issue Age
15 days to 70 years old (Other Life
Insureds)

Coverage Period Until age 85 Until age 75 Until age 75 Until age 80 Until age 70

100 of the sum assured 100% of the face amount 100% of the face amount 100% of the face amount 100% of the face amount less Minor
Death Benefit
CI benefit and/or angioplasty

Auto-renewal after 1 year; Auto-renewal after 10-years with Autorenewal after 10-years with Data not available Autorenewal after 5-years with
Renewability
premium increasing every year higher premium higher premium higher premium

Issuance SIO Full underwriting Full underwriting Full underwriting SIO

Critical Illness coverage
Type Accelerated Accelerated Accelerated Accelerated

100% of the sum assured 100% of face amount 100% of face amount 100% of the benefit amount 100% of the face amount
Benefit for major illness

Pays 50% of the sum assured Not applicable Not applicable Not applicable Pays 30% of the face amount. Can
claim up to 3 times as long as each
Benefit for minor illness
Minor CI benefit claimed does not
belong to the same group

Based on SOFI concept – per 10 major CI 10 major CI Bronze Package: 12 CI 8 minor and 5 major CI
Total no. of illnesses system and organ Silver Package covers 19 CI
covered Gold Package covers 44 CI
8CIs for children
Other benefits
Not applicable Cash value on 4th to 8th year in case Cash value on 4th to 8th year in case Data not available
Cash Value
of surrender of surrender

Not yet applicable Philam Vitality
Additional 20% coverage upfront
increase in base coverage. Increase
Hospitalization
can range from 0-50% depending
on status of either of the LI per
policy year
Philam Vitality HMO benefit c/o Kaiser None
Additional 20% coverage upfront International Health Group
increase in base coverage. Increase
can range from 0-50% depending
on status of either of the LI per
policy year

Maximum of 4 family members Maximum of 2 family members Maximum of 2 family members Not applicable Not applicable
Insured(s) including the main insured including main insured including main insured

Confidential 74
This presentation is only for internal use and not to be construed as a sales or marketing material to be shared with an external party. Market Conduct Guidelines (MCG) prohibits agents from making disparaging
remarks and/or making comparisons with the products of other insurers.
PRUHealth FamLove

Strengths of the product vs competitors

Shareability of coverage to up to 3 family
members depending on chosen package
Modern family allowed

SOFI for CI coverage which is a first in the

industry

Coverage for one year but renewable up to

age 85

Pays 50% of SA upon diagnosis of

moderate CI

Covers a wide spectrum of CI conditions

Available to juvenile life insureds

Confidential 75