Can I claim for hospitalization benefit due to illness, surgery, accident, or duty-related injuries?

As a token of sincere appreciation for members’ continuing support, AFPMBAI is pleased to offer the FREE Daily Hospital Income Benefit (DHIB) to members who are hospitalized due to sudden illness, duty-related injuries, or accident, effective 01 January 2024.

Members must be hospitalized for at least 18 hours at any government or private hospital and must be bonafide regular members of the Association. Military and uniformed personnel retirees who are enrolled under MBAI iProtek are also eligible to claim.

The DHIB is on top of the Wounded-in-Action Benefit up to ₱12,000 and Battle Injury Assistance up to ₱14,000. Under MBAI Protek Basic Insurance, there are also specific Dismemberment and Disability Benefits based on the table of benefits (ex. 1 hand or leg = 50% of Face Amount; 2 eyes = 100% of Face Amount).

You can also file for a Permanent Disability Claim under your MBAI Protek if you suffered from a work-related illness or suffered injury/accident in the line of duty, subject to medical evaluation.

REQUIRED DOCUMENTS:

Any of the following documents:

1. Narrative Summary
2. Clinical Summary
3. Medical Abstract
The document must include:
• Physician’s signature, license number, and contact information
• Dates of admission and discharge, or an indication that the in patient management is still ongoing
• Date of issuance of the document
4. Original and photocopy of AFPMBAI ID/Service ID/National ID (with 3 specimen signatures and contact number)
5. Latest Payslip (during the month of hospital confinement)
6. Duly accomplished DHIB Claim Form including DPA consent

*The above documents obtained after discharge from the hospital shall be required to be submitted by the affected regular member or his/her authorized representative.

EXCLUSIONS:

Outpatient care
Hospital confinement for physical check-up or diagnostic purposes or pregnancy related check-up
Pregnancy (including childbirth, miscarriage or abortion), and all complications arising therefrom
Injuries or illnesses which are self-inflicted, caused by suicide attempt or incurred as a result of or while participating in the commission of a crime
Rest cures, custodial domiciliary, or convalescent cares
Cosmetic surgery, and surgery for purpose of beautification
Functional disorders of the mind in relation to substance abuse, drug addiction, or alcoholism
Injury sustained while under the influence of alcohol or drugs
Sexually transmitted diseases
Provoked assault
Atomic explosion, nuclear fission, or radioactive gas

DHIB Claim Forms may be downloaded from the website at bit.ly/AFPMBAIForms.

Requirements may be submitted to AFPMBAI Customer Service through email at mail@afpmbai.ph or at an AFPMBAI Office near you (see branch directory at bit.ly/AFPMBAILocation).

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