11th Floor Sage House, 110 V.A.

Rufino Street,
Legaspi Village, Makati City 1229, Philippines
Telephone: (02) 8772 9264
Email: direct@paramount.com.ph
www.paramountdirect.com

Hospital Income
Benefit Plan
Contract and Insuring Clause
In this Policy you, the Insured, will be referred to as “you” or “your” and Paramount Life & General Insurance Corporation will be referred to as
“we”, “our”, “us”, “Paramount Life” or the “Company”. We agree, subject to the provisions of this Policy, to pay the appropriate benefits in case of
Covered Injury or Covered Sickness.

This Policy is issued to you in consideration of the application and the payment of the Initial Premium stated in the Policy Schedule.

This Policy, including the application and any endorsement attached to it, constitutes the entire contract of insurance.

Only the Chairman of the Board, President, Executive Vice-President and any other officer duly authorized by Paramount Life’s Board of Directors
may make or modify this contract, extend the time for payment of any premium, waive any of Paramount Life’s rights or requirements or bind us
by making any promise not contained in this Policy. Any such modification must be in writing and duly signed by the authorized officer.

Free Look
If for any reason you are not satisfied or disagree with the terms and conditions of this Policy, you may return it to us within fifteen (15) days
from receipt. Immediately upon our receipt, this Policy shall be void from its Effective Date and any premium paid shall be refunded to you.

Effective Date
Coverage under this Policy shall take effect on the date the Policy is issued, or the date the Initial Premium is paid, during your lifetime, whichev-
er occurs later.

Guaranteed Continuity
We guarantee the continuity of this Policy until your seventieth (70th) birthday following your policy anniversary as long as the effective premium
is consecutively paid when due or within the 31-day Grace Period. We also agree that the premium will not be adjusted unless the adjustment is
based on the experience of all similar policies issued by Paramount Life and is made on all such policies.

We shall not have the right to change the premiums on your Policy solely because of any change in your health or your individual claims history.

Policy Date
Policy Date is the date on which the first premium is due, as set forth in the Policy Schedule. It will be used to determine premium due dates,
policy years and policy anniversaries.

Issue Date
Issue Date is the date on which this Policy is issued by the Company.

Issue Age
“Issue age” shall mean age last birthday as of the Policy Date. The term “age” as used in this Policy shall mean the policy anniversary on which
the age last birthday is the specified age.

DEFINITIONS

Covered Sickness
“Covered Sickness” means illness or disease which begins after the Effective Date of this Policy and while this Policy is inforce and results in Hos-
pital Confinement. If sickness is the result of a Pre-existing Condition, the Pre-Existing Condition Limitation, as provided in the Policy Conditions,
will apply.

Injury
“Injury” shall mean bodily injury sustained while this Policy is in force, caused solely by external, violent and accidental means that produce a
visible contusion or wound on the exterior of the body, except in the case of drowning or of internal injury as revealed by an autopsy.

Covered Injury
“Covered Injury” means Injury occurring after the Effective Date of this Policy and while this Policy is inforce and results in Hospital Confinement.

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Dread Disease
“Dread Disease” means only cancer, poliomyelitis, muscular dystrophy, multiple sclerosis, cirrhosis of the liver or emphysema.

“Cancer” means a disease manifested by the presence of a malignant tumor characterized by the uncontrolled growth and spread of malignant cells,
the invasion of tissue or leukemia. Such cancer must be positively so diagnosed by a Doctor or pathologist either during the Insured’s lifetime or as
disclosed by a postmortem examination. The pathologist establishing the diagnosis shall base his judgment solely on the accepted criteria of malig-
nancy after a study of the histocytologic architecture or pattern of the suspected tumor, tissue or specimen.

Clinical diagnosis does not meet this standard. Whenever the requisite positive diagnosis of cancer can only be made by a postmortem, Paramount
Life shall assume retroactive liability. Such retroactive liability shall be limited to the period of time beginning with the date of terminal admission to
the Hospital, but in no event to exceed eight weeks prior to the demise of the Insured.

Doctor
“Doctor” means a legally qualified physician other than you or a member of your immediate family.

Hospital
“Hospital” means a legally constituted institution registered as a hospital or clinic with the Department of Health, is open at all times, provides 24-
hour nursing service by trained nurses, and providing facilities for diagnosis and major surgery, but shall not include any hospital, clinic or facility
contracted for or operated by the Philippine Government primarily for the treatment of members or ex-members of the armed forces, and shall
not include any institution used other than incidentally, as a place of rehabilitation, rest, for the aged, for drug addicts, or for alcoholics, a mental
institution, nursing or convalescent home or geriatric ward.

Covered Family Member

“Covered Family Member” means your spouse and any unmarried legitimate or legally adopted child over 90 days of age and under the age of
21 years who is residing with you and who is specified in the Application Form. Any child born to you and your spouse during the effectivity of
this Policy shall be automatically included in the coverage of this Policy effective either on the 90th day after birth or upon discharge of said child
from the Hospital, whichever shall last occur.

Hospital Confinement
“Hospital Confinement” means confinement in a Hospital for at least 18 hours as a resident patient for the treatment of Covered Sickness or
Covered Injury and which is recommended by a Doctor.

Pre-Existing Condition
“Pre-existing Condition” shall mean any Injury, illness or covered Dread Disease prior to the Effective Date or the date of last reinstatement of
this Policy (1) which was evident to the Insured or a Covered Family Member; or, (2) which the pathogenesis of such illness or covered Dread
Disease has started, whether or not the Insured or Covered Family Member is aware of such illness or condition; or, (3) for which the Insured or
Covered Family Member received any medical advice, diagnosis, care or treatment.

Look-back Period
“Look-back Period” shall mean two (2) years counted from the Effective Date of this Policy in which the Pre-existing Condition existed.

BENEFIT PROVISIONS

Hospital Confinement due to Dread Disease

If a Covered Sickness results in your Hospital Confinement or the Hospital Confinement of a Covered Family Member, and if such Confinement is
due to a Dread Disease, we will pay periodically the Daily Dread Disease Cash Benefit specified in the Policy Schedule during the continuance of
such Hospital Confinement commencing with the first day of such Hospital Confinement for a maximum period of 365 days.

Hospital Confinement due to an Injuruy or Illness (other than Dread Disease)

If a Covered Sickness or Covered Injury other than Dread Disease results in your Hospital Confinement or the Hospital Confinement of a Covered
Family Member, we will pay periodically the Daily Hospital Cash Benefit specified in the Policy Schedule during the continuance of such Hospital
Confinement commencing with the first day of such Hospital Confinement for a maximum period of 365 days.

Dread Disease Cash Benefit includes Hospital Cash Benefit. Where Dread Disease Cash Benefit is payable, Hospital Cash Benefit is not payable.

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Waiver of Premium Benefit
If you or a Covered Family Member is continuously confined in a Hospital for thirty days or more, any premium falling due during such period of
hospitalization will be waived.

Convalescence Benefit
If you or a Covered Family Member is continuously confined in a Hospital for thirty days or more, we will pay the Convalescence Benefit specified
in the Table of Inflation Benefit upon discharge from Hospital.

Inflation Benefit
The Daily Hospital Cash Benefit, Daily Dread Disease Benefit, and Convalescence Benefit will increase by 10% of the original amount at the end of
each of the first two (2) policy years, without any extra premium to you, in accordance with the Table of Inflation Benefit.

World-Wide Coverage
Coverage under this Policy applies throughout the world provided that you and all Covered Family Members are permanently residing in the
Philippines at Date of Issue.

Repeated Hospital Confinement

If benefits become payable under this Policy and you or a Covered Family Member are again confined in a Hospital due to the same or a related
Covered Sickness or Covered Injury, the subsequent period of Hospital Confinement shall be considered a continuation of the prior period and
benefits will commence with the first day of such Hospital Confinement for a Covered Sickness or Covered Injury and the total combined Hospital
Confinements will be subject to the 365 day maximum period, unless at least six (6) months elapse between confinements, in which event the
subsequent period of Hospital Confinement shall be considered as resulting from a different Covered Sickness or Covered Injury.

POLICY CONDITIONS
Pre-Existing Condition Limitation
No benefit shall be provided to the Insured or a Covered Family Member, if applicable, for Hospital Confinement resulting directly or indirectly
from any Pre-existing Condition within the Look-back Period and within one (1) year from the Effective Date of this Policy or the date of its last
reinstatement.

Any Injury, illness or covered Dread Disease that happened earlier than the Look-back Period shall not be used as a ground to deny the claim for
being based on a Pre-existing Condition.

Hospitalizations Not Covered by the Policy

This Policy does not cover hospital confinement caused by: self-inflicted injuries; nervous breakdown, depression and other related nervous
disorder; mental illness or disorder; pregnancy, childbirth, miscarriage, abortion, or complications of any of these; congenital deformities and
defects such as harelip, clubfoot, hernia, heart defect, abnormal bone or muscular growth; drug addiction; continued excessive or compulsive
use of alcoholic drinks; declared or undeclared war or civil strife; ionizing radiation or contamination by radioactivity from any nuclear fuel or any
nuclear waste; routine physical check-up and rest cures; cosmetic surgery. Neither does this Policy cover any hospital confinement or charges
incurred for the treatment of Acquired Immune Deficiency Syndrome (AIDS) nor charges for the examination, immunization and detection of
human immunodeficiency virus and other related viruses.

Payment of Premiums
Premiums are due and payable on the Policy Date and on each subsequent premium due dates as specified in the Policy Schedule. Premiums
may be paid monthly, quarterly, semi-annually or annually, at any offices of Paramount Life & General Insurance Corporation.

Grace Period
A Grace Period of thirty-one (31) days will be allowed for the payment of each premium after the first, during which time this Policy will remain
in force. If a Hospital Confinement occurs during the period of grace, any premium then due and unpaid shall be deducted from the amount
payable in settlement under this Policy.

Reinstatement
If any premium after the first is not paid within the time allowed for payment, this Policy will lapse. It may be reinstated at any time within
three (3) years on production of evidence of insurability satisfactory to us, and payment of past due premiums with interest at 10% per annum.
The reinstated policy shall cover only loss resulting from Injury sustained after the date of reinstatement and loss resulting from sickness
which began more than ten (10) days after such date. In all other respects, you and we shall have the same rights as existed under this Policy
immediately before the expiry of the Grace Period, subject to any restrictions which are attached in connection with the reinstatement.
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How to make a Claim
Notice of claim may be given to us within fifteen (15) days after the date of hospitalization. The failure to give notice within this time shall not
invalidate a claim if it was shown not to have been reasonably possible to give such notice. In this case, notice must be given as soon as was
reasonably possible.

To make a claim, you need only return, properly completed, the claim form which will be provided by us upon request. This formality and
obligation has one basic purpose in mind – to enable us to make claim payments as quickly as possible. If this information is not provided, claim
payment might either be delayed or refused.

We may, at our own expense, examine a claimant whenever reasonably necessary during the pendency of claim hereunder. Upon receipt of a
notice of claim, we will supply you with such forms as are usually furnished by us for confirmation of Hospital Confinement.

Payment of Benefits
All accrued benefits which this Policy provides will be paid upon discharge from the Hospital. However, in the event of a Hospital Confinement for
a period exceeding fourteen (14) days, we will, at your request, make periodical payments. All benefits will be payable to you or to your estate in
case of death.

Misstatement of Age
If your date of birth or the date of birth of a Covered Family Member has been misstated, all benefits payable under this Policy shall be adjusted
to the amount that the premium would have been purchased at the correct age.

Residence
You are eligible for coverage under this Policy only if, at the Date of Issue, you and all Covered Family Members are permanently residing in the
Philippines.

Limitation of Insurance
You and any Covered Family Members may have inforce one or more policy/ies of this type provided the total Daily Hospital Cash Benefits do not
exceed the maximum amounts as stated in the Policy Schedule. All premiums paid for additional policies of this type will be considered null and
void and the corresponding premiums will be refunded.

Termination
This Policy shall automatically terminate and our liability and your payment of premium shall stop:

1. On the policy anniversary following the Insured’s 70th birthday; or,

2. Upon non-payment of any premium on this Policy at the end of the Grace Period; or,
3. On the date this Policy is cancelled by you as of any Premium Due Date by giving written notice to PLGIC.

A covered child shall cease to be covered at the end of the premium paying period following the child’s marriage, cessation of dependency on
you or 21st birthday, whichever occurs first.

A covered spouse shall cease to be covered on the date the spouse ceases to be your Spouse.

Legal Action
No action at law or in equity shall be brought to recover on this Policy before the expiration of sixty (60) days after written proof of Hospital
Confinement has been submitted to us. If a claim be made and rejected and an action or suit has not commenced either in the Insurance
Commission or any Court of competent jurisdiction within one (1) year from receipt of notice of such rejection, then the claim shall for all
purposes be deemed to have been abandoned and shall not thereafter be recoverable.

Non-participation
This Policy is non-participating and does not share in the divisible surplus of the company.

Important Notice
The Insurance Commission, with offices in Manila, Cebu and Davao, is the government office in charge of the enforcement of all laws related
to insurance and has supervision over insurance providers and intermediaries. It is ready at all times to assist the general public in matters
pertaining to insurance. For any inquiries or complaints, please contact the Public Assistance and Mediation Division (PAMD) of the Insurance
Commission at 1071 United Nations Ave., Ermita, Manila with telephone numbers +632-5238461 to 70 and email address publicassistance@
insurance.gov.ph. The official website of the Insurance Commission is www.insurance.gov.ph.

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Currency
All amounts of money in this Policy are in the legal currency of the Philippines. The provision of Article 1250 of Civil Code of the Philippines
(RA No. 386) which reads

“In case an extraordinary inflation or deflation of the currency stipulated should supervene, the value of the currency at the time of
the establishment of the obligation shall be the basis of payment…”

is understood and agreed not to apply in determining the extent of any liability of the Company in this Policy.

TABLE OF INFLATION BENEFIT

DAILY HOSPITAL CASH BENEFIT
Policy Year Plan 250 Plan 500 Plan 750 Plan 1000 Plan 1250 Plan 1500 Plan 1750 Plan 2000 Plan 2250 Plan 2500

Year 1 P250 P500 P750 P1,000 P1,250 P1,500 P1,750 P2,000 P2,250 P2,500
Year 2 P275 P550 P825 P1,100 P1,375 P1,650 P1,925 P2,200 P2,475 P2,750
Year 3 P300 P600 P900 P1,200 P1,500 P1,800 P2,100 P2,400 P2,700 P3,000

Policy Year Plan 2750 Plan 3000 Plan 3250 Plan 3500 Plan 3750 Plan 4000 Plan 4250 Plan 4500 Plan 4750 Plan 5000

Year 1 P2,750 P3,000 P3,250 P3,500 P3,750 P4,000 P4,250 P4,500 P4,750 P5,000
Year 2 P3,025 P3,300 P3,575 P3,850 P4,125 P4,400 P4,675 P4,950 P5,225 P5,500
Year 3 P3,300 P3,600 P3,900 P4,200 P4,500 P4,800 P5,100 P5,400 P5,700 P6,000

DAILY DREAD DISEASE CASH BENEFIT

Policy Year Plan 250 Plan 500 Plan 750 Plan 1000 Plan 1250 Plan 1500 Plan 1750 Plan 2000 Plan 2250 Plan 2500

Year 1 P500 P1,000 P1,500 P2,000 P2,500 P3,000 P3,500 P4,000 P4,500 P5,000
Year 2 P550 P1,100 P1,650 P2,200 P2,750 P3,300 P3,850 P4,400 P4,950 P5,500
Year 3 P600 P1,200 P1,800 P2,400 P3,000 P3,600 P4,200 P4,800 P5,400 P6,000

Policy Year Plan 2750 Plan 3000 Plan 3250 Plan 3500 Plan 3750 Plan 4,000 Plan 4,250 Plan 4500 Plan 4750 Plan 5000

Year 1 P5,500 P6,000 P6,500 P7,000 P7,500 P8,000 P8,500 P9,000 P9,500 P10,000
Year 2 P6,050 P6,600 P7,150 P7,700 P8,250 P8,800 P9,350 P9,900 P10,450 P11,000
Year 3 P6,600 P7,200 P7,800 P8,400 P9,000 P9,600 P10,200 P10,800 P11,400 P12,000

CONVALESCENCE BENEFIT
Policy Year Plan 250 Plan 500 Plan 750 Plan 1000 Plan 1250 Plan 1500 Plan 1750 Plan 2000 Plan 2250 Plan 2500

Year 1 P5,000 P10,000 P15,000 P20,000 P25,000 P30,000 P35,000 P40,000 P45,000 P50,000
Year 2 P5,500 P11,000 P16,500 P22,000 P27,500 P33,000 P38,500 P44,000 P49,500 P55,000
Year 3 P6,000 P12,000 P18,000 P24,000 P30,000 P36,000 P42,000 P48,000 P54,000 P60,000

Policy Year Plan 2750 Plan 3000 Plan 3250 Plan 3500 Plan 3750 Plan 4000 Plan 4250 Plan 4500 Plan 4750 Plan 5000

Year 1 P55,000 P60,000 P65,000 P70,000 P75,000 P80,000 P85,000 P90,000 P95,000 P100,000
Year 2 P60,000 P66,000 P71,500 P77,000 P82,500 P88,000 P93,500 P99,000 P104,000 P110,000
Year 3 P66,000 P72,000 P78,000 P84,000 P90,000 P96,000 P102,000 P108,000 P114,000 P120,000

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