Insurance Company of North America O +632 8849 6045

A Chubb Company F +632 8325 1670

24 th Floor Zuellig Building www.chubb.com/ph
Makati Avenue corner Paseo de Roxas
Makati City, Philippines 1226

Confirmation of Cover
GInsure Bill Protect
Group Personal Accident
Insurance Policy
This certifies that the person named below, and hereafter called the Insured, is
covered under the indicated Group Policy issued by Insurance Company of
North America (a Chubb Company) to the named Policyholder subject to the
terms and conditions thereof.

Policyholder: G-XCHANGE, INC.

Insured: EDILBERTO JR LAZO

Effective Date: 01 June 2023

Expiry Date: 01 June 2024

From: 31 October 2023

Period of Insurance:
To: 30 November 2023

Group Policy No.: GCASH00011

COC Number: BPAZ8KIPBDKBFRT

COC Issue Date: 01 November 2023

Premium: Php 3.59

Benefit Section Benefit Amount

Php 14,040
A. Accidental Death Benefit Maximum Benefit Amount per
Insured /per month is P3.6M

Confirmation of Cover, GInsure Bill Protect Group Personal Accident Insurance Policy. Philippines. Published 05/2021.
© 2019 Chubb. Chubb® logo and Chubb. Insured.SM are protected trademarks of Chubb Limited. 1
 (regardless of number of
transactions)

Php 14,040

Maximum Benefit Amount per

B. Permanent Disablement Benefit Insured /per month is P3.6M

(regardless of number of
transactions)

Notice of Claim or Loss

In case of Injury or Accidental Death, written notice of claim must be given by
the Insured to the Company within thirty (30) days after a covered loss occurs
or as soon as is reasonably possible. Notice should include the Insured’s name
and the Confirmation of Cover number.

Availability of the Group Policy

This Group Policy shall kept be in the main office of the Policyholder and shall
be in the custody of its authorized officer. This Group Policy shall be available
to the Insured for inspection during the regular office hours of the
Policyholder.

Insurance Company of North America

A Chubb Company

______________________________
Authorized Signatory

Confirmation of Cover, GInsure Bill Protect Group Personal Accident Insurance Policy. Philippines. Published 05/2021.
© 2019 Chubb. Chubb® logo and Chubb. Insured.SM are protected trademarks of Chubb Limited. 2