PRUHEALTH_PRIME_TRAINING_SLIDES

PRUHealth Prime Training Material
March 2021 | Product Management

I. Market Overview
2
Market Overview
Chronic Diseases
Non-communicable diseases (NCDs), are

▪ Not passed from person to person
▪ They are of long duration and generally
slow progression
▪ Also known as lifestyle diseases as it is
usually linked to consumption of “sin”
products such as alcohol and cigarettes
Characteristics of Chronic conditions

▪ Persistent
▪ Long term
▪ Indefinite recovery
▪ No permanent cure
▪ Often requiring ongoing treatment
Confidential 3
Market Overview
Leading Causes of Death in the Philippines
Top 10 Causes of Death as of 2018

Total Number of Deaths Other important facts:
Ischaemic heart disease 88,433
Neoplasms 63,454 68% Percentage of all deaths in the

Philippines caused by NCDs
Cerebrovascular disease 61,959
Pneumonia 56,815 29% Probability of Filipinos dying between

ages of 30 to 70 years old due to NCDs
Diabetes Mellitus 32,106
Hypertensive diseases 26,836 Breast Cancer is the leading cause of
death among Filipino women
Chronic lower respiratory infections 24,820
Respiratory Tuberculosis 22,103 Ischemic Heart Disease is the top

cause of death for Filipino men
Other heart diseases 20,042
Remainder of diseases of the 16,029

genitourinary system
Source: https://psa.gov.ph/content/registered-deaths-philippines-
2018#:~:text=Ischaemic%20heart%20diseases%20lead%20causes%20of%20deaths&text=Neoplasms
Confidential 4
%2C%20which%20are%20commonly%20known,Figure%208%20and%20Table%208).
Market Overview
Cost of Getting Sick in the Philippines
Diseases Cost in PhP
Acute Heart Attack 978,650 84% Percentage of Filipinos that

are not financially prepared
for medical costs that come
Stroke 1,800,000 with
critical illness
Lung Cancer 2,780,000
Breast Cancer 438,000 4% Percentage of Filipinos

enrolled in HMO
Kidney Dialysis 192,000 to 432,000/year
Source: https://movendi.ngo/news/2019/11/03/philippines-ncds-cause-massive-economic-loss/
Confidential 5
Market Overview
Pru Life UK Claims Data
Critical illness conditions consist about 93% of Pru Life UK claims.

54% of it is from claims that are Cancer-related.
Top CI claim conditions
Cancer 54%
Stroke 19%
Heart attack 11%
Renal Failure 5%
Coronary Artery
4%
Bypass Surgery
*Data as of 2019
Confidential 6
Despite several critical illness
products in the market
Existing Pru Life UK stand Pru Life UK aspires to be
covering the most number of alone critical illness a key player in health and
conditions, no company products showed weak protection through
seems to clearly own the performance vis-à-vis PRUHealth Prime.
critical illness insurance competitors.
space.
Confidential 7
II. PRUHealth Prime
Confidential 8
PRUHealth Prime
Product Features
Product Type Variable life insurance

Premium
Level
Structure
Premium Term 20-pay
Issue Age 0 (30 days) to 60 (age of last birthday)
Coverage Period Until age 85
Currency Philippine Peso
Annual, Semi-annual, Quarterly, and
Mode of Payment
Monthly
If the fund value becomes insufficient to pay for applicable charges, top-ups may be required
even after premium payment term for the client to continuously enjoy the benefits of the policy.
Confidential 9
PRUHealth Prime
Core Benefits
Death Benefit The sum of:

Once Death Benefit is 1. 100% of Sum Assured less any Early Stage Cancer Benefit
claimed, the policy payout
terminates. 2. Fund Value
3. 125% of Top-ups less 125% of Withdrawals on the Top-up
units.
Cancer Benefits
Early Stage Upon early stage Cancer diagnosis:
Cancer Benefit 50% of the Sum Assured
Coverage continues but
at a lower coverage *subject to a cap of PhP 3.75M (for adult age 18-60) and PhP
amount. 1.5M (for juvenile age 0-17) per life
Late Stage Upon late stage Cancer diagnosis:

Cancer Benefit
The policy terminates The sum of:
once the Late Stage 1. 100% of the Sum Assured less any Early Stage Cancer Benefit
Cancer Benefit has been payout
claimed. 2. Fund Value
Confidential 10
PRUHealth Prime
Core Benefits
Hospitalization Benefits
Hospital Income Upon admission to hospital due to early or late stage Cancer
Benefit diagnosis:
0.125% of Sum Assured subject to a maximum of PhP 10,000
per day
If hospital confinement is in the Intensive Care Unit:

Twice the daily Hospital Income Benefit
▪ Subject to maximum of 90 days hospital confinement per life where

each hospitalization is capped at 45 days
▪ Should be filed and claimed simultaneously with the corresponding
Early Stage and/or Late-Stage Cancer Benefit to be payable.
Post-Hospitalization Lump sum payment of PhP 5,000 for specialist doctor visit due to
Benefit late stage Cancer following hospitalization discharge
This is payable once as a lump sum benefit on top of the HI

Benefit. It may also be claimed simultaneously with the Late
Stage and HI Benefit claim.
Confidential 11
PRUHealth Prime
Core Benefits
Maturity The sum of:

Benefit 1. 100% of the Sum Assured less any Early
Claimable once the Stage Cancer Benefit claims
insured reach age 2. Fund Value
85
Loyalty Bonus Additional 10% of the regular premium to be
given on policy year 11-20, subject to certain
conditions
The fund value is not guaranteed. If it becomes insufficient to cover outstanding charges even
after premiums have been fully paid, the policy will be terminated. The Policyowner may make
top-ups to keep the fund value sufficient and the policy in force.
Confidential 12
PRUHealth Prime
Sum Assured Limits
Minimum Basic PhP 500,000

Sum Assured
Maximum Limit
per life for Total Juvenile: PhP 3,000,000
Death and Late
Stage Cancer or Adult: PhP 15,000,000
CI
Maximum Limit Juvenile: PhP 1,500,000
per life for Early
Stage Cancer Adult: PhP 3,750,000
Maximum Sum PhP 10,000 per day or 80% of Life Insured’s Daily
Assured for Hospital Income, whichever is lower.
Hospital Income
Benefit Daily Income is equal to insured’s total annual income
divided by 365 days.
Definitions:
Juvenile is age 0 (30 days) to 17
Adult is age 18 to 60
Confidential 13
What if your clients want to be
covered against other critical
illness conditions?
Confidential 14
Apart from cancer coverage, your client can now attach
either Select Top 4 or Select 52 Critical Illness Rider
exclusive to PRUHealth Prime.
Confidential 15
PRUHealth Prime
Critical Illness Riders
Select Top 4 Select 52

Critical Illness Rider Critical Illness Rider
Description Provides benefits for top 4 Provides benefits for 52 covered
covered late stage critical late stage critical
illness conditions illness conditions
Business rules ▪ Addition of these benefits can be done during new business
application process and/or after policy issuance.
▪ These benefits cannot be attached to a policy at the same time.
Issue Age 0 (30 days) to 60 years old
Benefit Term Up to age 85
Critical Illness Late Stage Critical Illness Benefit
Benefit ▪ Provides 100% of the benefit amount of this rider upon
diagnosis of any of the covered late stage critical
illness conditions.
▪ All benefits under these riders terminate upon payout of the
Late Stage Critical Illness Benefit. Base plan benefits will
continue at the same sum assured.
Confidential 16
PRUHealth Prime

Hospitalization Hospital Income Benefit
benefit ▪ Pays a daily Hospital Income Benefit of 0.125% of the Late Stage
Critical Illness Benefit sum assured if the life insured is
hospitalized due to late stage critical illness
▪ Subject to a maximum of PhP 10,000 per day
▪ Twice the amount will be paid daily if hospitalization is in the
Intensive Care Unit (ICU)
▪ Should be filed and claimed simultaneously with the
corresponding Late Stage Critical Illness Benefit for it to be
payable.
▪ Subject to a maximum of 45 days of hospital confinement
(including ICU) for the duration of the policy.
▪ Total claims payable for both this rider and the base plan’s
Hospital Income Benefit for early stage or late stage Cancer shall
be capped at a maximum of 90 days in a given policy year.
Confidential 17
PRUHealth Prime

Hospitalization Post-Hospitalization Benefit
Benefit ▪ Lump sum amount of PhP 5,000 for a specialist doctor visit
due to the late stage critical illness following discharge from
hospital confinement for the said late stage critical illness.
▪ Payable once and may be claimed simultaneously with Late
Stage Critical Illness Benefit and/or Hospital Income
Benefit on Select Top 4 Critical Illness Rider or Select 52
Critical Illness Benefit.
Minimum Sum Late Stage Critical Illness Benefit:
Assured PhP 250,000
Hospital Income Benefit:
Equal to 0.125% of rider sum assured
Maximum Sum Late Stage Critical Illness Benefit:
Assured 100% of base plan sum assured, subject to maximum critical
illness limits of the Company
Hospital Income Benefit:
Subject to a cap of Php 10,000 per life
Confidential 18
PRUHealth Prime
Underwriting
Critical Illness SA Aggregation
Scenario 1
Policy 1
Underwriting Full underwriting applies.
PAA Plus Base Plan 1,500,000
Life Care Benefit SA 750,000
Substandard cases:
▪ *Death Benefit: allowable rating is capped at Policy 2
Rating D – 100% PRUHealth Prime Base Plan 2,500,000
▪ Cancer, CI and HI: allowable rating is capped at
Rating D – 100% Total CI SA to be aggregated 3,250,000
Since cancer benefit is bundled together with the

Scenario 2
death benefit, base plan sum assured will be used
Policy 1
in the CI per life limit aggregation.
PAA Plus Base Plan 1,500,000
If optional CI benefits are attached, base plan sum Life Care Benefit SA 750,000
assured + rider sum assured will be used as the
CI per life limit aggregation. Policy 2
PRUHealth Prime Base Plan 2,500,000
*The substandard rating for Death Benefit should not be Select 52 CI Benefit 1,500,000
greater than the Cancer rating.
Total CI SA to be aggregated 4,750,000
Confidential 19
PRUHealth Prime
Important Disclosures
Waiting Period Waiting period refers to a period which must pass before
Cancer- or critical illness-related illnesses or surgery get
covered.
▪ Waiting period is 90 days from the effectivity date of the
benefit or the date of approval of last reinstatement of the
benefit, whichever is later.
▪ This also applies to the HI Benefit since it is limited to
Cancer or critical illness conditions.
▪ A waiting period of 12 months from the approval date of
the late stage CI claim is also applicable before a
subsequent Late Stage Cancer claim may be filed
following a Late Stage Critical Illness (non-cancer) claim.
Survival Period Early or late stage cancer or CI benefits will be paid provided
that the Life Insured survives thirty 30 days from the date of
diagnosis.
Cooling-off period The client has fifteen (15) days from the date the
policy booklet/policy date page was received
to decide of the plan/CI rider is for them. Should they decide
that the product is not for them the Company will return the
following:
▪ Base plan: Any applied charges plus the fund value,
which may or may not be lower than the premium you
paid
▪ Select Top 4 and Select 52 CI Riders: Rider premium
paid in full
Confidential 20
PRUHealth Prime
Cancer and Critical Illness Claim Scenarios
Scenario 1
Policy details
Early Stage Lung Cancer Diagnosis
Base plan SA: 1,000,000
Hospital confinement of 10 days
Early Stage Cancer Benefit: 500,000
Late Stage Cancer Benefit: 1,000,000
Hospital Income Benefit: 1,250 Insured eligible for the following:
Post-Hospitalization Benefit: 5,000 ▪ 500,000 Early Stage Cancer claim
▪ 12,500 HI Benefit claim (10 days)
Early Stage Cancer benefit terminates.
Year 2021 Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Late Stage Lung Cancer Diagnosis

Insured eligible for the following:

▪ 500,000 Late Stage Cancer claim
▪ 5,000 Post-Hospitalization claim
▪ Fund value
Policy terminates.
Confidential 21
PRUHealth Prime
Scenario 2
Policy details Late Stage Breast Cancer Diagnosis

Base plan SA: 1,000,000 Hospital confinement of 50 days
Hospital Income Benefit: 1,250 Insured eligible for the following: Insured eligible for the following:
Post-Hospitalization Benefit: 5,000 ▪ 500,000 Early Stage Cancer claim ▪ 500,000 Late Stage Cancer claim
▪ 56,250 HI Benefit claim (45 days) ▪ 56,250 HI Benefit claim (45 days)
Early Stage Cancer benefit terminates. ▪ Fund value
Policy terminates.
Year 2021 Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Early Stage Breast Cancer Diagnosis

Insured not eligible to claim Early

Stage Cancer and HI Benefit since it
was already claimed for Early Stage
Lung Cancer.
Confidential 22
PRUHealth Prime
Scenario 3
Policy details
Suffered Heart Attack Base plan SA: 1,000,000
Hospital Income Benefit: 1,250
Insured eligible for the following: Post-Hospitalization Benefit: 5,000
▪ 500,000 Late Stage CI claim Select Top 4 CI - Late Stage CI Benefit: 500,000
▪ 28,125 HI Benefit claim (45 days) Select Top 4 CI - HI Benefit: 625
▪ 5,000 Post-Hospitalization claim Select Top 4 CI - Post-Hospitalization Benefit: 5,000
Select Top 4 CI benefit terminates.

Year 2021
May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Year 2022
Early Stage Lung Cancer Diagnosis Late Stage Lung Cancer Diagnosis
Hospital confinement of 50 days Hospital confinement of 50 days
Insured eligible for the following: Insured eligible for the following:
▪ 500,000 Early Stage Cancer claim ▪ 500,000 Late Stage Cancer claim
▪ 56,250 HI Benefit claim (45 days) ▪ 56,250 HI Benefit claim (45 days)
Early Stage Cancer benefit terminates. ▪ Fund value
Policy terminates.
Confidential 23
Policy details
PRUHealth Prime Base plan SA: 1,000,000
Cancer and Critical Illness Claim Scenarios Late Stage Cancer Benefit: 1,000,000
Hospital Income Benefit: 1,250
Post-Hospitalization Benefit: 5,000
Select Top 4 CI - Late Stage CI Benefit: 500,000
Select Top 4 CI - HI Benefit: 625
Scenario 4 Select Top 4 CI - Post-Hospitalization Benefit: 5,000
Suffered Heart Attack

Insured eligible for the following: Late Stage Lung Cancer Diagnosis
▪ 500,000 Late Stage CI claim Hospital confinement of 25 days
▪ 5,000 Post-Hospitalization claim Insured not eligible to claim Late Stage, HI and Post-
Hospitalization benefits due to *12 months waiting
Select Top 4 CI benefit terminates. period for subsequent Late Stage Cancer claim.
Year 2021
May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Year 2022
Suffered Stroke
Insured eligible for the following:
Insured not eligible for Late Stage CI
▪ 500,000 Early Stage Cancer claim
and HI Benefit claim since it was
already claimed when the insured
suffered from Heart Attack.
Early Stage Cancer benefit
terminates.
*Waiting period of 12 months from the approval date of the late stage CI claim is applicable before a Confidential 24
subsequent late stage Cancer claim may be filed following a late stage critical illness (non-cancer) claim.
PRUHealth Prime
Other Optional Benefits
Non-accelerated Total and Permanent Disability Benefit

Description Pays the rider benefit amount if the insured becomes totally and
permanently disabled due to bodily injury or disease
Issue Age 5 to 60 years old
Allowable Sum Assured Minimum SA: PhP 60,000 | Maximum SA: 100% of basic SA
Accidental Death and Disablement Benefit
Description Pays a portion or the full rider benefit amount if the insured sustains bodily
injury/ies or dies due to accident
Allowable Sum Assured Minimum SA: PhP 180,000 | Maximum SA: PhP 10,000,000
Confidential 25
PRUHealth Prime
Other Optional Benefits
Payor Term
Description Pays the rider benefit amount if the policyowner dies
Issue Age Insured: 0 to 60 years old | Payor: 18 to 60 years old
Benefit Term Payor: Up to age 75
Allowable Sum Assured Minimum SA: PhP 180,000 | Maximum SA: 100% of basic SA
Waiver of Premium on Total and Permanent Disability
Description Waives all future premiums after commencement and during the
continuance of total and permanent disability
Payor Waiver of Regular Premium Benefit
Description Waives all future regular premiums due to death or total and permanent
disability of the payor
Issue Age Insured: 0 to 17 years old
Payor: 18 to 59 years old
Benefit Term Up to age 25 of insured or age 60 of payor whichever comes first
Confidential 26
PRUHealth Prime
Investment Component
Premium Allocation
Issue Age 0 to 45 Issue Age 46 to 60
Schedule
Year 1 20% 40%
Year 2 40% 60%
Year 3 60% 70%
Year 4 75% 85%
Year 5 to 20 100% 100%
Investment Fund Options ▪ PRULink Bond Fund
▪ PRULink Managed Fund
▪ PRULink Growth Fund
▪ PRULink Proactive Fund
▪ PRULink Equity Fund
▪ PRULink Global Market Navigator Fund
▪ PRULink Equity Index Tracker Fund
Fund Managers Eastspring Investments (Singapore) Limited
Pru Life UK Investments
Top-ups Minimum: PhP 20,000 | Maximum: Subject to full underwriting
Withdrawals Minimum: PhP 10,000 | Minimum maintaining balance: PhP 20,000
Confidential 27
PRUHealth Prime
Policy Charges and Fees
Insurance Charges Equal to the sum of the following:

▪ Insurance and Rider charges for core and optional benefits are deducted monthly
through selling proportionate units using the unit price at the next pricing date as
long as the policy is in force. Deductions may change within one Policy Year as
charges are based on the attained age of the Life Insured. These charges are
inclusive of premium tax and Documentary Stamp Tax (DST).
▪ Extra charges shall be deducted monthly through cancellation of units for
substandard cases as long as the policy is in force.
▪ Charges are already inclusive of relevant fees and taxes. Charges may change in
the future. Any change will be implemented in a manner set out in the policy
booklet.
Policy Fee PhP 33.33 deducted monthly from the fund during premium payment term and
PhP 16.67 deducted monthly from the fund after premium payment term.
Premium Holiday Charge
(as a percentage of the premium to Issue Age 0 to 45 Issue Age 46 to 60
be deducted from the fund value)
Year 1 80% 60%

Year 2 60% 40%
Year 3 40% 30%
Year 4 25% 15%
Year 5 to 20 0% 0%
Top up Charge 3% of each top-up payment made Confidential 28
PRUHealth Prime
Withdrawals drawn from units created from regular premiums
Surrender Charge
(percentage of the amount withdrawn)
Year 1 50%
Year 2 40%
Year 3 35%
Year 4 30%
Year 5 25%
Year 6 20%
Year 7 20%
Year 8 15%
Year 9 15%
Year 10 10%
Year 11 and up 0%
This applies to partial and full withdrawals. All withdrawals will be made on a first-in-first-
out (FIFO) basis. The policy year will be counted from the policy effective date.
Confidential 29
PRUHealth Prime
Withdrawals drawn from units created from top-ups
Surrender Charge
(percentage of the amount withdrawn)
Year 1 5%
Year 2 4%
Year 3 3%
Year 4 2%
Year 5 1%
Year 6 onwards 0%
Applies to partial and full withdrawals. All withdrawals will be made on a first-in-first-out
(FIFO) basis. The policy year will be counted from the date the top-up is made.
Confidential 30
PRUHealth Prime
Commission Structure
SA Band 1 : SA < PhP 1,000,000

Year 1 Issue Age 0-45 Issue Age 46-50 Issue Age 51-55 Issue Age 56-60
Annual 27% 22% 17% 15%
Semi-annual 24.5% 19.5% 14.5% 12.5%
Quarterly 22% 17% 12% 10%
Monthly 19.5% 14.5% 9.5% 7.5%
SA Band 2: SA >= PhP 1,000,000
Year 1 Issue Age 0-45 Issue Age 46-50 Issue Age 51-55 Issue Age 56-60
Annual 32% 27% 22% 20%
Semi-annual 29.5% 24.5% 19.5% 17.5%
Quarterly 27% 22% 17% 15%
Monthly 24.5% 19.5% 14.5% 12.5%
Year 2 onwards
Year 2 10% 10% 10% 10%
Year 3 5% 5% 5% 5%
Year 4 5% 5% 5% 5%
Year 5 5% 5% 5% 5%
Year 6 & up 0% 0% 0% 0%
Confidential 31
PRUHealth Prime
Covered Cancer Conditions
Cancer Only
Early Stage Cancer Late Stage Cancer
Carcinoma In-Situ of Covered Organs A malignant tumour positively
Early Prostate Cancer diagnosed with histological
confirmation and characterized by the
Early Thyroid Cancer uncontrolled growth of malignant cells
Early Bladder Cancer with invasion and destruction of
Early Melanoma normal tissue.
Early Chronic Lymphocytic Leukemia
The term malignant tumour includes
leukemia, lymphoma and sarcoma.
Carcinoma In-Situ of Specified
Organs Treated with Radical Surgery Exclusions on the above definition can
be found in the policy contract.
Confidential 32
PRUHealth Prime
Select Top 4 Critical Illness Conditions
Late Stage Critical Illness

1 Heart Attack
2 Kidney Failure
3 Stroke
4 Benign Brain Tumor
Confidential 33
PRUHealth Prime
Select 52 Critical Illness Conditions

Heart-Related Liver/Gastrointestinal-Related
1 Heart Attack 11 End Stage Liver Failure
2 Serious Coronary Artery Disease 12 Fulminant Viral Hepatitis
3 Coronary Artery By-Pass Surgery 13 Chronic Autoimmune Hepatitis
4 Angioplasty And Other Invasive Treatments For Severe Crohn's Disease with Intestinal
14
Coronary Artery Disease (1) Fistula, Obstruction or Perforation
5 Heart Valve Surgery 15 Ulcerative Colitis with Total Colectomy
Kidney-Related
6 Cardiomyopathy
7 Infective Endocarditis 16 Kidney Failure
8 Severe Eisenmenger's Syndrome 17 Medullary Cystic Disease
9 Surgery to Aorta Systemic Lupus Erythematosus with
18
10 Primary Pulmonary Arterial Hypertension Severe Kidney Complications
Lung-Related
(1)The coverage is subject to a maximum of ten percent (10%) of the sum assured.
19 End-Stage Lung Disease
Confidential 34
PRUHealth Prime
Select 52 Critical Illness Conditions

Neurological-Related Blood-Related
20 Stroke 36 Chronic Aplastic Anemia
37 HIV Infection Due to Blood Transfusion
21 Coma
38 Occupationally Acquired Human
22 Benign Brain Tumor Immunodeficiency Virus (HIV) Infection
23 Encephalitis 39 Full-Blown Aids
24 Loss of Speech Others
25 Bacterial Meningitis 40 Paralysis of Limbs
26 Major Head Trauma 41 Blindness
27 Parkinson's Disease 42 Deafness
43 Third Degree Burns
28 Alzheimer’s Disease / Severe Dementia
44 Major Organ / Bone Marrow Transplant
29 Muscular Dystrophy 45 Poliomyelitis
30 Apallic Syndrome 46 Chronic Relapsing Pancreatitis
31 Progressive Supranuclear Palsy 47 Progressive Scleroderma
32 Motor Neuron Disease 48 Terminal Illness
49 Loss of Independent Existence
33 Multiple Sclerosis
50 Chronic Adrenal Insufficiency
34 Progressive Bulbar Palsy 51 Elephantiasis
35 Brain Surgery
52 Amputation due to complication from Diabetes
Confidential 35
PRUHealth Prime
Exclusions
Exclusions Cancer or Critical Illness Benefit is not paid if the claim is on account of or
contributed by, either directly or indirectly, by any of the following causes:
a. a Pre-Existing Condition which means an illness, sickness or condition which
existed prior to the Effectivity Date of this Benefit or the date of last
reinstatement of this Policy, whichever is later, in respect of which the Life
Insured:
i. had signs or symptoms of the illness, sickness or condition;
ii. was aware, or a reasonable person in the Life Insured’s position would
have been aware;
iii. 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 the Life
Insured’s position would have sought such advice or treatment; or
iv. has had a medical treatment, consultation or been prescribed
medication or therapy.
Confidential 36
PRUHealth Prime
Exclusions
a. wed
Exclusions b. diagnosed as having Early Stage Cancer, Late Stage Cancer or Late Stage Critical
Illness, or is recommended or advised to undergo surgery, within ninety (90) days
from the Effectivity Date of this Benefit or the date of approval of last
reinstatement of this Benefit, whichever is later;
c. Radiation/Toxics from the explosion / installation of Nuclear Weapon, Chemical
Weapon;
d. in the presence of Human Immunodeficiency Virus (HIV) infection or a HIV related
illness including Immune Deficiency Syndrome (AIDS) or AIDS related complex,
except where the HIV infection is due to a blood transfusion or is occupationally
acquired;
e. while under the influence of alcohol or any drug not prescribed by a registered
medical practitioner;
f. intentional self-inflicted act or injury while sane or insane;
g. where the Life Insured commits or attempts to commit a crime;
h. participation in war, insurrection, rebellion or riot;
i. participation in any hazardous sport or activity including, but not limited to,
underwater activities involving the aid of breathing apparatus, flying sports of any
kind, any activity involving explosives, driving or riding in any kind of race, bungee
jumping, mountain climbing, or any activity performed at dangerous heights; or
j. participation in flying aircrafts or any aviation activity except as a fare-paying
passenger of a licensed commercial aircraft.
Confidential 37
III. Target Market
38
Target Market
Primary Segments
Older Millennials Younger Generation X

Age 30 to 38 years old 39 to 55 years old
Civil status Single or married Mostly married
Career level Mostly handling middle Mostly in top management
management position position
Profile Mostly breadwinners or main income earners
With heightened awareness in terms of health because
they see family members (particularly parents) suffer
from illness/es
Confidential 39
Target Market
Primary Segments
Despite the generation gap, they share

the same need in terms of protection.
What are their main concerns? What do they need?
Older
▪ Welfare of parents and siblings or Enhanced need for
Millennials own family income protection in
▪ Live healthy so as not to develop case of critical illness or
illness/es like other family death as they are main
members or relatives providers / income
▪ Continuation of family’s income in earners
Younger
case of sickness, disability or death
Generation X
Confidential 40
IV. Application Process
41
Application Process
Application Form
The existing Individual

Insurance application form
shall be used for this product.
However, submissions may

only be done via PRUOne.
Confidential 42
Application Process
Sales Illustration
❑ New & Improved Product

Dashboard
Benefit Details 1
❑ Death Benefits Chart

Sum assured + fund value
based on Illustration of
Death Benefits page
❑ Living Benefit Chart

Based on fund projection on
Illustration of Benefits All Funds
Plan Benefit Table 2
page
❑ Illustration of Benefits
Fund description and allocation
chart moved per fund page
4 Living Benefit Chart
Death Benefits Chart 3
❑ Charges 5 Fund Allocation
Easier reference for deductible
charges to the policy
❑ Important Illustration Notes 6 Free-look Period

Which agents should discuss with
clients
Confidential 43
Application Process
Sales Illustration
Dashboard
Death Benefits Chart
❑ Dashboard
Sum assured + Fund value
Living
❑ Sum Benefit
assured + fund value
Based
based on Illustration
Fund Projection
of
Death Benefits page

Illustration
Based on fundof Benefitson
projection
page
Fund Description 7
❑ Charges
charges to the policy Fund Allocation Chart 8
Insurance Charges
❑ Important Illustration Notes
clients
Confidential 44
Application Process
Sales Illustration

Dashboard

Sum assured + fund value
based on Illustration of
Charges 9
Death Benefits page

page
❑ Charges

clients
Confidential 45
Application Process
Sales Illustration

Dashboard

Sum assured + fund value Illustration 10
based on Illustration of Notes
Death Benefits page

page
❑ Charges

clients
Confidential 46
Process Flow
Submission of QP for Rated Policies
• Enabling of Personal Info, Needs Analysis Card,

Product Customization, and Investment risk Profile
Card after NB Submission.
• Inclusion of dropdown feature reflecting available
ratings per benefit of PRUHealth Prime
Agent submits a non- NBU notifies agent on Agent to generate rated quotation
1 straight through new
2 submitted policy’s Info on
3 proposal (QP) following the ratings
business application via Ratings (IOR) via email or reflected on the IOR. This can be
PRUOne. PRISM. customized on PRUOne’s Product Card.
Agent to submit via email to

6 LOHelpdesk@prulifeuk.com.ph
Issuance Client to attach e-signature Rated QP generated from
of the the signed rated QP for 5 and indicate date of signing
4 PRUOne, to be received
Rated processing using email subject: on the pages of the Rated by client via email using
Policy “NBU Requirements: QP as proof of concurrence. PRUOne’s share button.
PN#XXXXXXXXX: Last Name,
Client First Name”
This can be done via Acrobat Reader. In case the client
cannot do this, he/she can print the QP, place his/her
handwritten signature and indicate date of signing.
After doing so, they can send it back via email it to
their agent.
Confidential 47
Process Flow Applicable in case the HI Benefit should be
lowered or there is an error in the submitted
Regeneration of Sales Illustration
QP and it needs to be regenerated.
Agent to recreate QP in PRUOne

3 adjusting PRUHealth Prime’s basic sum
1 Agent submits new 2 NBU notifies agent that assured to match the allowable HI Benefit
business application quotation proposal (QP) needs
via PRUOne. to be regenerated as the HI Benefits can be adjusted on PRUOne’s
Benefit should be lowered Product Card.
based on UC’s evaluation.
Agent to submit via email to

6 LOHelpdesk@prulifeuk.com.ph Client to attach e-signature Regenerated QP from
Issuance the signed QP for processing 5 and indicate date of signing
4 PRUOne, to be received
of the using email subject: “NBU on the pages of the QP as by client via email using
Policy Requirements: PN#XXXXXXXXX: proof of concurrence. PRUOne’s share button.
Last Name, Client First Name”
This can be done via Acrobat Reader. In case the client

cannot do this, he/she can print the QP, place his/her
handwritten signature and indicate date of signing.
After doing so, they can send it back via email it to
their agent.
Confidential 48
V. Filing a Claim
49
Filing a Claim
Basic Documentary Requirements
▪ Claimant Statement
▪ Policy Contract (consists of Application for Insurance, Policy Data Page, Sales Illustration
Form, Policy Booklet, and any contract endorsements)
▪ Two (2) valid identification cards of insured
▪ Two (2) valid identification cards of policyowner
▪ Two (2) valid identification cards of beneficiaries
▪ Complete medical records (Admission and Discharge Summary, Clinical Summary and
Abstract, Patient History Sheet)
Additional requirements for Cancer-related claims:

▪ Attending Physician’s Statement (accomplished by oncologist)
▪ Biopsy and/or Hispatology results
▪ If Leukemia, Bone Marrow diagnostic result
If the insured event happened outside the Philippines:

All forms and proofs of claim obtained outside the Philippines must be in English and duly authenticated by
the Philippine Embassy or Consul of the country where the event happened.
If claimant is outside the Philippines:

Signed Claimant statement authenticated by the Philippine Embassy or Consul.
Confidential 50
VI. Appendix
Covered Cancer and
Other Critical Illness
51
Descriptions
Early Stage Cancer
Early Stage Cancer
Carcinoma In-Situ 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.
The diagnosis of the Carcinoma in situ must always be supported by a histo-pathological report.
Furthermore, the diagnosis of Carcinoma in situ must always be positively diagnosed upon the basis of a
microscopic examination of the fixed tissue, supported by a biopsy result. Clinical diagnosis does not meet
this standard.
The following conditions are specifically excluded from coverage:

▪ Cervical Dysplasia, CIN-1, CIN-2 and CIN-3 and low grade & high grade squamous epithelial lesions.
▪ Prostatic Intraepithelial Neoplasia (PIN).
▪ Vulvar Intraepithelial Neoplasia (VIN).
▪ Any lesion or tumor which is histologically described as benign, dysplasia, premalignant, borderline
malignant, or suspicious malignant potential.
▪ All tumors in the presence of Human Immunodeficiency Virus (HIV) infection.
Early Prostate Cancer Prostate Cancer that is histologically described using the TNM Classification as T1a or T1b or Prostate
cancers described using another equivalent classification.
Early Thyroid Cancer Thyroid Cancer that is histologically described using the TNM Classification as T1N0M0 as well as Papillary
microcarcinoma of thyroid that is less than 1cm in diameter
Confidential 52
Descriptions
Early Stage Cancer
Early Stage Cancer
Early Bladder Cancer Papillary microcarcinoma of Bladder
Early Melanoma Invasive melanomas or less than 1.5mm Breslow thickness, or less than Clark Level 3.
Non-invasive melanoma histologically described as “in-situ” is excluded.
Early Chronic Lymphocytic Chronic Lymphocytic Leukemia (CLL) RAI Stage 1 or 2. CLL RAI stage 0 or lower is excluded.
Leukemia
Carcinoma In-Situ Of The actual undergoing of a Radical Surgery to arrest the spread of malignancy in that specific organ, which
Specified Organs Treated must be considered as appropriate and necessary treatment.
With Radical Surgery
“Radical Surgery” is defined in this policy as the total and complete removal of one (1) of the following
organs: breast (mastectomy), prostate (prostatectomy), corpus uteri (hysterectomy), ovary
(oopherectomy), fallopian tube (salpingectomy), colon (partial colectomy with end to end anastomosis) or
stomach (partial gastrectomy with end to end anastomosis). The diagnosis of the Carcinoma in situ must
always be positively diagnosed upon the basis of a microscopic examination of fixed tissues additionally
supported by a biopsy of the removed organ. Clinical diagnosis does not meet this standard.
Early prostate cancer that is histologically described using the TNM Classification as T1a or T1b or T1c or
Prostate cancers described using another equivalent classification is also covered if it has been treated with
a radical prostatectomy. All grades of cervical intraepithelial neoplasia (CIN) and prostatic intraepithelial
neoplasia (PIN) are specifically excluded.
Confidential 53
Descriptions
Early Stage Cancer
Early Stage Cancer
Carcinoma In-Situ Of The actual undergoing of the surgeries listed above and the surgery must be certified to be absolutely
Specified Organs Treated necessary by an oncologist Partial surgical removal such as lumpectomy and partial mastectomy and partial
With Radical Surgery prostatectomy are specifically excluded.
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.
The diagnosis of the Carcinoma in situ must always be supported by a histopathological report.
Furthermore, the diagnosis of Carcinoma in situ must always be positively diagnosed upon the basis of a
microscopic examination of the fixed tissue, supported by a biopsy result. Clinical diagnosis does not meet
this standard.
Confidential 54
Descriptions
Late Stage Cancer
Late Stage Cancer

Late Stage Cancer A malignant tumor positively diagnosed with histological confirmation and characterized by the uncontrolled
growth of malignant cells with invasion and destruction of normal tissue. The term malignant tumor includes
leukemia, lymphoma and sarcoma.
For the above definition, the following are excluded:

All tumors which are histologically classified as any of the following:
(a) Pre-malignant;
(b) Non-invasive;
(c) Carcinoma-in-situ;
(d) Having borderline malignancy;
(e) Having any degree of malignant potential;
(f) Having suspicious malignancy;
(g) Neoplasm of uncertain or unknown behavior; or
(h) Cervical Dysplasia CIN-1, CIN-2 and CIN-3;
(i) Any non-melanoma skin carcinoma unless there is evidence of metastases to lymph nodes or beyond;
(j) Malignant melanoma that has not caused invasion beyond the epidermis;
(k) All Prostate cancers histologically described as T1N0M0 (TNM Classification) or below; or Prostate
cancers of another equivalent or lesser classification;
(l) All Thyroid cancers histologically classified as T1N0M0 (TNM Classification) or below;
(m) All tumors of the Urinary Bladder histologically classified as T1N0M0 (TNM Classification) or below;
(n) All Gastro-Intestinal Stromal tumors histologically classified as T1N0M0 (TNM Classification) or below
and with mitotic count of less than or equal to 5/50 HPFs;
(o) Chronic Lymphocytic Leukemia less than RAI Stage 3; and
(p) All tumors in the presence of HIV infection.
Confidential 55
Descriptions

Heart-Related
Heart Attack Death of heart muscle due to obstruction of blood flow, that is evident by at least three (3) 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 a cardiologist.
For the above definition, 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
Serious Coronary Artery The narrowing of the lumen of at least one coronary artery by a minimum of 75% and of two (2) others by a
minimum of 60%, as proven by coronary arteriography, regardless of whether or not any form of coronary
Disease
artery surgery has been performed. Coronary arteries herein refer to left main stem, left anterior
descending, circumflex and right coronary artery.
Confidential 56
Descriptions

Heart-Related
Coronary Artery By-Pass The actual undergoing of open-chest surgery or Minimally Invasive Direct Coronary Artery Bypass surgery to
Surgery correct the narrowing or blockage of one (1) or more coronary arteries with bypass grafts. This diagnosis
must be supported by angiographic evidence of significant coronary artery obstruction and the procedure
must be considered medically necessary by a cardiologist.
Angioplasty and all other intra-arterial, catheter based techniques, ‘keyhole’ or laser procedures are
excluded.
Angioplasty and Other The actual undergoing of balloon angioplasty or similar intra-arterial catheter procedure to correct a
Invasive Treatments for narrowing of minimum 60% stenosis, of one or more major coronary arteries as shown by angiographic
Coronary Artery Disease evidence. The revascularisation must be considered medically necessary by a consultant cardiologist.
Coronary arteries herein refer to left main stem, left anterior descending, circumflex and right coronary
artery.
Diagnostic angiography is excluded. The coverage for this condition is subject to a maximum of ten percent
(10%) of the sum assured.
Heart Valve Surgery The actual undergoing of open-heart surgery to replace or repair heart valve abnormalities. The diagnosis of
heart valve abnormality must be supported by cardiac catheterization or echocardiogram and the procedure
must be considered medically necessary by a cardiologist.
Confidential 57
Descriptions

Heart-Related
Cardiomyopathy Cardiomyopathy as diagnosed by a cardiologist and characterized by impaired ventricular function of
unknown aetiology with permanent and irreversible physical impairment to the degree of class IV of the New
York Heart Association Classification of cardiac impairment.
For the claim to be admissible the severity of impairment must have persisted despite at least 6 months of
maximal medical therapy under the care of a cardiologist.
The diagnosis of Cardiomyopathy has to be supported by echocardiographic findings of compromised

ventricular performance.
The benefit does not cover Cardiomyopathy directly related to alcohol or drug usage.
Infective Endocarditis Severe Infective Endocarditis requiring surgery. Inflammation of the inner lining of the heart caused by
infectious organisms, where all of the following criteria are met:
(a) Positive result of the blood culture proving presence of the infectious organism(s);
(b) Echocardiogram evidence of valvular vegetations and evidence of heart valve incompetence or stenosis
attributable to Infective Endocarditis
(c) Have undergone heart valve surgery, that is replacement or repair; and
(d) The diagnosis of Infective Endocarditis and the surgery undergone for valvular impairment must be
confirmed by a cardiologist.
Confidential 58
Descriptions

Heart-Related
Severe Eisenmenger’s Shall mean the occurrence of a reversed or bidirectional shunt as a result of pulmonary hypertension,
Syndrome caused by a heart disorder.
All of the following criteria must be met:
(a) Presence of permanent physical impairment classified as NYHA class IV*; and
(b) The diagnosis of Eisenmenger Syndrome and the level of physical impairment must be confirmed by a
cardiologist.
*NYHA Class IV means that the patient is symptomatic during ordinary daily activities despite the use of
medication and dietary adjustment.
Surgery to Aorta The actual undergoing of major surgery to repair or correct an aneurysm, narrowing, obstruction or
dissection of the aorta through surgical opening of the chest or abdomen. For the purpose of this definition
aorta shall mean the thoracic and abdominal aorta but not its branches.
Surgery performed using only minimally invasive or intra arterial techniques are excluded.
Primary Pulmonary Arterial Primary Pulmonary Hypertension with substantial right ventricular enlargement confirmed by investigations
Hypertension including cardiac catheterization, resulting in permanent physical impairment of at least Class IV of the New
York Heart Association (NYHA) Classification of Cardiac Impairment.
The NYHA Classification of Cardiac Impairment:

• Class I: No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, dyspnea,
or anginal pain.
• Class II: Slight limitation of physical activity. Ordinary physical activity results in symptoms.
• Class III: Marked limitation of physical activity. Comfortable at rest, but less than ordinary activity causes
symptoms.
• Class IV: Unable to engage in any physical activity without discomfort. Symptoms may be presentConfidential
even at 59
rest.
Descriptions

Liver/Gastrointestinal-Related
End Stage Liver Failure End stage liver failure as evidenced by all of the following:
(a) Permanent jaundice;
(b) Ascites; and
(c) Hepatic encephalopathy.
Liver disease secondary to alcohol or drug abuse is excluded.
Fulminant Viral Hepatitis A submassive to massive necrosis of the liver by the Hepatitis virus, leading precipitously to liver failure.
This diagnosis must be supported by all of the following:
(a) rapid decreasing of liver size as confirmed by abdominal ultrasound;
(b) necrosis involving entire lobules, leaving only a collapsed reticular framework;
(c) rapid deterioration of liver function tests;
(d) deepening jaundice; and
(e) hepatic encephalopathy.
Confidential 60
Descriptions

Chronic Autoimmune A chronic necrotic inflammatory liver disorder of unknown cause associated with circulating auto-antibodies
Hepatitis and a high serum globulin level. The diagnosis must be supported by both of the following:
(1) The presence of at least one of the following auto-antibodies:

(a) Anti-nuclear antibodies;
(b) Anti-smooth muscle antibodies;
(c) Anti-actin antibodies;
(d) Anti-LKM-1 antibodies;
(e) Anti- LC1 antibodies;
(f) Anti-SLA/LP antibodies;
and
(2) Liver biopsy confirmation of the diagnosis of auto-immune hepatitis
The diagnosis must be confirmed by a Specialist Doctor in gastroenterology or hepatology.
This illness is only covered if the Life Insured has been put on continuous Immunosuppressive therapy for a
period of at least 6 months and the diagnosis must be confirmed by a registered gastroenterologist or
hepatologist.
Confidential 61
Descriptions

Severe Crohn’s Disease Crohn’s Disease is a chronic, transmural inflammatory disorder of the bowel. To be considered as severe,
with Intestinal Fistula, there must be evidence of continued inflammation in spite of optimal therapy, with all of the following having
Obstruction or Perforation occurred:
(a) Stricture formation causing intestinal obstruction requiring admission to a hospital, and
(b) Fistula formation between loops of bowel, and
(c) At least one bowel segment resection.
The diagnosis must be made by a Specialist Gastroenterologist and be proven histologically on a pathology
report and/or the results of sigmoidoscopy or colonoscopy.
Ulcerative Colitis with Total Means acute fulminant ulcerative colitis with life threatening electrolyte disturbances, and all of the following
Colectomy criteria must be met:
(a) The entire colon is affected with severe bloody diarrhea;
(b) The necessary treatment is total colectomy and ileostomy; and
(c) The Unequivocal Diagnosis must be based on histopathological features and confirmed by a Medical
Practitioner who is a gastroenterologist.
Confidential 62
Descriptions
Kidney-Related
Kidney Failure Chronic irreversible failure of both kidneys requiring either permanent renal dialysis or kidney
transplantation.
Medullary Cystic Disease The following criteria must be met:
(a) the presence in the kidney of multiple cysts in the renal medulla accompanied by the presence of tubular
atrophy and interstitial fibrosis; and
(b) decreased kidney function evidenced by requirement of permanent renal dialysis or renal transplant.
The diagnosis of Medullary Cystic Disease must be confirmed by a nephrologist. Isolated or benign kidney
cysts are specifically excluded from coverage under this benefit.
Systemic Lupus A multi-system, multifactorial, autoimmune disorder characterized by the development of autoantibodies
Erythematosus with Severe directed against various self-antigens. In respect of this rider, systemic lupus erythematosus will be
Kidney Complications restricted to those forms of systemic lupus erythematosus which involve the kidneys (Class III to Class V
Lupus Nephritis, established by renal biopsy, and in accordance with the WHO Classification). The final
diagnosis must be confirmed by a Physician specializing in Rheumatology and Immunology.
The WHO Classification of Lupus Nephritis:

• Class I - Minimal Change Lupus Glomerulonephritis
• Class II - Messangial Lupus Glomerulonephritis
• Class III - Focal Segmental Proliferative Lupus Glomerulonephritis
• Class IV - Diffuse Proliferative Lupus Glomerulonephritis
• Class V - Membranous Lupus
Confidential 63
Descriptions
Lung-Related
End-Stage Lung Disease End stage lung disease, causing chronic respiratory failure. This diagnosis must be supported by evidence of
all of the following:
(a) FEV1 test results which are consistently less than one (1) litre;
(b) Permanent supplementary oxygen therapy for hypoxemia;
(c) Arterial blood gas analyses with partial oxygen pressures of 55mmHg or less (PaO2 <=55mmHg); and
(d) Dyspnea at rest.
The diagnosis must be confirmed by a respiratory physician.
Confidential 64
Descriptions
Neurological-Related
Stroke A cerebrovascular incident including infarction of brain tissue, cerebral and subarachnoid hemorrhage,
intracerebral embolism and cerebral thrombosis resulting in permanent neurological deficit with persisting
clinical symptoms.
This diagnosis must be supported by all of the following conditions:

(a) Evidence of permanent clinical neurological deficit confirmed by a neurologist at least six (6) weeks after
the event; and
(b) Findings on Magnetic Resonance Imaging, Computerized Tomography, or other reliable imaging
techniques consistent with the diagnosis of a new stroke.
The following are excluded:

(a) Transient Ischaemic Attacks;
(b) Brain damage due to an accident or injury, infection, vasculitis, and inflammatory disease;
(c) Vascular disease affecting the eye or optic nerve; and
(d) Ischaemic disorders of the vestibular system.
Permanent means expected to last throughout the lifetime of the insured.
Confidential 65
Descriptions
Coma A coma that persists for at least ninety-six (96) hours. This diagnosis must be supported by evidence of all
of the following:
(a) No response to external stimuli for at least ninety-six (96) hours;
(b) Life support measures are necessary to sustain life; and
(c) Brain damage resulting in permanent neurological deficit which must be assessed at least thirty (30)
days after the onset of the coma.
Coma resulting directly from alcohol or drug abuse is excluded.
Benign Brain Tumor Benign brain tumor means a non-malignant tumor located in the cranial vault and limited to the brain,
meninges or cranial nerves where all of the following conditions are met:
(a) It is life threatening;
(b) It has caused damage to the brain;
(c) It has undergone surgical removal or, if inoperable, has caused a permanent neurological deficit; and
(d) Its presence must be confirmed by a neurologist or neurosurgeon and supported by findings on Magnetic
Resonance Imaging, Computerized Tomography, or other reliable imaging techniques.

(a) Cysts;
(b) Granulomas;
(c) Vascular Malformations;
(d) Haematomas; and
(e) Tumors of the pituitary gland or spinal cord.
Confidential 66
Descriptions
Encephalitis Severe inflammation of brain substance (cerebral hemisphere, brainstem or cerebellum) caused by viral
infection and resulting in permanent neurological deficit. This diagnosis must be certified by a consultant
neurologist and the permanent neurological deficit must be documented for at least six (6) weeks.
Encephalitis caused by HIV infection is excluded.
Loss of Speech Total and irrecoverable 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 twelve (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.
Bacterial Meningitis Bacterial infection resulting in severe inflammation of the membranes of the brain or spinal cord resulting in
significant, irreversible and permanent neurological deficit. The neurological deficit must persist for at least
six (6) weeks.
This diagnosis must be confirmed by:
(a) The presence of bacterial infection in cerebrospinal fluid by lumbar puncture; and
(b) A neurologist.
Confidential 67
Descriptions
Major Head Trauma Accidental head injury resulting in permanent neurological deficit with persisting clinical symptoms to be
assessed no sooner than six (6) weeks from the date of the accident. This diagnosis must be confirmed by a
consultant neurologist and supported by unequivocal findings on Magnetic Resonance Imaging,
Computerized Tomography, or other reliable imaging techniques. "Accident” in this section means an event
of violent, unexpected, external, involuntary and visible nature which is independent of any other cause and
is the sole cause of the head Injury.

(a) Spinal cord injury; and
(b) Head injury due to any other causes.
Permanent means expected to last throughout the lifetime of the Insured.

Permanent neurological deficit with persisting clinical symptoms means symptoms of dysfunction in the
nervous system that are present on clinical examination and expected to last throughout the lifetime of the
Insured. Symptoms that are covered include numbness, paralysis, localized weakness, dysarthria (difficulty
with speech), aphasia (inability to speak), dysphagia (difficulty swallowing), visual impairment, difficulty in
walking, lack of coordination, tremor, seizures, dementia, delirium and coma.
Parkinson's Disease The unequivocal diagnosis of idiopathic Parkinson’s Disease by a neurologist.

This diagnosis must be supported by all of the following conditions:
(a) The disease cannot be controlled with medication;
(b) Signs of progressive impairment; and
(c) Inability of the Insured to perform (whether aided or unaided) at least three (3) of the six (6) “Activities
of Daily Living” for a continuous period of at least six (6) months.
Confidential 68
Descriptions

Alzheimer’s Disease / Deterioration or loss of intellectual capacity as confirmed by clinical evaluation and imaging tests, arising
Severe Dementia from Alzheimer's disease or irreversible organic disorders, resulting in significant reduction in mental and
social functioning requiring the continuous supervision of the Insured. This diagnosis must be supported by
the clinical confirmation of a neurologist and supported by our appointed Physician.
(a) Non-organic diseases such as neurosis and psychiatric illnesses; and
(b) Alcohol related brain damage.
Muscular Dystrophy A group of hereditary degenerative diseases of muscle characterized by weakness and atrophy of muscle. The
diagnosis of muscular dystrophy must be unequivocal and made by a consultant neurologist. The condition must
result in the inability of the Insured to perform (whether aided or unaided) at least three (3) of the six (6)
“Activities of Daily Living”, as defined in General Definition of Terms section, for a continuous period of at least six
(6) months.
For the purpose of this definition, “aided” shall mean with the aid of special equipment, device and/or apparatus
and not pertaining to human aid.
Apallic Syndrome Universal necrosis of the brain cortex with the brainstem intact. This diagnosis must be confirmed by a
neurologist. This condition has to be medically documented for at least one (1) month.
Progressive Supranuclear Progressive supranuclear palsy resulting independently of all other causes with unequivocal diagnosis made by a
Palsy neurologist. The condition must result in neurological deficit persisting for at least 90 days and the permanent
inability to perform, without any form of assistance, at least three (3) of the six (6) “Activities of Daily Living”, as
defined in General Definition of Terms, for a continuous period of at least 180 days.
Confidential 69
Descriptions

Motor Neuron Disease Characterized by progressive degeneration of corticospinal tracts and anterior horn cells or bulbar efferent
neurones which include spinal muscular atrophy, progressive bulbar palsy, amyotrophic lateral sclerosis and
primary lateral sclerosis. This diagnosis must be confirmed by a neurologist as progressive and resulting in
permanent neurological deficit.
Multiple Sclerosis The definite occurrence of Multiple Sclerosis. The diagnosis must be supported by all of the following:
(a) Investigations which unequivocally confirm the diagnosis to be Multiple Sclerosis;
(b) Multiple neurological deficits which occurred over a continuous period.
Progressive Bulbar Palsy Characterized by progressive degeneration of the muscle innervated by cranial nerve and corticobulbar
tracts leading to difficulty in chewing, swallowing and talking. The Diagnosis must be made by a neurologist
as progressive and resulting in permanent neurological deficit with appropriate neuromuscular testing such
as Electromyogram (EMG).
Brain Surgery The actual undergoing of surgery to the brain under general anesthesia during which a craniotomy is
performed. Keyhole surgery is included however, minimally invasive treatment where no surgical incision is
performed to expose the target, such as irradiation by gamma knife or endovascular neuroradiological
interventions such as embolizations, thrombolysis and stereotactic biopsy are all excluded. Brain surgery as
a result of an accident is also excluded. The procedure must be considered medically necessary by a
neurologist.
Confidential 70
Descriptions

Blood-Related
Chronic Aplastic Anemia Chronic persistent bone marrow failure, confirmed by biopsy, which results in anemia, neutropenia and
thrombocytopenia requiring treatment with at least one (1) of the following:
(a) Blood product transfusion;
(b) Marrow stimulating agents;
(c) Immunosuppressive agents; or
(d) Bone marrow transplantation.
The diagnosis must be confirmed by a hematologist.
HIV Infection Due to Blood Infection with the Human Immunodeficiency Virus (HIV) through a blood transfusion, provided that all of the
Transfusion following conditions are met:
(a) The blood transfusion was medically necessary or given as part of a medical treatment;
(b) The blood transfusion was received in Philippines after policy effectivity date or reinstatement date of the
Policy, whichever is later;
(c) The source of the infection is established to be from the Institution that provided the blood transfusion
and the Institution is able to trace the origin of the HIV tainted blood; and
(d) The Insured does not suffer from Thalassaemia Major or Haemophilia.
This illness will not be covered if a cure has become available prior to the infection. “Cure” means any
treatment that renders the HIV inactive or non-infectious.
Confidential 71
Descriptions

Blood-Related
Occupationally Acquired Infection with the Human Immunodeficiency Virus (HIV) which resulted from an accident occurring after the
Human Immunodeficiency policy effective date or reinstatement date of this policy, whichever is later while the life insured was
Virus (HIV) Infection carrying out the normal professional duties of his or her occupation in Philippines, provided that all of the
following are proven to the Company’s satisfaction:
(a) Proof of the accident giving rise to the infection must be reported to the Company within thirty (30) days
of the accident taking place;
(b) Proof that the accident involved a definite source of the HIV infected fluids;
(c) Proof of sero-conversion from HIV negative to HIV positive occurring during the one hundred and eighty
(180) days after the documented accident. This proof must include a negative HIV antibody test conducted
within five (5) days of the accident; and
(d) HIV infection resulting from any other means including sexual activity and the use of intravenous drugs
is excluded.
This illness is only covered if the occupation of the Life Insured is a medical practitioner, housemen, medical
student, state registered nurse, medical laboratory technician, dentist (surgeon and nurse) or paramedical
worker, working in a medical center or clinic in the Philippines.
This illness will not be covered where a cure has become available prior to the infection.
“Cure” means any treatment that renders the HIV inactive or non-infectious.
Confidential 72
Descriptions

Blood-Related
Full-Blown Aids The clinical manifestation of AIDS (Acquired Immuno-deficiency Syndrome) must be 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.
Confidential 73
Descriptions
Others
Paralysis of Limbs Total and irreversible loss of use of at least two (2) entire limbs due to injury or disease persisting for a
period of at least 6 weeks and with no foreseeable possibility of recovery. This condition must be confirmed
by a neurologist.
Self-inflicted injuries are excluded.
Blindness 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.
Deafness Total and irreversible loss of hearing in both ears as a result of illness or accident. This diagnosis must be
supported by audiometric and sound threshold tests provided and certified by an Ear, Nose, Throat (ENT)
specialist doctor.
Total means “the loss of at least eighty (80) decibels in all frequencies of hearing.
Third Degree Burns Third degree (full thickness of the skin) burns covering at least 20% of the surface of the Insured’s body.
Major Organ / Bone The receipt of a transplant of:

Marrow Transplant (a) Human bone marrow using haematopoietic stem cells preceded by total bone marrow ablation; or
(b) One (1) of the following human organs: heart, lung, liver, kidney or pancreas that resulted from
irreversible end stage failure of the relevant organ.
Other stem cell transplants are excluded.
Confidential 74
Descriptions

Others
Poliomyelitis The occurrence of Poliomyelitis where the following conditions are met:
(a) Poliovirus is identified as the cause;
(b) Paralysis of the limb muscles or respiratory muscles must be present and persist for at least three (3)
months.
Chronic Relapsing The Chronic Relapsing Pancreatitis as a result of progressive severe destruction with all of the following
Pancreatitis characteristics:
(a) More than three (3) attacks of acute pancreatitis;
(b) Generalize calcium deposits in pancreas from imaging study; and
(c) Chronic continuous pancreatic function impairment resulting in mal-absorption of intestine (high fat in
stool) or diabetes.
Pancreatitis due to alcohol or drug abuse is excluded.
Progressive Scleroderma A systemic collagen-vascular disease causing progressive diffuse fibrosis in the skin, blood vessels and
visceral organs. This diagnosis must be unequivocally supported by biopsy and serological evidence and the
disorder must have reached systemic proportions to involve the heart, lungs or kidneys.

(a) Localized scleroderma (linear scleroderma or morphea);
(b) Eosinophilic fascitis; and
(c) CREST syndrome..
Confidential 75
Descriptions

Others
Terminal Illness The occurrence of a severe illness that will lead to the death of the life insured within twelve (12) months.
The following requirements must be met:

(a) The diagnosis must be supported by a specialist doctor; and
(b) in the opinion of the Company Physician, that the event will lead to death of the Insured within twelve
(12) months.
No benefit will be paid if any effective treatment is available for the illness.
Loss of Independent A condition as a result of a disease, illness or injury whereby the Insured is unable to perform (whether
Existence aided or unaided) at least three (3) "Activities of Daily Living“ for a continuous period of six (6) months. This
condition must be confirmed by our appointed Physician. Non-organic diseases such as neurosis and
psychiatric illnesses are excluded.
For the purpose of this definition, “aided” shall mean with the aid of special equipment, device and/or
apparatus and not pertaining to human aid.
Chronic Adrenal An autoimmune disorder causing a gradual destruction of the adrenal gland resulting in the need for lifelong
Insufficiency glucocorticoid and mineral corticoid replacement therapy. The disorder must be confirmed by a Specialist
Doctor in endocrinology through one of the following:
(a) ACTH simulation tests;
(b) Insulin-induced hypoglycemia test;
(c) Plasma ACTH level measurement;
(d) Plasma Renin Activity (PRA) level measurement.
Only autoimmune cause of primary adrenal insufficiency is included. All other causes of adrenal insufficiency
are excluded. Confidential 76
Descriptions

Others
Elephantiasis End stage Lymphatic Filariasis that meets all of the following criteria:
(a) Significant enlargement and disfiguration of the infected body (legs, genitals or breasts) due to blockage
of the lymphatic system by filariae parasites;
(b) The diagnosis of permanent lymphatic obstruction must be made by a medical practitioner who is a
qualified Specialist Doctor.
(c) Diagnosis must be supported by laboratory tests showing circulating filariae antigen or microfilariae in a
blood smear (Wuchereria bancrofti or Brugia malayi).
Other forms of lymphedema or acute lymphangitis are specifically excluded.
Amputation due to The actual undergoing of amputation of a leg or foot at or above the level of the ankles to treat gangrene
Complication from Diabetes that has occurred as a complication of diabetes.
Confidential 77
VII. Appendix
Details of Available Riders
78
Non-Accelerated Total and Permanent Disability
▪ If the insured is working at the time of disablement and is prevented from engaging in any
Conditions for total and
occupation or from performing any work for compensation or profit. Disability must be present and
permanent disability to be
must have existed continuously for not less than six (6) consecutive months
payable
▪ If the insured is not working at the time of disablement, and is permanently unable to undertake
without assistance three (3) or more of the Activities of Daily Living (refer to General Definition of
Terms Section)
▪ Total and permanent disability happened before the policy anniversary immediately following the
insured’s seventieth (70th) birthday
▪ Complete and irrecoverable loss of sight of both eyes
Other conditions considered
▪ Total and permanent loss by removal or disease of both hands or both feet or of one hand and one
as total and permanent
foot
disability
Exclusions ▪ Pregnancy, childbirth, or abortion or miscarriage or complication/s thereof

▪ Psychiatric disorders, drug or alcohol abuse
▪ Injuries or illness/es due to military service or suffered under conditions of war, whether declared or
not, insurrection, rebellion, or mutiny
▪ Intentional self-inflicted injuries or illness caused by attempts at suicide, or incurred as a result of or
while participating in the commission of a crime
▪ Engaging or taking part in driving or riding in any kind of race, professional sports or hazardous
sports, underwater activities involving the use of breathing apparatus, flying or aerial activities other
than as fare-paying passenger
▪ AIDS or AIDS-related complex
Confidential 79
Accidental Death & Disablement Benefit
▪ If the insured dies due to accident or sustains bodily injury effected directly and independently of all
Conditions for accidental
other causes by violent, accidental, external, and visible means which results in any of the losses
death and disablement
listed below within one hundred eighty (180) days from occurrence of the accident before the Policy
benefit to be payable
Anniversary immediately following the seventy-third (73rd) birthday of the insured.
▪ Below is the specified percentage of the Accidental Death and Disablement Benefit according to the
compensation schedule:
Type of injury Percentage of Sum
Assured
Total, Permanent and Irreversible:
Loss of both hands 100%
Loss of both feet 100%
Loss of sight of both eyes 100%
Loss of one hand and one foot 100%
Loss of one hand and sight of one eye 100%
Loss of one foot and sight of one eye 100%
Loss of one foot 50%
Loss of one hand 50%
Loss of sight of one eye 50%
Loss of both thumbs 25%
Loss of one thumb 10%
Loss of each finger 10%
Loss of hearing in both ears 50%
Loss of hearing in one ear 10%
Confidential 80
Exclusions No payment will be made if the death, loss or disablement is sustained or contracted, in whole or in
part, in any of the following circumstances:
▪ By intentional self-inflicted injury, suicide, or any attempt threat, while sane or insane
▪ By war, invasion, act of foreign enemy, hostilities or warlike operations (whether war be declared or
not), mutiny, riot, civil commotion, strike, civil war, rebellion, revolution, insurrections, conspiracy,
military or usurped power, martial law or state of siege, or any of the events or causes which
determine the proclamation or maintenance of martial law or state of siege, seizure, quarantine, or
nationalization by or under the order of any government or public or local authority
▪ By murder or any attempt thereof or assault provoked by the insured
▪ By any weapon or instrument employing atomic fission, thermonuclear fusion or any form of
radiation, whether in time of peace or war
▪ By congenital anomalies and conditions arising therefrom
▪ By pregnancy and resulting childbirth, miscarriage or abortion
▪ By cosmetic or plastic surgery, except as a result of injury
▪ While the insured is in active service in the armed forces of any country or any international
authority and in such an event, upon written notification by the Life Insured, we shall return the pro
rata premium for any such period of service
▪ While in any attempted commission of, or willful participation by the Life Insured in any crime
punishable under any prevailing law or ordinance of the Philippines or of any country in which the
crime was attempted or committed
▪ While resisting lawful arrest
▪ While entering, leaving, operating, servicing, or being in, on, or about any aerial or submarine device
or conveyance except as specifically provided herein
▪ By medical and surgical treatment except as may be necessary solely as a result of injury
Confidential 81
Exclusions ▪ By dental care or surgery except on natural teeth as occasioned by injury

▪ While under the influence of alcohol or unprescribed drugs
▪ By alcoholism or drug addiction
▪ By disease, bacterial infection or out of or consequent upon or contributed to by AIDS or AIDS-
related complex (ARC)
▪ By hernia, ptomaine, or other bacterial infections which are not pyogenic infections occurring at the
same time with or because of any accidental cut or wound
▪ By circumcision, sterilization, artificial insemination, sex transformation, diagnosis and treatment of
infertility
▪ By mental or nervous disorders
▪ By poison, gas, or fumes voluntarily or involuntary taken
▪ By automobile and motorcycle racing, judo, karate and similar martial arts, scuba diving, hang-
gliding, sky diving, bungee jumping, and any other dangerous sport
▪ By homicide or any attempt thereof, or physical injuries, occasioned by a provocation from the Life
Insured
▪ While Life Insured is driving or riding a motorcycle as a passenger, except when such is part of his
employment or profession, as declared in the Application Form.
Confidential 82
Waiver of Premium due to Total and Permanent Disability
Conditions for future ▪ If the insured is working at the time of disablement and is prevented from engaging in any
premiums to be waived due occupation or from performing any work for compensation or profit.
to total and permanent ▪ Disability must be present and must have existed continuously for not less than six (6) consecutive
disability months
▪ Total and permanent disability happened before the policy anniversary immediately following the
insured’s sixtieth (60th) birthday
Premiums to be waived ▪ Future premium falling due after the commencement and during the continuance of such total and
permanent disability. Future premiums to be waived will be based on the premium at the time of
approval of the WPTPD claim
Premiums not covered under ▪ Payment of any premium which has been due for more than six (6) months prior to the
this benefit commencement of such total and permanent disability
▪ This benefit will not waive future top-ups
Other conditions ▪ The total amount of benefits that can be claimed under the WPTPD shall not exceed one hundred
percent (100%) of the premium payments due.
Exclusions ▪ pregnancy, childbirth, or abortion or miscarriage or complication/s thereof

▪ psychiatric disorders, drug or alcohol abuse
▪ injuries or illness/es due to military service or suffered under conditions of war, whether declared or
not, insurrection, rebellion, or mutiny
▪ intentional self-inflicted injuries or illness caused by attempts at suicide, or incurred as a result of or
while participating in the commission of a crime
▪ engaging or taking part in driving or riding in any kind of race, professional sports or hazardous
sports, underwater activities involving the use of breathing apparatus, flying or aerial activities other
than as fare-paying passenger
▪ AIDS or AIDS-related complex
83
Payor Waiver of Regular Premium
Conditions for future Regular premiums will be waived until the end of the Benefit term of the rider if payor:
premiums to be waived ▪ Dies
under this rider ▪ Is totally and permanently disabled so that he/she is prevented from engaging in any
occupation or from performing any work for compensation or profit, and such disability is
present and has existed continuously for not less than six (6) consecutive months
▪ Suffer complete and irrevocable loss of sight of both eyes or
▪ Suffer total and permanent loss by removal or disease of both hands, both feet, or one
hand and one foot.
Conditions must happen before the policy anniversary immediately following the sixtieth (60 th)
birthday and before the policy anniversary immediately following the twenty-fifth (25th)
birthday of the Life Insured.
Exclusions ▪ Intentional self-inflicted injury

▪ Any act attributable to war, whether declared or not
▪ Military, naval or air service for any country at war, declared or not
84
Payor Term
Conditions for death to be ▪ If the Payor dies before the Policy Anniversary immediately following his/her seventy-fifth
payable under this rider (75th) birthday and before the expiry date of this Benefit
▪ Any policy debt is deducted from the Payor Term benefit.
85
Conditions applicable to Waiver of Premium due to Total and
Permanent Disability and Payor Waiver of Regular Premium
▪ Pru Life UK, at any time, may require due proof of continuance of such total and permanent disability and may
also, at any time, require the insured to undergo a medical examination by our designated physicians.
▪ Should such total and permanent disability continue for a period of two (2) years, we will not require such proof
of examination more than once in each of the following years of continuance of such disability.
▪ Should you fail to submit to such examination, or if, on request, proof is not furnished, or you recover as to be
able to engage in any occupation or perform any work for compensation or profit, all future premiums falling
due must be paid as originally provided in the Policy. If and when the insured recover from such disability,
he/she agrees to give us immediate notice.
For Payor Waiver

▪ Once the payor dies or is totally and permanently disabled and we have accepted the claim under this Benefit,
the Policy, including its core and any optional benefits, continues.
86
VIII. Appendix
General Definition of Terms
87
1. Accident means any unintentional, unforeseen or unexpected event which directly causes an Injury.
2. Activities of Daily Living shall mean any of the following:
▪ Continence – The ability to voluntarily control bowel or bladder functions or to clean up or perform urinary
excretion without the use of any catheter or other external device.
▪ Dressing – The ability to put on or take off garments and/or medical appliances usually worn with or without
the use of modified clothing or adaptive devices such as tape fastener or zipper pulls.
▪ Bathing – The ability to wash oneself completely in the bath or shower or by other means to maintain
personal hygiene with or without the aid of special equipment or adapted devices.
▪ Feeding – The ability to take any form of nourishment once it has been prepared and made available with or
without use of adaptive utensils.
▪ Mobility – The ability to move from one room to an adjoining room or from one side of a room to another. If a
person can move with the help of equipment such as a cane, walker, crutches, grab bars or other support
devices, then he or she will be considered mobile.
▪ Transferring – The ability to move in or out of a chair, including a wheelchair, bed or other stationary position,
or to walk.
3. Hospital means a facility which must include all of the following:
▪ a licensed, lawfully operating institution duly constituted and registered as a hospital

▪ is open at all times
▪ is operated mainly to diagnose and treat disabilities on an inpatient basis and at the patient’s expense
▪ has organized facilities for major surgery
▪ has a staff of one or more doctors on call at all times
▪ has twenty-four (24) hours nursing services by or under the supervision of registered nurses
▪ is not other than incidentally a skilled nursing facility, clinic, place for alcoholics or drug addicts, nursing home,
rest home, convalescent home, home for the aged, place for the treatment of mental disorders or a similar
establishment
▪ maintains a daily medical report for each patient, which is accessible to our designated Physician
Confidential 88
4. Hospital Confinement means a continuous, medically necessary period of time, lasting at least twelve (12) hours,
during which the Life Insured is confined in a hospital as an inpatient. The first day of
confinement starts at the time of admission to the hospital and each subsequent day of
confinement starts twenty-four (24) hours after the start of the previous day of confinement.
The day of discharge is considered as a day of confinement if the time of discharge of the Life
Insured from the hospital is more than twelve (12) hours from the later of the time of
admission to hospital or the end of the previous day of confinement.
5. Illness means sickness or disease contracted and commencing more than thirty (30) days following
the Policy Effectivity Date or the date of last reinstatement.
6. Injury means bodily injury caused by accident, directly and independently of all other causes, and
which is evidenced by a visible contusion on the exterior of the body except in the case of
drowning or of internal injury revealed by an autopsy.
7. Intensive Care Unit means a unit or department in a Hospital, excluding the post-operating room or emergency
(ICU) room, which provides in-hospital boarding and which is:
▪ established by the Hospital to provide intensive care and treatment
▪ reserved for serious patients whose vital functions are threatened and who require
continuous monitoring and examining from doctors as prescribed by the attending Physician
▪ equipped with all equipment’s, medicines and other necessary emergency aids available for
immediate intervention
Confidential 89
8. Loss of means complete and permanent paralysis or actual severance as the result of an accident of any of the
(as used in the following as specified below:
Schedule of Coverage ▪ hand – at the wrist
under Accidental ▪ arm between elbow or wrist – above the wrist joint and below the elbow joint
Death and ▪ arm at or above elbow – at or above the elbow joint
Disablement Rider) ▪ foot – at the ankle joint
▪ leg below knee – above the ankle joint and below the knee joint
▪ leg at or above knee – at or above the knee joint
▪ fingers – through or above the metacarpophalangeal joints
▪ toes- through or above the metatarsophalangeal joints
9. Loss of finger means complete and permanent paralysis or actual severance of all three phalanges as the result of an
accident
10. Loss of hearing means permanent, irrecoverable and irreversible total loss of hearing for all sounds as confirmed by a
certified Ear, Nose, and Throat (ENT) specialist doctor through audiometric and sound-threshold tests.
11. Loss of sight means permanent, irrecoverable and irreversible loss of visual acuity of more than eighty percent
(80%) as certified by an ophthalmologist’s report.
12. Loss of speech means the inability to speak comprehensible words or understandable verbal language due to
permanent, irrecoverable and irreversible:
▪ total loss or damage of vocal cord or its adjacent organs as confirmed by a certified Ear, Nose and
Throat (ENT) specialist doctor; or
▪ damage of speech center in the brain resulting in Aphasia as confirmed by a certified neurologist
and which must be established for a continuous period of six (6) months from date of accident.
Confidential 90
13. Loss of use means the complete and permanent inability of the Insured to move or perform an action for
which his limbs, fingers, toes or metacarpals are normally fitted or used, or for which they
normally exist. It includes paralysis which means complete and permanent inability to move as
a result of neurological damage.
14. Physician means any person legally authorized in the geographical area of his practice to render medical
and surgical services, other than the Insured or a member of the Insured’s immediate family.
15. Specialist Doctor means a doctor who has a qualification as a professional in medical science as evidenced by a
license to practice as a specialist doctor from an authorized institution in the geographical area
where the doctor practices, who is not the Policyowner, Life Insured or a member of the Life
Insured’s immediate family.
Confidential 91
IX. Appendix
Product Comparison
92
Product Comparison – Cancer Only
PRU LIFE UK SUN LIFE
Product Name Health Prime Sun Cancer Care
Product Type Unit-Linked Product Traditional Product
Participating No Yes
Payment Term 20-pay 5,10,15,20-pay
Premium Structure Level Level
Issue Age 0 – 60 25-45
Coverage Period up to Age 85 Up to Age 100
Death Benefit 100% of the SA – ESCa payout + 100% of the SA + Dividends +
Fund Value Paid-up Bonus
Critical Illness
Major
Type Accelerated Accelerated
No. of Illnesses Late Stage Cancer only Late Stage Cancer
Amount 100% of SA – ESCa payout + Fund 100% of FA – Minor CI payout
Value
Minor
Type Accelerated Accelerated
No. of Illnesses Early Stage Cancer only Early Stage Cancer
Amount 50% of the SA with a cap of 3.75 or 20% of the FA
1.5 million
Other Benefits
Surrender Value Full Withdrawable Value Cash Value + Dividends + Paid-up
Bonus
Maturity Value 100% of the SA less any ESCa Cash Value + Dividends + Paid-up
payout + Fund Value Bonus
Other Core Benefits Hospital Income, Post- Benign Tumor Excision – 5% of FA,
hospitalization Benefit, Loyalty Treatment Support – 5% of FA (12
Bonus mos) after Major Cancer claim
Optional Riders Select Top 4 CI, Select 52 CI, TPD, Accidental Death, Total Disability,
ADD, Waiver on TPD, Payor Term, Waiver of Premium on Death,
Payor Waiver Waiver of Premium on Death or
Disability
Confidential 93
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.
Product Comparison – Cancer Only
PRU LIFE UK SUN LIFE

Product Name Health Prime Sun Cancer Care
Product Type Unit-Linked Product Traditional Product
Living & Death

Benefit
Premium Term 20-pay 20-pay
LI Age, Gender 30, Male 30, Male
Sum Assured 1,000,000 1,000,000
Annual Premium 28,640 25,550
Living Benefit @4% @3.8%
Year 5 59,051.11 49,800
Year 9 174,375.89 125,050
Year 15 449,337.14 241,090
Age 60 903,245.10 709,839
Age 65 978,012.76 871,013
Death Benefit
Year 5 1,078,734.82 1,000,000
Year 9 1,205,148.10 1,000,000
Year 15 1,449,337.14 1,000,000
Age 60 1,903,245.10 1,241,779
Age 65 1,978,012.76 1,346,553
Above figures are for illustration purposes only and should not be considered guaranteed amounts. Living and death benefits are based Confidential 94
on the projected performance of Equity Fund which are not guaranteed.
Product Comparison – With other CI products
PRU LIFE UK SUN LIFE PHILAM PHILAM Manulife
Product Name Health Prime Sun Fit & Well AIA Critical Protect Health Invest Plus HealthFlex
Product Type Unit-Linked Product Traditional Product Traditional Product Unit-Linked Product Traditional Product
Participating No Yes No No Yes
Payment Term 20-pay 10,15,20-pay 10-pay, 20-pay 3,5,7,10-pay 5-pay, 10-pay, Payable to
60
Premium Structure Level Level Level Level Level
Issue Age 0 – 60 0 - 60 0-65, 0-55 18-65 0-70
Coverage Period up to Age 85 up to Age 100 up to Age 100 up to Age 75 Up to Age 100
Death Benefit 100% of the SA – ESCa 100% of the SA + 100% of the SA Higher between 100% of 100% of SA
payout + Fund Value Accumulated Endowment + the Life SA and the Fund
Dividends + Paid-up Bonus Value
Critical Illness
Major
Type Accelerated Accelerated Accelerated Non-Accelerated
No. of Illnesses Late Stage Cancer only 64 57 56 Cancer/3 CI/ Cancer+/ 3CI+
Amount 100% of SA – ESCa payout 100% of Sum Assured 100% of Sum Assured 100% of the CI Sum 100% of Sum Assured
+ Fund Value Assured
Minor (Optional benefit)
Type Accelerated Accelerated Accelerated (optional rider) Accelerated from CI Accelerated
Coverage
No. of Illnesses Early Stage Cancer only 34 34 11 Early-stage
Amount 50% of the SA with a cap of 20% of Face Amount, up to 25% of Face Amount 25% from the CI Sum 25% of Sum Assured
3.75 or 1.5 million 3 claims Assured, up to 4 claims
Other Benefits
Surrender Value Full Withdrawable Value Cash Value + Accumulated Guaranteed Cash Value Full Withdrawable Value Cash Value
Endowment + Dividends +
Paid-up Bonus
Maturity Value 100% of the SA less any Cash Value + Accumulated Cash Value Fund Value Sum Assured (must not
ESCa payout + Fund Value Endowment + Dividends + have any claim)
Paid-up Bonus
Other Core Benefits Hospital Income, Post- Cancer boost - +50% to FA, nil DHI, LTH, ICU, OTB, Waiver Waiver of Premium
hospitalization Benefit, Accidental Death, Total of Premium for CI, ADD
Loyalty Bonus Disability
Optional Riders Select Top 4 CI, Select 52 nil Gender specific rider, nil Early-stage CI
CI, TPD, ADD, Waiver on Recovery Benefit, Waiver of Recovery Benefit
TPD, Payor Term, Payor Premium on Death or Total 2nd Advanced CI
Waiver Disability Child CI
Male/Female Cancer benefit
Confidential 95
PRU LIFE UK AXA FWD
Product Name Health Prime Health Max Set for Health
Product Type Unit-Linked Product Traditional Product Traditional Product
Participating No No No
Payment Term 20-pay 10-pay, 20-pay 5,7,10-pay
Premium Structure Level Level Level
Issue Age 0 – 60 2-56, 2-46 0-60, 0-55, 0-45
Coverage Period up to Age 85 up to Age 100 up to Age 75
Death Benefit 100% of the SA – ESCa payout 100% of the SA + Advanced 100% of the SA
+ Fund Value Health Fund Interest
Critical Illness
Major
Type Accelerated Accelerated Accelerated
No. of Illnesses Late Stage Cancer only 56 42
Amount 100% of SA – ESCa payout + 100% of Sum Assured 100% of Sum Assured
Fund Value
Minor
Type Accelerated Accelerated Accelerated
No. of Illnesses Early Stage Cancer only 18 15
Amount 50% of the SA with a cap of 20% of the SA, up to 2 claims 20% of Face Amount
3.75 or 1.5 million
Other Benefits
Surrender Value Full Withdrawable Value Cash Value + Advanced Health None
Fund with Interest
Maturity Value 100% of the SA less any ESCa Cash Value + Advanced Health Return of Premiums if there
payout + Fund Value Fund Interest are no prior CI claims at age
75
Other Core Benefits Hospital Income, Post- Advance Health Fund Waiver of premium on CI
hospitalization Benefit, Loyalty
Bonus
Optional Riders Select Top 4 CI, Select 52 CI, nil nil
TPD, ADD, Waiver on TPD,
Payor Term, Payor Waiver
Confidential 96
PRU LIFE UK SUN LIFE PHILAM PHILAM AXA FWD Manulife
Product Name Health Prime Sun Fit & Well AIA Critical Health Invest Health Max Set for Health HealthFlex
Protect Plus
Product Type Unit-Linked Traditional Traditional Unit-Linked Traditional Traditional Product Traditional Product
Product Product Product Product Product
Living &
Death Benefit
Premium 20-pay 10-pay 20-pay 10-pay 20-pay 10-pay 10-pay
Term
LI Age, 30, Male 30, Male 30, Male 30, Male 30, Male 35, Male 30, Male
Gender
Sum Assured 1,000,000 1,000,000 1,000,000 1,000,000 1,000,000 1,000,000 1,000,000
With Gender 500,000 for CI
Specific Booster
Annual 28,640 53,000 25,312 63,664 25,650 63,260 52,490
Premium
Living Benefit @4% @3.5% n/a @4% @3.5% n/a 3%
Year 5 59,051.11 119,370 16,000 181,352 38,000 148,480 n/a
Year 9 174,375.89 241,970 65,750 449,121 122,000 321,660 n/a
Year 15 449,337.14 391,130 152,250 649,688 277,000 Not available n/a
Age 60 903,245.10 733,958 356,000 942,611 Not available Not available n/a
Age 65 978,012.76 881,490 425,500 1,014,896 Not available 604,530 n/a
Death Benefit
Year 5 1,078,734.82 1,000,000 1,000,000 1,000,000 1,000,000 1,000,000 1,000,000
Year 9 1,205,148.10 1,000,000 1,000,000 1,000,000 1,000,000 1,000,000 1,000,000
Year 15 1,449,337.14 1,064,590 1,000,000 1,000,000 1,000,000 1,000,000 1,000,000
Age 60 1,903,245.10 1,243,708 1,000,000 1,000,000 1,000,000 1,000,000 1,000,000
Age 65 1,978,012.76 1,334,338 1,000,000 1,014,896 1,000,000 1,000,000 1,000,000
Above figures are for illustration purposes only and should not be considered guaranteed amounts. Living and death benefits are based Confidential 97
on the projected performance of Equity Fund which are not guaranteed.
PRUHealth Prime
Strengths of the product vs. CI products of competitors
Advancement of 50% of the SA

for early-stage cancer
Covers full spectrum of cancer

from early to late stage
With built-in hospitalization

benefits
Maturity benefit at age 85
Available to juvenile life insureds
Confidential 98
Product Comparison – With PAA Plus
Product Name PAA Plus + LCB + DHI +

PAA Plus + LCB
Health Prime ICU
(15K base premium)
(15K base premium)
Product Type Unit-Linked Product Unit-Linked Product Unit-Linked Product
Pay period 20 years Regular-pay Regular-pay
No. of CI covered Cancer Only 36 36
CI benefit type Accelerated Accelerated Accelerated
ESCI benefit 50% of SA for Cancer N.A. N.A.
SA Base SA: 1,000,000 Base SA: 1,000,000 Base SA: 1,000,000
LSCA SA: 1,000,000 LCB SA: 1,000,000 LCB SA: 1,000,000
HI SA HI: 1,250 or 2,500 if in None DHI: 1,000

ICU ICU: 2,000 (on top of DHI)
Post-Hospitalization: 5,000
Age 30, Male
Premium 28,640 26,781 28,709
Fund Value At 4% At 4% At 4%
Age 50 694,160.06 512,220.93 532,369.32
Age 60 903,245.10 769,268.69 789,735,74
Age 65 978,012.76 820,745.96 829,499.10
Death Benefit
Age 50 1,694,160.06 1,512,220.93 1,532,369.32
Age 60 1,903,245.10 1,769,268.69 1,789,735,74
Age 65 1,978,012.76 1,820,745.96 1,829,499.10
Above figures are for illustration purposes only and should not be considered guaranteed amounts. Confidential 99
Living and death benefits are based on the projected performance of Equity Fund which are not guaranteed.
PRUHealth Prime
Strengths of the product vs. PAA Plus
Payable for 20 years
Advancement of 50% of the SA

for early-stage cancer
Cancer coverage is until age 85
Maturity benefit at age 85
Fund allocation on Year 1
Available to juvenile life insureds

Confidential 100
Product Name Health Prime Health Prime + Health Prime +
Cancer Only Select Top 4 CI Select 52 CI
Core benefits
SA Base SA: 1,000,000 Base SA: 1,000,000 Base SA: 1,000,000
ESCA: 500,000 ESCA: 500,000 ESCA: 500,000
LSCA SA: 1,000,000 LSCA SA: 1,000,000 LSCA SA: 1,000,000
HI SA HI: 1,250 or 2,500 if in ICU HI: 1,250 or 2,500 if in ICU HI: 1,250 or 2,500 if in ICU
Post-Hospitalization: 5,000 Post-Hospitalization: 5,000 Post-Hospitalization: 5,000
Optional benefits
CI Rider SA None LSCI: 1,000,000 LSCI: 1,000,000
HI SA None HI: 1,250 or 2,500 if in ICU HI: 1,250 or 2,500 if in ICU

Post-Hospitalization: 5,000 Post-Hospitalization: 5,000
Age 30, Male

Premium 28,640 36,420 43,752
Fund Value At 4% At 4% At 4%
Age 50 694,160.06 877,302.45 1,059,153.50
Age 65 978,012.76 1,221,858.94 1,498,786.50
Age 70 1,007,597.27 1,253,137.75 1,546,049.57
Death Benefit
Age 50 1,694,160.06 1,877,302.45 2,059,153.50
Age 65 1,978,012.76 2,221,858.94 2,498,786.50
Age 70 2,007,597.27 2,253,137.75 2,546,049.57
Above figures are for illustration purposes only and should not be considered guaranteed amounts. Confidential 101
Living and death benefits are based on the projected performance of Equity Fund which are not guaranteed.
Confidential 102

PRUHEALTH_PRIME_TRAINING_SLIDES

Uploaded by

Copyright:

Available Formats

You might also like

PRUHEALTH_PRIME_TRAINING_SLIDES

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

PRUHEALTH_PRIME_TRAINING_SLIDES

Uploaded by

Copyright:

Available Formats

PRUHealth Prime Training Material

March 2021 | Product Management

Non-communicable diseases (NCDs), are

Characteristics of Chronic conditions

Top 10 Causes of Death as of 2018

Neoplasms 63,454 68% Percentage of all deaths in the

Pneumonia 56,815 29% Probability of Filipinos dying between

Respiratory Tuberculosis 22,103 Ischemic Heart Disease is the top

Remainder of diseases of the 16,029

Diseases Cost in PhP

Acute Heart Attack 978,650 84% Percentage of Filipinos that

Breast Cancer 438,000 4% Percentage of Filipinos

Critical illness conditions consist about 93% of Pru Life UK claims.

Top CI claim conditions

Heart attack 11%

Product Type Variable life insurance

Death Benefit The sum of:

Late Stage Upon late stage Cancer diagnosis:

If hospital confinement is in the Intensive Care Unit:

▪ Subject to maximum of 90 days hospital confinement per life where

This is payable once as a lump sum benefit on top of the HI

Maturity The sum of:

Minimum Basic PhP 500,000

Select Top 4 Select 52

Select Top 4 Select 52

Select Top 4 Select 52

Critical Illness SA Aggregation

Since cancer benefit is bundled together with the

Early Stage Cancer benefit terminates.

Late Stage Lung Cancer Diagnosis

Insured eligible for the following:

Policy details Late Stage Breast Cancer Diagnosis

Early Stage Breast Cancer Diagnosis

Insured not eligible to claim Early

Select Top 4 CI benefit terminates.

Suffered Heart Attack

Non-accelerated Total and Permanent Disability Benefit

Insurance Charges Equal to the sum of the following:

Year 1 80% 60%

Withdrawals drawn from units created from regular premiums

Withdrawals drawn from units created from top-ups

SA Band 1 : SA < PhP 1,000,000

Late Stage Critical Illness

Late Stage Critical Illness

Late Stage Critical Illness

Older Millennials Younger Generation X

Despite the generation gap, they share

What are their main concerns? What do they need?

The existing Individual

However, submissions may

❑ New & Improved Product

❑ Death Benefits Chart

❑ Living Benefit Chart

❑ Important Illustration Notes 6 Free-look Period

❑ Living Benefit Chart

❑ New & Improved Product

❑ Death Benefits Chart

❑ Living Benefit Chart

❑ Important Illustration Notes