We would like to help you with your claim application. Please fill out the form below and complete all fields marked with (*).

Before submitting your application, please prepare the following documentation for your convenience in the next steps.

1. Registered Death Certificate with seal and issued by the Local Civil Registrar or Philippine Statistics Authority (PSA)

2. Photocopy of Valid IDs of Planholder (Government-issued ID’s)

3. Marriage Contract (if claimant is the spouse and or if Planholder’s daughter is already married)

4. Signed Waiver of Rights (for multiple beneficiaries noted in the Life Plan Contract)

LPA Number:*

Claimant's First Name:*

Claimant's Middle Name:*

Claimant's Last Name:*

Date of Birth:*

Mobile Number:*

Email Address:*

Lot #:*

Street:*

Province:*

City:*

District:*

Barangay:*

Zip Code:*

Date of Death:*

Certificate of Full Payment Number:

Relationship to the Planholder:*

Registered Death Certificate*

Photocopy of Valid IDs of Planholder*

Marriage Contract

Signed Waiver of Rights