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IC Filing of Complaint

The document outlines the process for filing formal complaints against insurance companies, mutual benefit associations, and health maintenance organizations with the Insurance Commission of the Philippines. It details the 5 main steps: 1) Filing the complaint and certifications, 2) Paying legal fees, 3) Recording and docketing the complaint, 4) Preparing and reviewing summons, and 5) Releasing summons. The total processing time is estimated to be 3 days and 12 minutes. Various legal fees are also outlined based on the principal amount being claimed.

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Jenny Bascuna
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187 views4 pages

IC Filing of Complaint

The document outlines the process for filing formal complaints against insurance companies, mutual benefit associations, and health maintenance organizations with the Insurance Commission of the Philippines. It details the 5 main steps: 1) Filing the complaint and certifications, 2) Paying legal fees, 3) Recording and docketing the complaint, 4) Preparing and reviewing summons, and 5) Releasing summons. The total processing time is estimated to be 3 days and 12 minutes. Various legal fees are also outlined based on the principal amount being claimed.

Uploaded by

Jenny Bascuna
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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PROCESS OF HANDLING FORMAL COMPLAINTS/ PROCESS OF ACTING ON FILING


OF COMPLAINTS
 About the Service

This service is being offered to assist clients in the filing of formal complaints
against insurance and pre-need companies, mutual benefit associations, and
health maintenance organizations.

 Office/Division

Claims Adjudication Division

 Classification

Simple

 Type of Transaction

Government-to-Citizen (G2C)

 Who May Avail of the Service

All policyholders, plan holders, MBA members, and HMO members

 Requirement/s

Checklist of Requirements Where to secure


1. Statement of Claims; or Insurance Commission – Claims and
Adjudication Division
Verified Complaint Prepared by complaining party’s
counsel
2. Certificate of Non-forum Claimant
Shopping
3. All annexes mentioned in the Claimant
complaint, if any
Note:
Statement of Claims for small claims amounting to Php 400,000.00 and below
Verified Complaint for claims amounting to above Php 400,000.00 but not exceeding Php 5,000,000.00

 Schedule of Availability of Service

Monday – Friday (except holidays) 8:00 AM – 5:00 PM

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 How to Avail of the Service

SERVICE FEES TO BE PROCESSING PERSON IN


STEP CLIENT STEPS
PROVIDED PAID TIME CHARGE

1. Presentation of Client presents the Upon the filing of the None 1 day Division Manager
the Statement of following: complaint, the
Claims or Commission
Verified 1. Statement of determines whether
Complaint Claims or Verified the same is sufficient Assisting Officer
Complaint in form and (Administrative
substance and the Assistant III/
2. Certification of Assisting Officer (AO) Administrative
Non-Forum prepares the Order of Aide II)
Shopping Payment.

If the complaint is not


sufficient in form and
substance, the
Commission, motu
proprio, shall refuse
to accept it.

2. Payment of The client proceeds The Cashier See Schedule 7 minutes Cashier Staff
Legal Fees to the Cashier processes the of Legal Fees
Section to pay the payment and Below
legal fees. releases the Official
Receipt to be
submitted to CAD
thereafter.

3. Recording and The AO assigns a None 5 minutes Assisting Officer


Docketing of unique docket (Administrative
Complaint number for the Assistant III/
complaint and Administrative
records the case in Aide II)
the docket book.
AO
4. Preparation and The AO prepares None 1 day
(Administrative
Review of summons as
Assistant III/
Summons instructed by Division
Administrative
Manager.
Aide II)

The AO reviews the Division Manager


summons then
forwards the same to
the Division Manager
for signature.

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SERVICE FEES TO BE PROCESSING PERSON IN
STEP CLIENT STEPS
PROVIDED PAID TIME CHARGE

5. Release of The AO sends the None 1 day Assisting Officer


Summons summons to the (Administrative
concerned parties. Assistant III/
Administrative
Aide II)
TOTAL: See Schedule 3 days and 12
of Legal Fees minutes
Below

SCHEDULE OF LEGAL FEES

2022 Amendments to the 2014 Rules of Procedure Governing Trial and Hearing of Claims
Cases Involving Insurance or Reinsurance Policies or Those Arising from Membership
Certificates Issued by Mutual Benefit Associations, in the Insurance Commission
(Rule 4, Section 1 of IMC No. 2022-01)
Principal Amount Being Claimed Docket Fee Legal Research
Fee (1%)
More than PHP 400,000.00 but less than PHP 1,000,000.00 PhP 5,000.00 PhP 50.00
PHP 1,000,000.00 or more but less than PHP 2,000,000.00 PhP 10,000.00 PhP 100.00
PHP 3,000,000.00 up to PHP 5,000,000.00 PhP 15,000.00 PhP 150.00

Rules of Procedure for Small Claims Cases in the Insurance Commission


(Section 7 of Insurance Memorandum Circular No. 2016-01, as amended by 2020-01)
Legal Research
Principal Amount being Claimed Docket Fee Summons Fee
Fee (1%)
Does not exceed PHP 100,000.00 Php1,000.00 PhP10.00
Exceeds PHP 100,000.00, but does not exceed
PhP2,000.00 PhP20.00
PHP 200,000.00
Exceeds PHP 200,000.00, but does not exceed Php 3,000.00 PhP1,000.00
PhP30.00
PHP 300,000.00
Exceeds PHP 300,000.00, but does not exceed Php 4,000.00
PhP40.00
PHP 400,000.00

Rules of Procedure for Adjudication of Cases against Health Maintenance Organizations in the Insurance
Commission
(Rule V, Section 3 of Insurance Memorandum Circular No. 2017-01)
Principal Amount being Claimed Docket Fee Legal Research Fee (1%)
More than PhP400,000.00 up to PhP500,000.00 PhP5,000.00 PhP50.00
More than PhP500,000.00 up to PhP600,000.00 PhP6,000.00 PhP60.00
More than PhP600,000.00 up to PhP700,000.00 PhP7,000.00 PhP70.00
More than PhP700,000.00 up to PhP800,000.00 PhP8,000.00 PhP80.00
More than PhP800,000.00 up to PhP900,000.00 PhP9,000.00 PhP90.00
More than PhP900,000.00 up to PhP1,000,000.00 PhP10,000.00 PhP100.00
More than PhP1,000,000.00 up to PhP2,000,000.00 PhP15,000.00 PhP150.00
More than PhP2,000,000.00 up to PhP3,000,000.00 PhP20,000.00 PhP200.00
More than PhP3,000,000.00 up to PhP4,000,000.00 PhP25,000.00 PhP250.00
More than PhP4,000,000.00 up to PhP5,000,000.00 PhP30,000.00 PhP300.00
More than PhP5,000,000.00 PhP35,000.00 PhP350.00
138

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