Article 60p. 60

COMMERCIAL LAWS NEGOTIABLE INSTRUMENTS, CORPORATION, INSURANCE, TRANSPORTATION, BANKING

such

transfer

of

securities

is

approved

by

the

Commissioner. The Commissioner may authorize other

transfers among such accounts, if, in his opinion, such

transfers would not be inequitable. All amounts and

assets allocated to any such separate variable account

shall be owned by the company and with respect to the

same the company shall not be nor hold itself out to be a

trustee.

SECTION 244. Any insurance company which has

established

one

or more separate variable accounts

pursuant

to

the

preceding

section

may

invest and

reinvest all or any part of the assets allocated to any such

account in the securities and investments authorized by

Sections 204, 206, 207 and 208 for any of the funds of an

insurance company in such amount or amounts as may

be approved by the Commissioner. In addition thereto,

such company may also invest in common stocks or

other equities which are listed on or admitted to trading

in a securities exchange located in the Philippines, or

which

are

publicly

held

and

traded

in

the

over-the-counter market as defined by the Commissioner

and as to which market quotations have been available:

Provided, however , That no such company shall invest in

excess of ten percent (10%) of the assets of any such

separate variable accounts in any one corporation issuing

such common stock. The assets and investments of such

separate

variable

accounts

shall

not

be

taken

into

account

in

applying

the

quantitative

investment

limitations

applicable

to

other

investments

of

the

company. In the purchase of common capital stock or

other equities, the insurer shall designate to the broker, or

to the seller if the purchase is not made through a broker,

the specific variable account for which the investment is

made.

SECTION

245.

Assets

allocated

to

any

separate

variable account shall be valued at their market value on

the date of any valuation, or if there is no readily available

market value then in accordance with the terms of the

variable contract applicable to such assets, or if there are

no such contract terms then in such manner as may be

prescribed

by

the

rules

and

regulations

of

the

Commissioner.

SECTION

246.

The

reserve

liability

for

variable

contracts

shall

be

established

in

accordance

with

actuarial procedures that recognize the variable nature of

the benefits provided, and shall be approved by the

Commissioner.

TITLE 11 Claims Settlement

SECTION

247.

(a)

No

insurance

company

doing

business in the Philippines shall refuse, without just

cause, to pay or settle claims arising under coverages

provided by its policies, nor shall any such company

engage in unfair claim settlement practices. Any of the

following acts by an insurance company, if committed

without just cause and performed with such frequency as

to indicate a general business practice, shall constitute

unfair claim settlement practices:

(1) Knowingly misrepresenting to claimants pertinent

facts or policy provisions relating to coverage at issue;

(2)

Failing

to

acknowledge

with

reasonable

promptness pertinent communications with respect to

claims arising under its policies;

(3)

Failing

to

adopt

and

implement

reasonable

standards for the prompt investigation of claims arising

under its policies;

(4) Not attempting in good faith to effectuate prompt,

fair and equitable settlement of claims submitted in

which liability has become reasonably clear; or

(5)

Compelling policyholders to institute suits to

recover

amounts

due

under

its policies by offering

without justifiable reason substantially less than the

amounts ultimately recovered in suits brought by them.

(b) Evidence as to numbers and types of valid and

justifiable complaints to the Commissioner against an

insurance company, and the Commissioner's complaint

experience

with

other

insurance

companies

writing

similar lines of insurance shall be admissible in evidence

in an administrative or judicial proceeding brought under

this section.

(c) If it is found, after notice and an opportunity to be

heard, that an insurance company has violated this

section, each instance of noncompliance with paragraph

(a) may be treated as a separate violation of this section

and

shall

be

considered

sufficient

cause

for

the

suspension or revocation of the company's certificate of

authority.

SECTION 248. The proceeds of a life insurance policy

shall be paid immediately upon maturity of the policy,

unless such proceeds are made payable in installments or

as an annuity, in which case the installments, or annuities

shall be paid as they become due: Provided, however ,

That in the case of a policy maturing by the death of the

insured, the proceeds thereof shall be paid within sixty

(60) days after presentation of the claim and filing of the

proof of death of the insured. Refusal or failure to pay the

claim within the time prescribed herein will entitle the

beneficiary to collect interest on the proceeds of the

policy for the duration of the delay at the rate of twice the

ceiling prescribed by the Monetary Board, unless such

failure or refusal to pay is based on the ground that the

claim is fraudulent.

The proceeds of the policy maturing by the death of

the insured payable to the beneficiary shall include the

discounted value of all premiums paid in advance of their

due dates, but are not due and payable at maturity.

SECTION 249. The amount of any loss or damage for

which an insurer may be liable, under any policy other

than life insurance policy, shall be paid within thirty (30)

days after proof of loss is received by the insurer and

ascertainment of the loss or damage is made either by

agreement between the insured and the insurer or by

arbitration; but if such ascertainment is not had or made

within sixty (60) days after such receipt by the insurer of

the proof of loss, then the loss or damage shall be paid

within ninety (90) days after such receipt. Refusal or

failure

to

pay the loss or damage within the time

prescribed

herein

will

entitle the assured to collect

interest on the proceeds of the policy for the duration of

the delay at the rate of twice the ceiling prescribed by the

Monetary Board, unless such failure or refusal to pay is

based on the ground that the claim is fraudulent.

SECTION

250.

In

case

of

any

litigation

for

the

enforcement of any policy or contract of insurance, it shall

be the duty of the Commissioner or the Court, as the case

may be, to make a finding as to whether the payment of

the claim of the insured has been unreasonably denied or

withheld; and in the affirmative case, the insurance

company shall be adjudged to pay damages which shall

consist of attorney's fees and other expenses incurred by

the insured person by reason of such unreasonable denial

or withholding of payment plus interest of twice the

ceiling prescribed by the Monetary Board of the amount

of the claim due the insured, from the date following the

time prescribed in Section 248 or in Section 249, as the

case may be, until the claim is fully satisfied. Provided,

That failure to pay any such claim within the time

prescribed in said sections shall be considered prima

facie evidence of unreasonable delay in payment.

SECTION 251. It is unlawful to:

(a) Present or cause to be presented any fraudulent

claim for the payment of a loss under a contract of

insurance; and

(b) Fraudulently prepare, make or subscribe any

writing with intent to present or use the same, or to allow

it to be presented in support of any such claim. Any

person who violates this section shall be punished by a

fine

not

exceeding

twice

the

amount

claimed

or

imprisonment of two (2) years, or both, at the discretion of

the court.

© Compiled by RGL

60 of 211