“Emergency” is defined as “a sudden and unexpected onset of an illness or injury that at the time of occurrence reasonably appears to have the potential to cause immediate permanent disability or death, or that requires the immediate relief of severe pain and discomfort.” Examples of these are: (a) immediate treatment of wounds or fractures sustained from an accident; (b) massive bleeding; (c) acute appendicitis; (d) acute myocardial infarction; (e) hypertensive cases, and (f) incessant and severe pain.

Given the urgency of the situation, you may seek treatment at a hospital or clinic that may or may not be accredited COCOLIFE HEALTHCARE providers. In accredited hospitals, you only need to follow the availment process. For emergency consultations and/or admissions in non-accredited hospitals, you will need to do the following:

1. Notify COCOLIFE HEALTHCARE of your confinement within 24 hours from admission.
2. Before discharge, settle all hospital bills and professional fees.
3. Secure the following initial requirements:
   1. Hospital Statement of Account with PhilHealth Deductions
   2. Charge slips / tickets
   3. Official receipt of the hospital bills and doctors’ fees
   4. Clinical abstracts or medical certificate by the attending physician
   5. Operative and histopathological reports (if any)
   6. Police report in cases of accidents or medico legal cases
4. Submit the documents above with your request for reimbursement within 30 days from the date you were discharged to:

          HealthCare Division

          COCOLIFE

          8th Floor Feliza Building, 108 V.A. Rufino Street,

          Legaspi Village, Makati City

Claims are processed within ten (10) working days. We shall reimburse you 80% of your expenses, but this should not exceed the amount we would have paid to our accredited service provider, or up to an amount stipulated in your Master Policy.

Additional medical information necessary for the proper evaluation of your claim may be required. We shall advise you accordingly.

Reminder: Please call 812-9090 or 0917-536-0962 / 0922-892-8828 / 0908-894-7763 to advise us of your confinement.

Coverage of your hospitalization will be shouldered by COCOLIFE HEALTHCARE in the event that your physician determines that you need to be confined for proper management of your medical condition. However, please also take note that:

1. Before or during your confinement, you will need to secure a PhilHealth form from your employer. Complete the required information and forward the form to the hospital’s billing section. Otherwise, you will be required by the hospital to pay the PhilHealth portion of your hospital bills before you are cleared for discharge.
2. Your attending physician will authorize your discharge from the hospital on a specific day once he or she determines that you have already sufficiently recovered from your illness.
3. If you incurred additional expenses that are not covered by your COCOLIFE HEALTHCARE program, you will have to settle these directly with the hospital before you are discharged. These may include:
   • Room rate differential if you decided to upgrade your room accommodation than what is specified in your COCOLIFE HEALTHCARE plan.
   • Incremental charges of at least 20% of the total hospital bills if you were confined in a room with higher classification than what is specified in your COCOLIFE HEALTHCARE plan.
   • Charges for non-essential items such as extra tray, extra bed, and the like.
   • Charges for additional stay in the hospital after you have been cleared for discharge by your attending physician.

Your outpatient benefits include the following:

• Consultations including specialists’ evaluations
• Necessary x-ray and laboratory examinations
• First aid treatment of injuries sustained from accidents
• Minor surgeries