Please read and confirm the following before submitting your claim/s:

• • I confirm that all information I am providing and documents I am submitting are true, correct, and complete to the best of my knowledge. I understand that providing incomplete or unclear information or documents may result in delays in the evaluation and processing of my claim. I also understand that insurance fraud is prohibited under the Philippine law. Submitting false, misleading, fraudulent, altered, exaggerated, or fabricated claims or supporting documents may result not only in denial of benefits and policy cancellation but may also subject me to possible civil or criminal liability under applicable Philippines laws.
• • In accordance with the Data Privacy Act of 2012 (Republic Act No. 10173), its Implementing Rules and Regulations, and other applicable data protection and privacy laws, I consent to the collection and processing of my personal data (which may include identification information, contact details, financial information, and medical records) for the purpose of evaluating and settling my claim.
  I acknowledge that I have read and understood LLIBI’s Privacy Notice, available at https://llibi.com/corporate-governance/#DataPrivacy, which explains how my personal data is collected, used, stored, shared, and protected. I further understand that, as a data subject, I have rights under the laws, which include the right to access, correct, update, withdraw consent, or request deletion of my personal data, subject to lawful limitations, and that I may exercise these rights in accordance with the procedures outlined in the Notice.
  I understand that appropriate safeguards are in place to protect my personal data and that my information will be retained only for as long as necessary to fulfill legal, regulatory, and contractual obligations.
  I agree that my information may be shared, only when necessary and in accordance with the laws, with authorized third parties such medical professionals, insurers, reinsurers, service providers, legal advisors, and regulatory authorities for legitimate insurance, compliance, and fraud prevention purposes.
• • I confirm that all bank account and payment details provided by me are accurate and belong either to me or to a duly authorized representative. I acknowledge that any error or misdirected payment resulting from incorrect or incomplete banking information provided by me shall not render LLIBI liable. LLIBI shall be deemed to have fulfilled its payment obligation once payment has been processed based on the banking details I submitted.
• • I confirm that I am the policyholder or a policyholder’s duly authorized representative, and I take responsibility for the accuracy and completeness of all information, documents, and bank details provided in support of this claim.