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Stela Family

We extend the same protection of women to the people that matters to them the most. - Her family members and household employees. For full product features, click here.

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PRIMARY ASSURED DETAILS

Complete Name

Gender

Male
Female

Thank you for your interest. Primary insured for Stela Family will need to be Female. However, you may still get yourself protected as primary insured's family member below.

Date of Birth

Beneficiary Name

Relationship to Assured

Present Address

Permanent Address

Same as Present Address?

Contact Details

Status

Employment Information

FAMILY MEMBERS For Personal Accident Insurance

EMPLOYEES MEMBERS For Personal Accident Insurance

Hospitalization Insurance - Maternity Benefit
Include Note: (should also be covered for PA Insurance, can be the Women Entrepeneur or one of the members or employees)

The person can only avail Hospitalization Insurance – maternity benefit if the person is the primary assured or covered for personal accident under family members or employees members.

Hospitalization Insurance - Unattended Dependent Minors Benefit
Include Note: (should also be covered for PA Insurance, can be the Women Entrepeneur or one of the members or employees)

The person can only avail Hospitalization Insurance – unattended dependent minors benefit if the person is the primary assured or covered for personal accident under family members or employees members.

Murder & Unprovoked Assault:
Include Note: (should also be covered for PA Insurance, can be the Women Entrepeneur or one of the members or employees)

The person can only avail Murder & Unprovoked Assault if the person is the primary assured or covered for personal accident under family members or employees members.

Declaration

DATA PRIVACY I acknowledge that Malayan Insurance Company, Inc. (Malayan) may collect, use, process and share my personal information to its employees, duly authorized representatives, other insurers, reinsurers, adjusters, investigators, and other third party providers for purposes such as underwriting, administration, claims adjudication and management, investment, data analytics, statistical analysis, risk analysis/ assessment/management, financial and tax monitoring/review/reporting, protection against fraud, errors, or misrepresentations, profiling, research, due diligence, company evaluation, studies/customer satisfaction surveys, and compliance with legal, regulatory or contractual requirements. Further, I agree that Malayan may notify and offer me any of its products and services that may be useful to me. In furtherance of these purposes, my personal information, unless prohibited, may be processed outside the Philippines and be subject to different data protection standards.

AUTHORITY TO DISCLOSE I hereby authorize Malayan to grant the members of the Yuchengco Group of Companies (YGC), their and Malayan’s affiliates, subsidiaries, contractors, partners, agents and representatives, intermediaries, industry associations, and other third parties access to my personal information, including this form, for purposes of marketing, sales or promotional information campaigns, and provision of any products, services, or offers through mail/email/SMS/telephone, or any type of electronic facility.

AUTHORITY TO VERIFY INFORMATION I also authorize Malayan to verify and investigate the information given by me, including submitted documents from whatever source it may consider appropriate.

RIGHTS OF THE DATA SUBJECT I acknowledge that I have the right to access the given information and I undertake to correct, rectify or supplement the same should any information be found to be inaccurate or incomplete. I shall notify Malayan in writing of any changes in the information given above.

UNDERTAKING I hereby warrant that all personal information given by me are true, correct, updated to the best of my knowledge, and freely and voluntarily given to Malayan. I agree and consent that the above information are being collected, used, processed and recorded for purposes of securing insurance protection or any other business transaction(s) with Malayan and for other purpose as indicated herein. If purchasing, transacting and/or acting in behalf of other person(s), I hereby warrant that I have been duly authorized to perform such acts and permitted to give their information to Malayan. I hereby bind myself to advise all other persons in whose behalf I have acted, transacted with and/or purchased any product or services from Malayan of all the terms and conditions herein. I will hold Malayan, directors, officers, employees, agents, successors and assigns free and harmless from any liability that may arise as a result of the authorization given above.

By signing this form, I hereby certify that I have read and understood the foregoing and this consent remains valid and binding unless I submit a written notice to Malayan revoking or altering the same.

Agreement

I acknowledge and agree to the data sharing declaration above.

Anti-Fraud: Section 251 of the lnsurance Code, as amended, imposes a fine not exceeding twice the amount claimed and/or imprisonment of two (2) years, or both, at the discretion of the court, to any person who presents or causes to be presented any fraudulent claim for the payment of a loss under a contract of insurance, and who fraudulently prepares, makes or subscribes any writing with intent to present or use the same, or to allow it to be presented in support of any claim.