HB02681- AMENDMENT TO SECTION 2(3) OF RA 9048

AN ACT AMENDING SECTION 2 (3) OF RA 9048 OTHERWISE KNOWN AS AN ACT AUTHORIZING THE CITY OR MUNICIPAL CIVIL REGISTRAR OR THE CONSUL GENERAL TO CORRECT A CLERICAL OR TYPOGRAPHICAL ERROR IN AN ENTRY AND/OR CHANGE OF FIRST NAME OR NICKNAME IN THE CIVIL REGISTER WITHOUT NEED OF A JUDICIAL ORDER, AMENDING FOR THIS PURPOSE ARTICLES 376 AND 412 OF THE CIVIL CODE OF THE PHILIPPINES

Principal Author: ESPINA, ROGELIO J., M.D.

http://www.congress.gov.ph/download/basic_15/HB02681.pdf

 

I. Construction of Insurance Contracts

1) Calanoc vs. Court of Appeals, 98 Phil. 79

In construing ambiguous terms in an insurance policy covering accidental death, the Supreme Court held that such terms are to be construed strictly against the insurer, and liberally in favor of the insured so as to effect the dominant purpose of indemnity or payment to the insured. The killing of the victim was a pure accident on his part since it is possible that the malefactor had fired the shot merely to scare away the people around for his own protection and not necessarily to kill or hit the victim.

2) Biagtan vs. The Insular Life Assurance Company, Ltd. 44 SCRA 58

Unlike the ruling in the case of Calanoc vs. Court of Appeals, where the killing of the victim was held as accidental and thus covered by the insurance policy, the Supreme Court held that in the instant case, the insured was killed intentionally. The term “intentional” implies the exercise of the reasoning faculties, consciousness and volition.

3) Finman General Assurance Corp. vs. Court of Appeals, 213 SCRA 493

The terms “accident” and “accidental” are construed by the courts in their ordinary and common acceptation. The terms have been taken to mean that which happen by chance, without intention and design, and which is unexpected, unusual and unforeseen. Where the death or injury is not the natural or probable result of the insured’s voluntary act, the resulting death is within the protection of the policies insuring against death or injury from accident.

4) Zenith Insurance Corporation vs. Court of Appeals, 185 SCRA 398

Under the Insurance Code, in case of unreasonable delay in the payment of the proceeds of an insurance policy, the damages that may be awarded are: a) attorney’s fees; b) other expenses incurred by the insured person by reason of such unreasonable denial or withholding of payment; c) interest at twice the ceiling prescribed by the Monetary Board of the amount of the claim due the injured; and d) the amount of the claim.

5) Sun Insurance Office, Ltd. vs. Court of Appeals, 211 SCRA 554

An accident is an event which happens without any human agency or, if happening through human agency, an event which, under the circumstances is unusual to and not expected by the person to whom it happens. There is no accident when a deliberate act is performed unless some additional, unexpected, independent and unforeseen happening occurs which produces or brings about their injury or death. There is nothing in the policy that relieves the insurer of the responsibility to pay the indemnity agreed upon if the insured is shown to have contributed to his own accident.

The Social Security Act of 1997 and the Social Security System: Taking Care of the Private Sector (Part 6)

VI. Sources:

Azucena, Cesario Alvero Jr. The Labor Code with Comments and Cases (6th ed.) 2007.

R.A. 8282, Social Security Act Of 1997

http://www.asean-ssa.org/CP_Philippines_SSS

http://www.sss.gov.ph/

http://www.supremecourt.gov.ph

The Social Security Act of 1997 and the Social Security System: Taking Care of the Private Sector (Part 5)

V. SSS Today

At present, the SSS continues to provide services and benefits to the employees and their families. It has come up with innovative ways to improve its services such as the SMEC Benefit Payment through the Bank Program, which involves the remittance by SSS of sickness, maternity and employee’s compensation (SMEC) reimbursements to the employer’s designated bank, which in turn shall be credited to the employer’s savings or current account.

The Program aims to attain a higher degree of efficiency and safety in the delivery of SMEC benefit payments, as well as provide a simplified monitoring and audit system for SMEC payments. There is also the “Text-SSS”, which is a short messaging service (SMS)-based information service system that allows members to inquire about their number of contributions, status of loan applications, salary loan payment period and loan balances using text messaging.

In addition, the Flexi-fund Program serves as a supplement to SSS benefits and provides OFWs the opportunity to set aside a part of their earnings abroad and maximize the returns on their Flexi-fund contributions. The SSS also offers the Auto-Debit Arrangement (ADA) Program, which is a one-time enrollment scheme wherein the social security contributions and loan amortizations will be automatically deducted from a member’s bank account every 10th of the month.

Furthermore in its investments, the SSS “helps the country attain a more stable economy even as it works to provide its members a more secure future.” Hopefully, the SSS will stay true to its policy of providing protection to the members and their families against the hazards of disability, sickness, maternity, old age, death and other contingencies resulting in loss of income or financial burden.

The Social Security Act of 1997 and the Social Security System: Taking Care of the Private Sector (Part 4-E)

IV. SSS Benefits

E. Maternity

The maternity benefit is a daily cash allowance granted to a female member who was unable to work due to childbirth or miscarriage. Every pregnant woman in the private sector, whether married or unmarried, is entitled to the maternity benefits. (No. IX, DOLE Handbook on Workers’ Statutory Monetary Benefits)

She is qualified to avail of this maternity benefit if: (1) she has at least three monthly contributions within the 12-month period immediately preceding the semester of contingency; and (2) she has given the required notification of her pregnancy, including the probable date of childbirth, to her employer or the SSS in the case of self-employed and voluntary members.

The maternity benefit is a daily cash allowance equal to 100% of the member’s ADSC multiplied by the number of compensable days, which are 78 days for caesarian delivery and 60 days for normal delivery or miscarriage. A female member is eligible to receive benefits only for the first four deliveries or miscarriages beginning on May 24, 1997. In addition, the payment of daily maternity benefits shall preclude the recovery of sickness benefits for the same period for which daily maternity benefits have been received.

The Social Security Act of 1997 and the Social Security System: Taking Care of the Private Sector (Part 4-D)

IV. SSS Benefits

D. Death

The death benefit is a cash benefit either in monthly pension or lump sum paid to the beneficiaries of a deceased member. The primary beneficiaries (i.e., dependent spouse, until he or she remarries, and dependent legitimate, legitimated, legally adopted and illegitimate children) shall be entitled to a monthly pension upon the death of an SSS member who has at least 36 monthly contributions prior to the semester of death.

The BMP is the same as in old age, including the 13th month and dependents’ pensions, while the guaranteed minimum is the same as in disability. If the member has paid less than 36 monthly contributions, the primary beneficiaries shall be entitled to monthly pension times the number of monthly contributions paid prior to the semester of death, or to twelve (12) times the monthly pension. In the absence of primary beneficiaries, secondary beneficiaries (i.e., dependent parents or any other person designated by the member as beneficiary) will get a lump-sum amount equal to 36 times the BMP before the semester of death, or a monthly pension times the number of monthly contributions paid or twelve (12) times the monthly pension, whichever is higher, if the member has paid less than 36 monthly contributions prior to the semester of death.

The beneficiaries are also entitled to a 13th month pension payable every December, and the funeral benefit in the amount of up to PhP20,000, which is paid to whoever, shouldered the funeral expenses of the deceased member. Survivorship pensioners prior to the effectivity of RA 7875 on March 4, 1995 are also entitled to hospitalization benefits under PhilHealth. However, those who wish to avail of PhilHealth benefits may enroll in the Individually-Paying Program (for voluntary/self-employed) or the Indigent Program (IP) of PhilHealth. Lastly, primary or secondary beneficiaries of a deceased member, who has been reported for coverage but with no contribution, will qualify for the funeral benefit only.

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Illustrative Case:
Azucena O. Salalima vs. ECC and SSS, G.R. No. 146360, May 20, 2004.

The Social Security Act of 1997 and the Social Security System: Taking Care of the Private Sector (Part 4-C)

IV. SSS Benefits

C. Disability

Disability is defined as any restriction or lack of ability (resulting from impairment) to perform an activity in the manner or within the range considered normal for a human being. Disability is intimately related to one’s earning capacity. It should be understood less on its medical significance but more on the loss of earning capacity.
(Austria vs. Court of Appeals, G.R. No. 146636, August 12, 2002)

The lifetime monthly pension is provided only in the case of permanent total disability⁴ for those who have at least 36 monthly contributions prior to the semester of disability. For SSS members with permanent partial disability⁵, pensions are limited to a certain number of months depending on the degree of disability designated by law. In both cases, a member will receive cash benefits, provided that he has paid at least one month of contribution.

A disabled member who does not have the required 36 monthly contributions shall be given benefits in lump sum. For permanent total disability, the lump-sum benefit is equal to the BMP times the number of monthly contributions, or BMP times 12, whichever is higher. For permanent partial disability, it is equal to the BMP times the percentage of disability in relation to the whole body, or BMP times 12, whichever is higher. The computation of the basic monthly pension is the same as in retirement, including 13th month and dependents’ pensions. However, this is subject to the following guaranteed minimum: (1) PhP1,000 for those with less than 10 CYS; (2) PhP1,200 for those with at least 10 CYS but less than 20 CYS; and (3) PhP2,400 for those with more than 20 CYS. A monthly supplemental allowance of PhP500 is also given as financial assistance for other expenses of the member in relation to his disability.

Like in retirement, the disability benefits are also subject to suspension in case a disabled member resumes gainful employment or self-employment, recovers from disability, or fails to submit oneself to annual physical exam. The disability pension of a member who is on partial disability pension and retires or dies shall also cease upon his retirement or death. In case of death of a total disability pensioner, his primary beneficiaries will be entitled to 100% of the BMP plus dependents’ pension. If he dies within the 60-month period from the start of pension and has no primary beneficiaries, his secondary beneficiaries will receive a lump-sum amount equal to the difference between 60 times the monthly pension and the total monthly pensions already paid, excluding dependents’ pension.

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Illustrative Case:

Pablo A. Austria vs. Court of Appeals and ECC (SSS), Central Azucarera de Tarlac, G.R. No. 146636, August 12, 2002.

The Social Security Act of 1997 and the Social Security System: Taking Care of the Private Sector (Part 4-B)

IV.SSS Benefits

B. Sickness

The sickness benefit is a daily cash allowance paid for the number of days a member is unable to work due to sickness or injury. The amount of a member’s sickness benefit per day is equivalent to 90% of the member’s average daily salary credit (ADSC)³ , payable for a maximum of 120 days in one calendar year but not exceeding 240 days for the same illness or injury. Any unused portion of the 120 days sickness benefit cannot be added to the total number of allowed compensable days for the next year. In case the sickness or injury after 240 days, the claim may fall under the disability benefit.

The sickness benefit is available to a member who has: (1) contributed for at least three months within the 12-month period immediately preceding the semester of sickness; (2) has been confined either in the hospital or at home for at least four days; (3) has used up all company sick leaves with pay for the current year; and (4) has notified his employer or the SSS in the case of self-employed and voluntary members. Otherwise, confinement shall be deemed to have started not earlier than the fifth day immediately preceding the date of notification, or the employer shall be reimbursed only for each day of confinement starting from the 10th calendar day immediately preceding the date of notification to the SSS.

An employer who has failed to notify the SSS although the employee has duly notified such employer shall have no right to recover the daily sickness allowance advanced to the employee. For hospital confinement, the claim must be filed within one year from the last day of confinement. Failure to submit requirements within the prescriptive period will result to denial of the claim.
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Footnote:
³Equal to the sum of the six highest monthly salary credits (MSCs) in the 12-month period immediately prior to semester of contingency divided by 180. (Sec.8(n), ibid.)

The Social Security Act of 1997 and the Social Security System: Taking Care of the Private Sector (Part 4-A)

IV. SSS Benefits

A. Retirement Benefit

The retirement benefit is a cash benefit either in monthly pension or lump sum that is paid to a member who can no longer work due to old age. For voluntary retirement, a member must be at least 60 years old, is separated from employment or has ceased to be self-employed, and has paid at least 120 monthly contributions prior to the semester of retirement. For compulsory retirement, a member must have reached the age of 65, and contributed for 120 months before the semester of retirement. However, in the case of an SSS member who is an underground mineworker for at least five years, either continuous or accumulated, and whose actual date of retirement is not earlier than March 13, 1998, voluntary retirement is at age 55 while compulsory retirement is at age 60.

The SSS also provides pensioners the option to receive the first 18 months’ pension (excluding dependents’ and 13th month pensions) in lump sum, discounted at a preferential rate of interest as determined by the SSS. This option is exercised upon filing of the retirement claim. Payment of pension will resume on the 19th month.

Although a monthly pension is granted to an SSS retiree for as long as he lives, it is subject to suspension if said retiree is below the age of 65 years and he becomes gainfully re-employed or resumes self-employment. In such case, he is again placed under mandatory coverage until his compulsory retirement. For SSS members who reach retirement age but are ineligible for pension, a lump-sum amount equal to total contributions plus interest is given to them.

The lifetime basic monthly pension (BMP) of a retiree is the highest of the sum of: (1) PhP300 plus 20% of the average monthly salary credit (AMSC)¹ and 2% of the AMSC for each accredited year of service (CYS)² in excess of 10 years; or (2) 40% of the AMSC; or (3) PhP1,200 if the member has at least 10 but less than 20 CYS, or PhP2,400 if the member has at least 20 CYS. A member also receives a 13th month pension, payable every December.

Each minor child conceived on or before the date of retirement, but not exceeding five, beginning with the youngest and without substitution, is also a monthly dependents’ pension equal to 10% of the BMP (minimum of PhP250). A child that reaches the age of 21, marries, or obtains employment and earns at least PhP300 a month, or dies will cease to receive the dependent’s pension. However, children who are over 21 years old, but are incapacitated and incapable of self-support due to mental defect that is congenital or acquired during minority shall still receive pension.

Upon the death of an old age pensioner, his primary beneficiaries will receive 100% of the BMP, including dependents’ pension. Absent any primary beneficiary, the pensioner’s secondary beneficiaries will receive a lump-sum amount equal to the total monthly pensions corresponding to the balance of the five-year guaranteed benefit period, excluding the dependents’ pension.

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Illustrative Case:

Rufina Patis Factory and Jesus Lucas, Sr. vs. Juan Alusitain, G.R. No. 146202, July 14, 2004.

The Social Security Act of 1997 and the Social Security System: Taking Care of the Private Sector (Part 3)

III. Coverage

The compulsory coverage of the employer shall take effect on the first day of his operation and that of the employee on the day of his employment. However, the compulsory coverage of the self-employed person shall take effect upon his registration with the SSS.

Coverage under the SSS is compulsory for all employers in the private sector and their employees who are not over 60 years of age, whether with permanent or provisional employment status, including domestic helpers earning at least PhP1,000 a month. All self-employed persons are also subject to mandatory coverage under the Regular Self Employed Program for artists, entertainers, proprietors and professionals, and the Expanded Self Employed Program for those with monthly earnings of at least PhP1,000 regardless of trade, business or occupation. Farmers and fishermen earning at least PhP1,500 also fall under the self-employed category.

Coverage under the SSS may also be on a voluntary basis as for the following: Filipino workers recruited by foreign-based employers for work abroad, SSS members separated from employment but would like to continue paying contributions, and non-working spouses of SSS members (i.e., spouses who devote full time to managing the household and family affairs).

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Illustrative Case:

Chua vs. Court of Appeals, G.R. No. 125837, October 6, 2004.