The Insurance SLA is essential for organizations requiring formalized insurance service arrangements in the Philippines. This document is typically used when establishing or renewing insurance service relationships that require specific performance metrics, service standards, and operational requirements. It combines elements of traditional service level agreements with insurance-specific provisions mandated by Philippine insurance regulations, including the Insurance Code of the Philippines and Insurance Commission circulars. The document addresses critical aspects such as claims processing timeframes, premium payment terms, reporting requirements, and compliance obligations, while establishing clear metrics for measuring service quality and provider performance. It's particularly relevant for complex insurance arrangements or when regulatory compliance needs to be clearly documented.
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1. Parties: Identification of the insurance provider and the insured party, including complete legal names, addresses, and registration details
2. Background: Context of the agreement, relationship between parties, and purpose of the insurance service level agreement
3. Definitions: Detailed definitions of technical terms, insurance-specific terminology, and key concepts used throughout the agreement
4. Scope of Services: Detailed description of insurance services covered, including types of coverage, limits, and exclusions
5. Service Level Standards: Specific measurable service standards, response times, and performance metrics for insurance services
6. Premium and Payment Terms: Details of premium calculations, payment schedules, and payment methods
7. Claims Processing: Procedures, timeframes, and requirements for filing and processing insurance claims
8. Reporting and Documentation: Requirements for regular reporting, documentation maintenance, and performance monitoring
9. Compliance Requirements: Obligations to comply with Philippine insurance laws, regulations, and Industry standards
10. Data Protection and Privacy: Requirements for handling personal and sensitive information in accordance with Philippine data protection laws
11. Term and Termination: Duration of the agreement, renewal terms, and conditions for termination
12. Dispute Resolution: Procedures for handling disputes, including mediation and arbitration processes
13. General Provisions: Standard contractual clauses including governing law, notices, and assignment
1. Business Continuity and Disaster Recovery: Include when the insurance services are critical or when required by regulatory requirements
2. Regulatory Reporting: Include for regulated insurance products requiring specific reporting to authorities
3. Multi-currency Provisions: Include when the insurance services involve multiple currencies
4. Anti-Money Laundering Compliance: Include for insurance products with significant cash value or investment components
5. Digital Services: Include when the insurance services include online platforms or digital delivery
6. Reinsurance Arrangements: Include when reinsurance affects service delivery or claims processing
7. Agency and Broker Provisions: Include when insurance services are provided through intermediaries
1. Schedule A - Service Level Metrics: Detailed breakdown of performance metrics, targets, and measurement methodologies
2. Schedule B - Premium Calculation: Detailed formula and factors for premium calculations
3. Schedule C - Claims Procedures: Step-by-step procedures for claims processing and required documentation
4. Schedule D - Reporting Templates: Standard formats for regular performance and compliance reporting
5. Schedule E - Contact Details: Key contacts and escalation matrix for both parties
6. Appendix 1 - Technical Requirements: Technical specifications for digital services or system integration if applicable
7. Appendix 2 - Compliance Checklist: Regulatory compliance requirements and verification checklist
8. Appendix 3 - Service Credits: Calculation method and application of service credits for performance failures
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