Notice To You:This application does not bind You, or Us, COCOGEN. However, it is agreed that this application will be the basis of the contract, should a policy be issued, and will be attached to, and made part of the policy. You agree that if the information supplied on this application changes between the date of this application and the inception date of this policy. You will immediately notify Us of such changes. Important Notice:The complete terms and conditions are contained in the policy schedule and policy wordings. COCOGEN is supervised by the Insurance Commission. The Insurance Commissioner, with offices in Manila, Cebu, and Davao, is the Government official in charge of the enforcement of all laws relating to Insurance and has supervision over insurance companies. He is ready at all times to render assistance in settling any controversy between an insurance company and a policyholder relating to insurance matters.

Declaration and Consent

I hereby apply for insurance as set out in the above application form and declare, to the best of my knowledge and belief, that the foregoing statements and particulars are true and complete. I hereby agree to notify COCOGEN of any material change in the information as stated above. I hereby certify that I voluntarily and expressly consent to the collection, processing, sharing, storing of my personal and/or sensitive information by COCOGEN for the purpose/s necessary in processing my insurance policy and in processing my insurance policy and in any related transactions and/or in other purposes as stated in the Data Privacy Statement of COCOGEN or in wwww.cocogen.com/data-privacy. I hereby certify that I carefully understand the terms above before giving my consent.

Privacy Policy

Data Privacy Statement UCPB General Insurance Company, Inc. ("COCOGEN") upholds an individual’s data privacy rights and assures that all your personal information, sensitive personal information and privileged information (collectively, “Personal Data”), collected and to be collected, are processed in compliance with the Data Privacy Act of 2012 (Republic Act No. 10173) and its Implementing Rules and Regulations (IRR). This Privacy Statement explains how we gather, protect, use, manage, and disclose the Personal Data that We obtain about the Company’s clients in the course of doing business, communications in social media or as a user of this our website. Data Gathering
We collect data about our existing and prospective clients when:
   1. They register, apply for, avail of or inquire about any of our products and services;
   2. They renew their existing policies and/or they request to update personal data for record purposes;
We also collect personal data when clients transact with our authorized agents, brokers, employees, and representatives requiring the production of personal information.
Upon application or availing of our products, our authorized agents, employees, brokers and representatives may use the data gathered to aid us in giving the best products and services.
Data Collected
Personal Data that will be collected includes, but are not limited to the following:
    (1) name, age, gender, birth date, home and/or business address, contact number, and email address;
    (2) educational background, financial background, and employment record and/or business information;
    (3) medical record and/ or information or fit to travel certificate for clients, if necessary in availing our products.
    (4) specimen signature, details and copy of government or company-issued ID, and
    (5) other information necessary to give the needed products, and incidental to the main transaction.
We collect personal data that are essential and incidental to provide excellent and valuable service that our existing and prospective clients truly deserve.
Data Protection
COCOGEN adheres to the Data Privacy Act of 2012 (R.A. 10173) its Implementing Rules and Regulations and other related issuances of the National Privacy Commission. In line with this, We take responsibility in collecting, processing, holding or use of personal data. We assure that all information that our clients and potential clients will provide shall be used solely for processing their transactions with our Company, they consented to, and for other legitimate purposes mandated by law. We shall implement reasonable and appropriate organizational, physical, and technical security measures for the protection of your personal data.
Rights as Data Subject:
We uphold and recognize the rights of our clients, as data subjects, provided under the Data Privacy Act of 2012, which are:
    1. Right to be informed;
    2. Right to object;
    3. Right to access;
    4. Right to correct;
    5. Right to rectification, ensure or blocking;
    6. Right to damages; and
    7. Right to data portability;
Use of information
We use the information provided by our client and potentials client to;
    1. Process their application;
    2. Answer their inquiries and other transactions that may be necessary or otherwise incidental to the availment of our products and services.
    3. Offer other products and services of the Company that we believe to be useful to the clients.
    4. Any other transactions which are normal in the course of business or as mandated by law.
Disclosure of Information
We may share the Personal Data provided by our clients to our affiliates, subsidiaries and service providers with the obligation to take care and keep all the information shared to them confidential.
We may also use or share your Personal Data to third-party service providers or government agencies, to collect more information about our clients, if necessary, for business transactions.
Data Retention
We will retain and/or preserve your Personal Data within the agreed period as stated in the policy and/or contract and if it is necessary for keeping track of your records and servicing your policy and contract.
If required or mandated by law, we will extend the retention of your Personal Data within the period provided by law.
Any correction or erasures of the Personal Data shall be recorded.
After the expiration of the period as earlier mentioned, we will destroy, delete or dispose of all the personal data and the materials, in our storage or server, in accordance with the requirement of Data Privacy Act.
Changes in our Privacy Policy:
COCOGEN may periodically update or amend Privacy Policy in order to adhere to new and existing laws affecting the Data Privacy Act, including any change or improvement we establish to secure our clients' personal data. If we amend our Privacy Policy, we will post the updated and revised here in our website: www.ucpbgen.com and will take effect immediately. Rest assured, however, that any updates or changes shall not alter how we handle previously collected personal data without obtaining our clients’ consent unless required by law.
For any concerns, requests, complaints or queries, you may Contact Us at
Data Protection Officer:Mr. Edgardo D. Rosario
Address: UCPB General Insurance Company, Inc. Office Address – 22F One Corporate Center Doña Julia Vargas corner Meralco Ave., Ortigas, Pasig City
Email: data_privacy@cocogen.com
Cocogen Client Services: (632) 8-830-600
Important: Section 251 of the Insurance Code, as amended, imposes a fine not exceeding twice the amount claimed and/or imprisonment of 2 years, or both, at the discretion of the court, to any person who presents or 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.
Definition Of Terms according to Republic Act 10173 or Data Privacy Act:
*“Personal information” refers to any information, whether recorded in a material form or not, from which the identity of an individual is apparent or can be reasonably and directly ascertained by the entity holding the information, or when put together with other information would directly and certainly identify an individual.
Sensitive personal information refers to personal information:
    1. About an individual’s race, ethnic origin, marital status, age, color, and religious, philosophical or political affiliations;
    2. About an individual’s health, education, genetic or sexual life of a person, or to any proceeding for any offense committed or alleged to have been committed by such individual, the disposal of such proceedings, or the sentence of any court in such proceedings;
    3. Issued by government agencies peculiar to an individual which includes, but is not limited to, social security numbers, previous or current health records, licenses or its denials, suspension or revocation, and tax returns; and
    4. Specifically established by an executive order or an act of Congress to be kept classified
*“Privileged information” refers to any and all forms of data, which, under the Rules of Court and other pertinent laws constitute privileged communication;