Affidavit of Loss for PhilHealth ID in the Philippines: Template, Requirements, and Steps

Introduction

In the Philippines, the Philippine Health Insurance Corporation (PhilHealth) provides universal health coverage to Filipinos through its national health insurance program. Members are issued a PhilHealth Identification Card (ID), which serves as proof of membership and is essential for availing benefits such as hospital discounts, outpatient services, and other healthcare privileges. Losing this ID can be inconvenient, but it is replaceable. A key document required for replacement is an Affidavit of Loss, a sworn legal statement attesting to the circumstances of the loss. This article provides a comprehensive guide on the Affidavit of Loss for a PhilHealth ID, tailored to the Philippine legal context. It covers the purpose, requirements, step-by-step process, a sample template, potential costs, common pitfalls, and related legal considerations. This information is based on standard Philippine legal practices and PhilHealth procedures as governed by Republic Act No. 7875 (National Health Insurance Act of 1995), as amended by Republic Act No. 11223 (Universal Health Care Act of 2019), and relevant administrative issuances.

What is an Affidavit of Loss?

An Affidavit of Loss is a formal, sworn declaration made under oath before a notary public or an authorized officer, stating that a specific item—such as a document, card, or property—has been lost, misplaced, or destroyed. It details the facts surrounding the loss, including when, where, and how it occurred, and affirms that the affiant (the person making the statement) has made diligent efforts to locate the item without success. In Philippine law, affidavits are governed by the Rules of Court (particularly Rule 132 on Evidence) and the Notarial Law (Act No. 2711, as amended). They serve as prima facie evidence in administrative proceedings and are often required by government agencies like PhilHealth to prevent fraud, such as duplicate issuances or identity theft.

For a PhilHealth ID, the affidavit is crucial because the ID contains sensitive personal information, including the member's PhilHealth Number (PIN), which is unique and linked to their health records. Without it, PhilHealth cannot issue a replacement without verification to ensure the request is legitimate.

Why is an Affidavit of Loss Required for PhilHealth ID Replacement?

PhilHealth mandates an Affidavit of Loss to:

Establish the fact of loss and absolve the member from liability for any misuse of the lost ID.
Comply with data privacy laws under Republic Act No. 10173 (Data Privacy Act of 2012), ensuring that replacement IDs are issued only to verified individuals.
Align with anti-fraud measures, as lost IDs could be used for unauthorized claims.
Facilitate record-keeping, as PhilHealth tracks issuances and replacements in its database.

Failure to submit a proper affidavit may result in delays or denial of the replacement request. Note that if the ID was stolen rather than lost, a police report (Blotter Entry) may be required in addition to or instead of the affidavit, depending on the circumstances.

Requirements for Filing an Affidavit of Loss and Replacing PhilHealth ID

To prepare and submit an Affidavit of Loss for a PhilHealth ID replacement, the following requirements apply:

Personal Information and Identification:
- Valid government-issued ID (e.g., Passport, Driver's License, Voter's ID, SSS/GSIS ID, or Postal ID) to prove the affiant's identity. At least two (2) IDs are recommended, one with a photo.
- PhilHealth Member Data Record (MDR) or any document showing the member's PIN, if available.
Details for the Affidavit:
- Full name, age, civil status, address, and contact details of the affiant.
- Description of the lost item: PhilHealth ID, including the PIN (if known), date of issuance (approximate if unknown), and physical description.
- Circumstances of loss: Date, time, place, and how it was lost (e.g., "while commuting in a jeepney in Quezon City").
- Efforts made to recover it (e.g., "searched home, reported to local authorities").
Notarization:
- The affidavit must be notarized by a licensed notary public. Notarial fees typically range from PHP 100 to PHP 300, depending on location.
- Community Tax Certificate (Cedula) of the affiant, required for notarization.
Additional Documents for PhilHealth Submission:
- Duly accomplished PhilHealth Member Registration Form (PMRF) or Request for Replacement Form, if applicable.
- Proof of payment for replacement fee (PHP 90 for the ID card, subject to updates).
- If applicable: Police report for theft, or affidavit from witnesses.

Requirements may vary slightly by PhilHealth Local Health Insurance Office (LHIO) or accredited service center, especially in rural areas. For overseas Filipino workers (OFWs) or those abroad, the affidavit can be executed at a Philippine Consulate and apostilled under the Apostille Convention.

Step-by-Step Process

Replacing a lost PhilHealth ID involves two main phases: preparing the affidavit and submitting it to PhilHealth. Here's a detailed guide:

Phase 1: Preparing the Affidavit of Loss

Draft the Affidavit: Use a standard template (see sample below). Write it in clear, concise language, preferably in English or Filipino. Ensure it is typed or legibly handwritten on legal-sized paper.
Gather Supporting Documents: Collect your valid IDs and Cedula.
Visit a Notary Public: Go to a notary's office (often found in law firms, malls, or government buildings). Present your documents, swear to the truth of the statement, and sign in the notary's presence.
Pay Fees: Settle notarial and documentary stamp tax (DST) fees (PHP 20 DST per affidavit).
Obtain Copies: Get at least two (2) notarized copies—one for PhilHealth and one for personal records.

Phase 2: Submitting to PhilHealth for Replacement

Locate a PhilHealth Office: Visit the nearest PhilHealth LHIO, Regional Office, or accredited partner (e.g., selected malls or hospitals). Use the PhilHealth website or hotline (02-8441-7442) to find locations.
Fill Out Forms: Complete the PMRF or replacement request form, attaching the Affidavit of Loss.
Submit Documents: Present all requirements to the PhilHealth officer. They will verify your identity and membership status via the PhilHealth database.
Pay the Fee: Pay PHP 90 (or current rate) for the replacement ID. Payment is usually in cash or via authorized channels.
Processing Time: Wait for approval. Processing typically takes 1-2 weeks, after which the new ID can be claimed or mailed.
Claim the New ID: Return to the office with a claim stub. The new ID will have the same PIN but a new issuance date.

For online options: PhilHealth encourages digital submissions via their eServices portal, but affidavits must still be scanned and uploaded, with originals presented upon claiming.

Sample Template for Affidavit of Loss

Below is a standard template for an Affidavit of Loss for a PhilHealth ID. Customize it with your details. This is not legal advice; consult a lawyer for personalization.

REPUBLIC OF THE PHILIPPINES)
CITY/MUNICIPALITY OF [City/Municipality]) S.S.

AFFIDAVIT OF LOSS

I, [Full Name], of legal age, [Civil Status], Filipino, and a resident of [Complete Address], after having been duly sworn in accordance with law, do hereby depose and state that:

I am a member of the Philippine Health Insurance Corporation (PhilHealth) with PhilHealth Identification Number (PIN) [Your PIN, if known].
I was issued a PhilHealth Identification Card (ID) on or about [Approximate Date of Issuance], which I have been using as proof of my membership.
Sometime on or about [Date of Loss], at [Place of Loss], said PhilHealth ID was lost under the following circumstances: [Detailed Description, e.g., "It fell out of my wallet while I was riding a public bus in Manila, and despite immediate search, it could not be found."].
I have exerted diligent efforts to locate the said ID, including [List Efforts, e.g., "searching my home, vehicle, and workplace, and inquiring at the lost and found section of the bus terminal"], but to no avail.
The said PhilHealth ID has not been confiscated by any government authority nor pledged or given as security to any person or entity.
I am executing this Affidavit of Loss to attest to the truth of the foregoing facts and for the purpose of securing a replacement PhilHealth ID from PhilHealth, and for whatever legal purpose this may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this [Date] day of [Month], [Year] at [City/Municipality], Philippines.

[Signature over Printed Name]
Affiant

SUBSCRIBED AND SWORN to before me this [Date] day of [Month], [Year] at [City/Municipality], Philippines, affiant exhibiting to me his/her [Valid ID Details, e.g., Passport No. XXXXX issued on YYYY-MM-DD at ZZZ].

Doc. No. _____;
Page No. _____;
Book No. _____;
Series of [Year].

[Notary Public's Name and Signature]
Notary Public
Until [Expiration Date]
PTR No. [PTR No.], [Date/Place]
IBP No. [IBP No.], [Date/Place]
Roll No. [Roll No.]

Potential Costs Involved

Notarial Fee: PHP 100-300.
Documentary Stamp Tax: PHP 20.
Replacement Fee: PHP 90.
Miscellaneous: Transportation, photocopying (PHP 50-100 total).

Indigent members may request fee waivers under PhilHealth's policies for vulnerable sectors.

Common Pitfalls and Tips

Incomplete Details: Ensure the affidavit includes specific facts; vague statements may be rejected.
Falsification: Perjury under Article 183 of the Revised Penal Code carries penalties of arresto mayor (1-6 months imprisonment) if false information is provided.
Multiple Losses: Frequent replacements may trigger audits; keep records secure.
For Minors or Dependents: A parent/guardian must execute the affidavit on behalf of minors.
Data Privacy: PhilHealth handles personal data confidentially; report any breaches to the National Privacy Commission.
Alternatives: While waiting for replacement, use your PIN and MDR to avail benefits at accredited facilities.
Updates: PhilHealth procedures may evolve; check their official channels for the latest.

Legal Considerations and Related Laws

Notarial Requirements: Must comply with the 2004 Rules on Notarial Practice (A.M. No. 02-8-13-SC).
Evidence Value: The affidavit is admissible in court or administrative bodies as a public document.
Replacement Limits: PhilHealth may impose limits on free replacements; subsequent ones could incur higher fees.
Inter-Agency Linkages: Linked to other systems like the Philippine Identification System (PhilSys) under RA 11055, which may eventually integrate health IDs.

In summary, obtaining a replacement PhilHealth ID via an Affidavit of Loss is a straightforward process rooted in Philippine administrative law. By following these steps and using the template, members can swiftly restore access to essential health benefits. For complex cases, consulting a lawyer or PhilHealth directly is advisable.