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Republic of the Philippines
Department of Finance
INSURANCE COMMISSION {
1071 United Nations Avenue
Manila

INSURANCE MEMORANDUM
clRcuLAR NO. 2021 - c1

REVISED RULES OF PROCEDURE GOVERNING ADMINISTRATIVE CASES

BEFORE THE INSURANCE COMMISSION

Pursuant to Sections 437 and 438 of the lnsurance Code of the Philippines, as
amended by Republic Act No. '10607; Sections 6 and 53 of Republic Act No.
9829, otherwise known as the "Pre-Need Code of the Philippines"; and Sections
4 and 1'1 of Executive Order No. 192, s. 2015, the lnsurance Commission hereby
promulgates the following rules of procedure governing actions and proceedings
before it against insurance companies, pre-need companies, health maintenance
organizations, intermediaries, and other regulated entities duly issued with a
Certificate of Authority to act as such:

RULE I
GENERAL PROVISIONS

SECTION 1. Title - These Rules shall be known as the "Revised Rules of

Procedure Governing Administrative Cases before the lnsurance Commission".

SECTION 2. Applicability - These Rules shall apply to all administrative cases

brought before the lnsurance Commission in the exercise of its administrative
and/or regulatory powers and functions under the lnsurance Code, as amended,
the Pre-Need Code, EO No. 192, s. 201 5, and any other law vesting the
lnsurance Commission with administrative and/or regulatory authority over the
following entities:

(a) Those with license issued by this Commission;

(b) Those with previous license issued by this Commission with respect
to regulated acts committed during the effectivity of such license;

(c) Those against which a Cease and Desist Order (CDO) has been
issued by this Commission; and,

(d) Those under conservatorship, receivership, and/or liquidation, in

accordance with the relevant provisions of the lnsurance Code, as
amended, the Pre-Need Code, and EO No. '192, s. 2015.
These Rules shall be without prejudice to the Commission's authority to conduct
motu proprio investigations in relation to violation of pertinent laws, circulars, and
such other rules or regulations by regulated entities.

Head Office, PO. Box 3589 Manila lTrunk Line: +(632) 8523-8461 to 70 J Fax Noi +(632) 8522-1434 lwww.insurance.gov.ph
SECTION 3. Construction - These Rules shall be liberally construed to promote
public interest and to assist the parties in obtaining just, prompt, expeditious, and
inexpensive resolution, settlement, and/or disposition of every action brought
before the lnsurance Commission in the exercise of its administrative and/or
regulatory powers.

SECTION 4. Nature of Proceedings - Administrative proceedings before the

lnsurance Commission shall be non-litigious in nature, and the technical rules of
evidence and procedure obtaining in the courts of law shall not strictly apply
thereto.

SECTION 5. Suppletory Application of the Rules of Court - ln the absence of

any applicable provision in these Rules, the pertinent provisions of the Rules of
Court and prevailing jurisprudence may, in the interest of justice and whenever
practicable and convenient, be applied by analogy or in a suppletory character
and effect.

SECTION 6. Parties - ln all administrative cases filed with the lnsurance

Commrssion, the party initiating the action shall be called the "Complainant" and
the party against whom the action is made shall be called the "Respondent".

RULE II
VENUE AND AUTHORITY

SECTION 1. Venue - All actions brought under these Rules shall be commenced
at the principal offlce of the lnsurance Commission in Manila or in any of its
regional district offices or branches.

All actions brought under these Rules shall be heard by the Regulation,
Enforcement and Prosecution Division (REPD), or such other regional district
offices or branches of the lnsurance Commission where such actions may be
filed.

SECTION 2. Hearing Officer - The proceedings shall be heard by the head of

the REPD or by any hearing officer within the same division with a lawyer
designation or, in their absence, the available nexlin-rank personnel: Provided,
That such next-in-rank personnel shall only be allowed to act as a hearing officer
for purposes of conducting the final mediation conference or resetting the
scheduled proceedings. The lnsurance Commissioner orthe Deputy
Commissioner for Legal Services may likewise authorize other officer/s outside
REPD to act as hearing officer in proceedings filed pursuant to these Rules.

For actions commenced in the Commission's regional district offices or branches,

the heads of such offices or branches shall hear the proceedings or, in case of
their absence, by the nextin-rank personnel: Provided, That if such next-in-rank
personnel does not have a lawyer designation, they shall only be allowed to act

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as a hearing officer for purposes of conducting the flnal mediation conference or
resetting the scheduled proceedings.

The Hearing Officer shall conduct the proceedings and shall be empowered to
issue subpoenas, take evidence, and compel the attendance of parties and
witnesses and the production of any books, papers, correspondences,
memoranda, or other records relevant or material to the present case.

RULE III
PLEADINGS

SECTION 1. Pleadings - The only pleadings allowed to be flled are the

complaints and the answers thereto, which must be verified. All affidavits
attached thereto shall be in the form of a .judicial affidavit.

SECTION 2. Prohibited Pleadings/Motions - The following pleadings are

prohibited:

(a) Motion for Bill of Particulars;

(b) Second lvlotion for Reconsideration;

(c) Reply;

(d) Petition for relief from judgment;

(e) Motion for extension of time to file pleadings or any other written
submissions, except for meritorious reasons:

(0 Dilatory motions for postponement;

(S) Third-partycomplaint;

(h) lntervention;

(i) Motion to hear affirmative defenses;

0) Modes of discovery; and

(k) Any pleading or motion similar in effect to any of the foregoing

RULE IV
COMMENCEMENT OF ACTIONS

SECTION 1. Complaint - An action shall commence upon the filing of a

complaint and payment of the filing fee. The complaint shall be limited to matters

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pertaining to the violation of pertinent laws, rules and regulations on the conduct
of business and operations of insurance, pre-need, and HMO companies,
excluding any discussion on claims. The complaint shall include the following:

(a) Full name of the parties to the case as well as facts showing the
capacity of the parties to sue or be sued;

(b) Concise statement of ultimate facts constituting the complainant's

cause/s of action:

(c) The relief/s sought, which may include a general prayer for such
other relief/s as may be deemed just or equitable;

(d) Certification of Non-Forum Shopping to the following effect:

(i) That the complainant has not commenced any action or filed
any claim involving the same issues in any court, tribunal or
quasi-judicial agency and, to the best of their knowledge, no
such other action or claim is pending therein;

(ii) That if there is such other pending action or claim, a

complete statement of the present status thereof; and

(iii) That if the complainant should thereafter learn that the same
or similar action or claim has been filed or is pending, the
complainant shall undertake to notify the Commission within
five (5) calendar days therefrom.

The authorization of the affiant to act on behalf of a party, whether

in the form of a secretary's certificate or a special power of attorney,
should be attached to the pleading.

lf the acts of a party or their counsel clearly constitute willful and

deliberate forum shopping, the same shall be a ground for summary
dismissal with prejudice and shall constitute direct contempt; and

(e) Verification.

SECTION 2. Evaluation of the Complaint - Upon filing of the complaint, the

Division Manager or any hearing officer shall evaluate the complaint. lf found
sufficient in form and substance, an order of payment for the filing fee shall be
issued.

SECTION 3. Filing Fee - Upon the filing of a complaint, the complainant shall
pay a filing fee in the amount of Three Thousand Pesos (Php. 3,000.00),

SECTION 4. Docketing of Cases - After payment of the filing fee, the complaint
shall be docketed and assigned a case number.

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SECTION 5. Summons - Within three (3) working days from receipt of a
complaint, the Commission shall issue a summons requiring the respondenUs to
file a verified answer within fifteen (15) days from receipt thereof. A copy of the
complaint and its annexes, if any, shall be attached to the said summons.

SECTION 6. Service of Summons, Orders, and Other Processes - Summons,

orders, and other processes shall be served personally upon the parties by a duly
authorized public officer, by registered mail, by private courier, or electronically,
as may be warranted, prior to the proceeding.

SECTION 7. Answer - Within fifteen (15) days from service of summons, the
respondent shall file their answer to the complaint and serve a copy thereof on
the complainant. Affirmative and negative defenses not pleaded therein shall be
deemed waived, except in the following instances:

(a) When the Commission has no jurisdiction over the subject matter;

(b) When there is another action pending between the same parties for
the same cause; or

(c) When the action is barred by the statute of limitations.

SECTION 8. Effect of Failure to File Answer - Should the respondent fail to file
an answer to the complaint within the period stated above, the Commission, rnolu
proprio or upon motion, shall render.iudgment as may be warranted by the
allegations in the complaint, as well as the afftdavits and other evidence on
record, unless the Commission, in its discretion, requires the complainant to
submit additional evidence.

RULE V
DISMISSAL OF THE COMPLAINT

SECTION 1. Grounds for Dismissal - The Commission may motu proprio

dismiss the complaint if it appears from the complaint and/or the documents
attached thereto that it has no jurisdiction over the subject matter, or there is
another action pending between the same parties for the same cause, or that the
action is barred by a prior judgment or by the statute of limitations.

RULE VI
MOTION TO DISMISS

SECTION 1. Grounds - Within the time for but before filing an answer to the
complaint, a motion to dismiss may be made on any of the following grounds:

(a) That the Commission has no jurisdiction over the person of the
respondent;
 (b) That the Commission has no jurisdiction over the subject matter of
the complaint;

(c) That the complainant has no legal capacity to sue;

(d) That there is splitting of cause of action by the complainant;

(e) That there is another action pending between the same parties for
the same cause;

(0 That the cause of action is barred by a prior judgment or by the

statute of limitations;

(g) That the complaint asserting the claim states no cause of action;
and

(h) That a condition precedent for filing the complaint has not been
complied with.

SECTION 2. Time to Plead - lf the motion is denied, the respondent shall file an
answer within fifteen (15) days from receipt of the notice of the denial.

SECTION 3. Effect of Dismissal - Subject to the right to appeal, an order

granting a motion to dismiss based on paragraph (f) of Section t hereof shall bar
the refiling of the same action or claim.

SECTION 4. Pleading Grounds as Affirmative Defenses - lf no motion to

dismiss has been filed, any of the grounds for dismissal provided for in Section 1
hereof may be pleaded as an affirmative defense in the answer.

RULE VII
PRELIMINARY CONFERENCE

SECTION 1. Preliminary Conference - After the filing of answer, the Hearing

Officer shall immediately set the case for preliminary conference and direct the
parties to submit their respective preliminary conference briefs and iudicial
affidavits to support their allegations.

SECTION 2. Preliminary Conference Brief - The parties shall file with lhe
Commission and furnish each other of their respective preliminary conference
briefs and judicial affidavits to support their allegations in such manner as to
ensure receipt by the Commission and the other party at least five (5) before the
date set for the preliminary conference.

The parties shall set forth in their preliminary conference briefs the following:

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 (a) Brief statement of the nature of the case, which shall include a
concise summary of the party's theory of the case;

(b) Allegations admitted by either or both parties;

(c) Proposed stipulation of facts;

(d) Documents or exhibits to be presented stating the purpose thereof;

(e) Amendments to the pleadings;

(0 Statement of the issues to be tried or resolved, which shall

separately summarize the factual and legal issues;

(s) Names, addresses, and contact details of affiants, as well as their

judicial affidavits supporting the parties' respective positions on
each of the issues,

(h) Statement of their willingness to enter into amicable settlement or

alternative modes of dispute resolution, including the specafic terms
thereof; and

(i) Such other matters as may aid in the just and speedy disposition of
the case.

SECTION 3. Affidavits - All affidavits to be submitted shall be in the format

prescribed under Sectaons 3 and 4 of A.M. No. 12-8-8-SC or the Judicial Affidavit
Rule. The Commission shall not admit as evidence judicial affidavits that do not
conform to the prescribed form under the Judicial Affidavit Rule.

SECTION 4. Motions - The following motions shall be allowed during the

preliminary conference:

(a) Motion for extension to file the preliminary conference brief; and

(b) Motion for postponement of proceedings.

Each party may be allowed to file each of the foregoing motions up to a maximum
of three (3) times and for a period not exceeding fifteen ( 1 5) days in any instance.
No additional extension of time will be granted by the Commission except in
extraordinary and meritorious circumstances.

Further, the movant shall pay a postponement fee of One Thousand Pesos (Php.
1,000.00) upon filing of the said motions. Non-payment of the postponement fee
shall give no effect to such motion and the same shall not form part of the records
of the case.

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SECTION 5. Effect of Failure to Submit Preliminary Conference Brief - The
failure of the complainant to submit a preliminary conference brief within the
specified period shall be a ground for the dismissal of the complaint. Failure on
the part of the respondent to file a preliminary conference brief shall not preclude
the Commission from rendering judgment based on the evidence presented.

SECTION 6. Preliminary Conference - The Commission shall direct the parties

and their counsels to appear before it for a preliminary conference to consider:

(a) The possibility of an amicable settlement;

(b) The simplification of the issues,

(c) The necessity or desirability of amendment to the pleadings;

(d) The possibility of obtaining admission or stipulation of facts;

(e) The exchange and acceptance of service of exhibits to be offered

in evidence;

(D The admissibility and relevance of evidence proposed to be

submitted by the parties; and

(S) Such other matters as may aid in the lust, speedy, and inexpensive
drsposition of the case.

All the parties and their respective counsels shall attend the preliminary
conference. The presence of a party is indispensable unless their counsel is
authorized to enter into agreement on any or all the above matters. The parties
shall inform each other of the nature and character of evidence they propose to
offer, indicating the purpose of each item of evidence.

The absence of the complainant without justifiable cause or ground during the
preliminary conference shall cause the dismissal of the case. Meanwhile, should
the respondent fail to appear, the Commission, motu proprio or upon motion, shall
render judgment as may be warranted by the allegations in the complaint, as well
as the affidavits and other evidence on record, unless the Commission, in its
discretion, requires the complainant to submit additional evidence.

ln case of any agreement between the parties, the same shall be reduced into
writing and duly signed by the parties and their counsel. Such agreement shall
be the basis of an order or decision of the Commission. ln no instance shall the
Commission rule on any claims for damages and/or attorney's fees raised in
actions filed in accordance with these Rules.

SEGTION 7. Record of Preliminary Conference - After the preliminary

conference, the Commission shall issue an order reciting in detail the matters
taken up during the preliminary conference, the actions taken on such matters,

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the amendments allowed in the pleadings, and the agreements or admissions
made by the parties as to any of the matters considered. The Commission shall
rule on all objections to or comments on the admissibility of any evidence
proposed to be offered, including affidavits or any part thereof.

SECTION 8. Submission of Position Papers - The Commission, in its order

mentioned in the preceding section, shall direct the parties to simultaneously file
their respective position papers, setting forth the law and the facts relied upon by
them and attaching thereto judicial affidavits, as may be necessary, as well as
other evidence on the factual issues as defined in the Order, within a period of
thirty (30) days from receipt of the Order.

The parties are required to attach to their position papers their respective draft
decisions stating therein the facts, issues, and bases which the lnsurance
Commission, in its discretion, may consider in promulgating its decision. A reply,
if necessary, may be filed within a non-extendible period of twenty (20) days from
receipt of the other party's position paper.

Only previously marked documenvs and judicial affidavits shall be allowed to be

attached to the position paper or reply.
RULE VIII
CLARIFICATORY HEARING

SECTION 1. Clarificatory Hearings Following Submission of Position

Papers - Upon submission of the parties' position papers, the Commission may
set the case for clarificatory hearing/s on any matter which it deems necessary
before rendering Judgment.

The order setting the case for clarificatory hearing shall be issued not later than
thirty (30) days from receipt of the last position paper or the expiration of the
period for filing the same. The clarificatory hearing shall be scheduled within
fifteen (15) days from the issuance of such order and shall be completed not later
than fifteen (15) days thereafter.

The parties shall be represented and accompanied by their respective counsels

during the clarificatory hearings. The Hearing Officer may ask questions for the
purpose of clarifying points of law or facts involved in the case.

RULE IX
DECISIONS OR ORDERS

SECTION 1. Submission of the Case for Decision - Upon the submission by

the parties of their positaon papers and replies, if any, the Commission shall issue
an order providing that the case is submitted for decision unless the Hearing
Officer calls for a hearing or clarificatory conference in accordance with Section
1 of Rule Vlll.

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ln the case of clarificatory hearings following submission of position papers, the
case shall be deemed submitted for decision upon termination of the said
clarificatory hearings.

SECTION 2. Finality of the Decision or Order - Any decision or order

determining the merits of a case shall be in writing and signed by the
Commissioner, and a copy thereof shall be served upon the parties personally,
by registered mail, or by private courier. The Decision or Order of the Commission
shall become final and executory after the lapse of fifteen (15) days from the date
of receipt of a copy thereof by the parties unless a Motion for Reconsideration or
an appeal from such Decision or Order is filed withan the period herein prescribed.

RULE X
MOTION FOR RECONSIDERATION

SECTION 1 . Motion for Reconsideration - Within fifteen (1 5) days from receipt

of the Decision or Order of this Commission, the aggrieved party may be allowed
to file a motion for reconsideration of such order, ruling, or decision. lf the motion
is denied, the aggrieved party may appeal in accordance with Rule Xl hereof. No
second motion for reconsideration shall be allowed or entertained.

SECTION 2. Grounds - A Motion for Reconsideration shall be based on any of

the following grounds:

(a) Newly discovered evidence which could not have been discovered
and produced during the proceedings and which, if admitted, would
probably alter the results;

(b) The Decision is not supported by the evidence on record;

(c) Errors of law or irregularities have been committed prejudicial to the

interest of the movant, and

(d) Fraud, accident, mistake or excusable negligence which ordinary

prudence could not have guarded against and by reason of which
such aggrieved party has probably been impaired of their rights.

SECTION 3. Opposition to Motion for Reconsideration - Within fifteen ("15)

days from receipt of a copy of a Motion for Reconsideration, the adverse party
may file an opposition thereto and serve a copy thereof upon the party who filed
the Motion for Reconsideration.

SECTION 4. When Deemed Submitted - After the opposition is filed, or upon

the expiration of the period for filing the same without any opposition having been
filed, the Motion for Reconsideration shall be deemed submitted for resolution by
the Commission unless the latter shall consider it necessary to hear the oral
arguments of the parties, in which case, it shall issue a corresponding order or
notice to that effect.

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The Commission shall assue an order setting forth that the Motion for
Reconsideration is deemed submitted for resolution and directing the parties to
submit their respective draft resolutions within fifteen (15) days from receipt of
such order.

SECTION 5. Denial of Motion for Reconsideration lf the Motion for

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Reconsideration is denied and appeal has not been availed of by the aggrieved
party in accordance with Rule Xl of these Rules, the Decision of this Commission
shall become final and executory after the lapse of fifteen (15) days from the date
of receipt of a copy of said denial.

RULE XI
APPEAL FROM ORDER OR DECISION

SECTION '1. How Appeal ls Taken - Any party aggrieved by a denial of a Motion
for Reconsideration on a Decision finally resolving the case heard by the
Commission pursuant to its powers under the lnsurance Code, as amended, and
EO No. 192, s. 201 5 may appeal from such denial by filing with the Commissioner
within fifteen (15) days from receipt of a copy of such denial a notice of appeal to
the Secretary of Finance, along with a memorandum of appeal, copies of which
shall be served on the adverse party.

The Memorandum of Appeal shall contain a concise statement of the facts and
issues involved and the grounds relied upon for the review, and shall be
accompanied by a duplicate original or a certified true copy of the ruling, award,
order, decision, or judgment appealed from, together with certified true copies of
such material portions of the record as are referred to therein and other
supporting papers. The Memorandum of Appeal shall state the specific material
dates showing that it was filed within the period of appeal fixed herein.

For cases heard by the Commission pursuant to its powers under the Pre-Need
Code, the aggrieved party may appeal the denial of a Motion for Reconsideration
to the Court of Appeals by petition for review in accordance with the pertinent
provisions of the Rules of Court.

SECTION 2. Effect of Appeal - The appeal shall suspend the order, ruling, or
decision appealed from.

RULE XII
CONTEMPT

SECTION 1. Direct Contempt - Pursuant to Section 437(g) of the lnsurance

Code, as amended, Section 4(l) of EO No. 192, s. 2015, and Section 6(f) of the
Pre-Need Code, the Commissioner or Hearing Officer under Section 2, Rule ll of

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these Rules may summarily adjudge in direct contempt any person who has
committed or is committing any act of misbehavior in their presence and while the
proceedings are ongoing, including disrespect towards them, offensive
personalities towards others, or refusal to be sworn or to answer as a witness or
to subscribe an affidavit or deposition when lavrfully required to do so in
accordance with the Rules of Court. lf the offense is committed against the
Commissioner, the same shall be punished by a fine not exceeding Ten
Thousand Pesos (Php 10,000.00) or imprisonment not exceeding ten (10) days
or both. lf the offense is committed against any hearing officer acting under the
authority of the lnsurance Commissioner, the same shall be punished by a fine
not exceeding Five Thousand Pesos (Php. 5,000.00) or imprisonment not
exceeding one (1) day or both.

SECTION 2. Remedy The person adjudged in direct contempt by the

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Commission may not appeal therefrom but may avail themselves of the remedies
of certiorari or prohibition in accordance with the Rules of Court. The execution
of the contempt order shall be suspended pending resolution of such petition,
provided such person files a bond fixed by the Commission and conditioned that
they will abide by and perform the said order should the petition be decided
against them.

SECTION 3. lndirect Contempt - The Commissioner or Hearing Officer may

also cite any person for indirect contempt upon grounds and in the manner
prescribed under Section 3, Rule 71 of the Rules of Court.

RULE XIII
APPEARANCE OF ATTORNEYS; STENOGRAPHERS

SECTION 1. Appearance of Lawyers in the Commission - Every lawyer

appearing before any proceedings conducted by the Commission pursuant to
these Rules shall manifest orally or in writing their appearance for a party,
indicating their name and exact address, their Professional Tax Receipt for the
current year, IvICLE compliance, and IBP Receipt Number. Any pleading filed and
signed by them shall likewise contain such information, otheMise they shall not
be allowed to represent a party in any proceedings before this Commission
pursuant to these Rules.

SECTION 2. Stenographic Notes - lt shall be the duty of the stenographic

reporter who has attended the hearing conducted by the Commission to submit
to the Hearing Officer within a reasonable period of time the transcript of
stenographic notes duly initialed on each page and signed on the last page
thereof.

RULE XIV
JUDGMENTS, FINAL ORDERS, AND ENTRY THEREOF

SECTION 1. Final and Executory Judgment, Order, or Decision - lf no appeal

or motion for reconsideration is filed within the time provided in these Rules, the

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judgment, final order, or decision rendered by the Commission becomes final and
executory.

SECTION 2. Entry of Judgment, Orders, or Decision - After the judgment,

order or decision becomes final and executory, the same shall be entered in the
book of entries of judgments. The date of finality of the judgment or final order
shall be deemed to be the date of its entry.

RULE XV
REPEALING AND SEPARABILITY CLAUSE

SECTION'1. Repealing Clause - lnsurance lvlemorandum Circular No. 1-93 is

hereby repealed in its entirety.

All other existing rules, circulars, procedures, and practices that are inconsistent
with these Rules are hereby repealed, amended, or modified accordingly.

SECTION 2. Separability Clause - lf any part or provision of these Rules is held

invalid or unconstitutional, the validity, legality, and enforceability of the remaining
provisions shall not in any way be affected or impaired thereby, and shall remain
in force and effect.

RULE XVI
TRANSITORY PROVISION AND EFFECTIVITY

SECTION 1. Transitory Provision - Parties to existing cases pending resolution

before this Commission at the time of the effectivity of these Rules may opt to
apply these Rules. These Rules shall apply, however, in all actions filed after the
effectivity of these Rules.

Circular Letter No. 2020-7 4 or the "Guidelines on the Use of Videoconferencing

for the Conduct of Hearings and Other Proceedings before the CAD and REPD"
and any subsequent amendments thereto shall remain applicable.

SECTION 2. Effectivity - These Rules shall take effect fifteen (15) days from the
date of publication in a newspaper of general circulation in Philippines.

Manila, Philippin€S, Seltemler 21, 2G1

DEN IS B. FUNA
lnsurance

"JJ

Date of Publication: 31 December 2021 (The Philippine Star)

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