COMPROMISE AGREEMENT

This Compromise Agreement (the “Agreement”) is made and entered into this
____________ by and between”

___________________, a corporation organized and existing under the

laws of the Republic of the Philippines, with principal place of business
at __________________________________, represented herein by
_____________________, hereinafter referred to as ____________.

and

_____________________, Filipino, of legal age and with residence at

_________________________________ hereinafter referred to as
“_____________”.

WITNESSETH:

WHEREAS, ________________ is the complainant in the case entitled

________________, with Case No. ________________, pending before the Insurance
Commission (the “Pending Action”).

WHEREAS, the parties have reached an agreement to amicably settle the

aforesaid Pending Action and to have the same dismissed.

NOW THEREFORE, for and in consideration of the foregoing premises, the

parties hereby agree as follows:

1. ________________ shall pay and deliver to ________________the amount

of ________________, covered by BDO Check No. __________ dated _________ 2018,
representing the complete and final settlement amount for the Pending Action,
including any and all claims which ________________ may have in connection with,
directly or indirectly, the incident which gave rise to the Pending Action.

2. The parties shall simultaneously execute an acknowledgment receipt and

release and quitclaim which shall irrevocably, fully, and forever release, acquit and
discharge each other, their respective successors-in-interest and assigns, stockholders,
officers, employees and representatives, or any person acting on their behalf, from any
and all liabilities, actions, demands, proceedings or claims of whatever type or nature
arising from, by reason of or in relation to any cause, act, matter or thing related to the
Pending Action.

3. This Agreement may not be changed, modified, amended or

supplemented in any way except by an instrument in writing executed by both parties.

4. The failure of any party and/or their authorized representatives at any

time to insist upon the strict observance of any of the provisions of this Agreement, or
to exercise any rights in respect thereto, shall not be construed as a waiver of such
provisions or right, or in any way affect the validity of this Agreement, or any of the
herein provisions or the right of any party to insist upon strict observance thereof. No
waiver shall be valid unless made in writing and signed by the party waiving the
provisions or right under this Agreement.

1
 5. This Agreement was voluntarily executed by the parties without any
duress, or undue influence on the part of, or behalf of, any party.

6. Each party hereto expressly represents that they have obtained and
utilized the advice of independent legal counsel in the preparation and execution of this
Agreement and that they have read this Agreement and fully understood the contents
and the consequences hereof.

7. This Agreement shall constitute the entire agreement between the Parties
and shall supersede all prior negotiations, commitments or arrangements between the
Parties with respect to the subject matter hereof.

8. In the event that any one of the provisions contained herein shall, for any
reason, be declared invalid or unenforceable by agreement or by the courts of law, such
invalidity or unenforceability shall not affect any other provision of this Agreement
which shall continue to be in full force and effect as if such invalid or unenforceable
provision/s had not been embodied herein.

IN WITNESS WHEREOF, the Parties hereby sign this Agreement on the date
first above-written.

By:

_________________________________ _________________________________
[Authorized Representative]

Signed in the presence of:

_________________________________ _________________________________

2
 ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES )

CITY OF ) S.S.

BEFORE ME, a Notary Public for and in __________ on this ________________,

personally appeared the following parties:

Name Competent Evidence Date/Place of Issue

of Identity

[Authorized Representative]

who were identified by me through competent evidence of identity, and who

acknowledged to me that this instrument is their own free and voluntary act and deed
and of the corporation herein represented, and that they are duly authorized by the
corporations respectively represented by them.

I FURTHER CERTIFY that this Agreement consists of __________ ( ) pages only,

including this page where this Acknowledgment is written.

WITNESS my hand and seal on the date and at the place first above-written.

Doc. No._______;
Page No._______;
Book No.______;
Series of 2018.