Escolar Documentos
Profissional Documentos
Cultura Documentos
PHILIPPINE GUARANTY
CO., INC.
vs.
THE CENTURY INSURANCE CO., LTD., defendant-appellant.
December 2, 1924
Facts:
OCTOBER 30, 1972
Petitioner:
Republic Bank
Respondent:
FACTS:
On January 12, 1962, the Union Manufacturing Co., Inc. obtained certain
loans from the Republic Bank in the total sum of 415,000.00. To
secure the payment thereof, UMC executed real and chattel mortgage
on certain properties.
The Republic Bank procured from the defendant Philippine Guaranty
Co., Inc. an insurance coverage on loss against fire for 500,000.00
over the properties of the UMC, as described in defendants cover note
dated September 25, 1962, with the annotation that loss or damage, if
any, under said cover note is payable to Republic Bank as its interest
may appear, subject however to the printed conditions of said
defendants Fire Insurance Policy Form.
On September 6, 1964, a fire occurred in the premises of UMC and on
October 6, 1964, UMC filed its fire claim with the PGC Inc., thru its
adjuster, H.H. Bayne Adjustment Co., which was denied by said
defendant in its letter dated November 26, 1964 on the following ground:
Policy Condition No. 3 and/or the Other Insurance Clause of the policy
was violated because you did not give notice to us of the other insurance
which you had taken from New India for 80,000.00. Sincere Insurance
for 25,000.00 and Manila Insurance for 200,000.00 with the result
that these insurances of which we became aware of only after the fire,
were not endorsed on our policy.
ISSUE:
Whether Republic Bank can recover.
HELD:
Without deciding- whether notice of other insurance upon the same
property must be given in writing, or whether a verbal notice is sufficient
to render an insurance valid which requires such notice, whether oral or
written, we hold that in the absolute absence of such notice when it is
one of the conditions specified in the fire insurance policy, the policy is
null and void. (Santa Ana vs. Commercial Union Ass. Co., 55 Phil. 128).
If the insured has violated or failed to perform the conditions of the
contract, and such a violation or want of performance has not been
waived by the insurer, then the insured cannot recover. Courts are not
permitted to make contracts for the parties. The functions and duty of the
courts consist simply in enforcing and carrying out the contracts actually
made.
While it is true, as a general rule, that contracts of insurance are
construed most favorably to the insured, yet contracts of insurance, like
other contracts, are to be construed according to the sense and meaning
of the terms which the parties themselves have used. If such terms are
clear and unambiguous they must be taken and understood in their plain,
ordinary and popular sense.
The annotation then, must be deemed to be a warranty that the property
was not insured by any other policy. Violation thereof entitles the insurer
to rescind. The materiality of non-disclosure of other insurance policies is
not open to doubt.
The insurance contract may be rather onerous, but that in itself does not
justify the abrogation of its express terms, terms which the insured
accepted or adhered to and which is the law between the contracting
parties.
A building of the plaintiff was insured against fire by the defendant in the
sum of P30,000, as well as the goods and merchandise therein
contained in the sum of P15,000. The house and merchandise insured
were burnt early in the morning of February 28, 1923, while the policies
issued by the defendant in favor of the plaintiff were in force. The
appellant contends that under clause 14 of the conditions of the policies,
it may rebuild the house burnt, and although the house may be smaller,
yet it would be sufficient indemnity to the insured for the actual loss
suffered by him. The clause states that: The Company may at its option
reinstate or replace the property damaged or destroyed, or any part
thereof, instead of paying the amount of the loss of damages, or may join
with any other Company or insurers in so doing, but the Company shall
not be bound to reinstate exactly or completely, but only as
circumstances permit and in reasonable sufficient manner, and in no
case shall the Company be bound to expend more in reinstatement that
it would have cost to reinstate such property as it was at the time of the
occurrence of such loss or damage, nor more than the sum insured by
the Company thereon. If the clause is valid it may either rebuild it or pay
it. It must be taken in consideration that the insurance company must
notify the insured which between the 2: either rebuild it or pay it, will be
fulfilled. In which case, the final notice was not given and the rebuilding
of the property would be the better option.
Issue:
Whether or not the Insurance Company should rebuild the house or not?
Ruling of the Court:
It was held that the trial judge very aptly says in his decision: "It would be
an imposition unequitable, as well as unjust, to compel the plaintiff to
accept the rebuilding of a smaller house than the one burnt, with a lower
kind of materials than those of said house, without offering him an
additional indemnity for the difference in size between the two house,
which circumstances were taken into account when the insurance
applied for by the plaintiff was accepted by the defendant." And we may
add: Without tendering either the insured value of the merchandise
contained in the house destroyed, which amounts to the sum of
P15,000." The election alleged by the appellant to rebuild the house
burnt instead of paying the value of the insurance is improper.
G.R. No. L-26827
Insurance, excluding its liability to pay claims under the policy in behalf
of "persons who are under the age of sixteen (16) years of age or over
the age of sixty (60) years ..." It is pointed out that the insured being over
sixty (60) years of age when she applied for the insurance coverage, the
policy was null and void, and no risk on the part of the respondent
insurance corporation had arisen therefrom.
The trial court sustained the contention of the private respondent and
dismissed the complaint. It was reasoned out that a policy of insurance
being a contract of adhesion, it was the duty of the insured to know the
terms of the contract he or she is entering into; the insured in this case,
upon learning from its terms that she could not have been qualified
under the conditions stated in said contract, what she should have done
is simply to ask for a refund of the premium that she paid. It was further
argued by the trial court that the ruling calling for a liberal interpretation
of an insurance contract in favor of the insured and strictly against the
insurer may not be applied in the present case in view of the peculiar
facts and circumstances obtaining therein.
In the given case, plaintiff's brother, who was at the wheel at the time of
the collision, did not have a valid license because the one he had
obtained had already expired and had not been renewed as required by
Section 31 of the Motor Vehicle Law. That since he had renewed his
license one week after the accident, it did not cure the delinquency or
revalidate the license which had already expired (Syllabus, Tanco, Jr. vs.
Phil. Guaranty Co., 122 Phil. 709). Wherefore the case is against
Gutierrez.
Issue:
Ruling:
vs.
MANILA BANKERS LIFE INSURANCE CORPORATION and the
COURT OF FIRST INSTANCE OF RIZAL, BRANCH V, QUEZON CITY,
respondents-appellees.
The Supreme Court reversed trial court's decision. The Court ruled that
the age of the insured Carmen Lapuz was not concealed to the
insurance company. Her application for insurance coverage which was
on a printed form furnished by private respondent and which contained
very few items of information clearly indicated her age of the time of filing
the same to be almost 65 years of age. Despite of, it could hardly be
overlooked in the application form, considering its prominence thereon
and its materiality to the coverage applied for, the respondent insurance
corporation received her payment of premium and issued the
corresponding certificate of insurance without question. The accident
which resulted in the death of the insured, a risk covered by the policy,
occurred on May 31, 1969 or FORTY-FIVE (45) DAYS after the
insurance coverage was applied for. There was sufficient time for the
private respondent to process the application and to notice that the
applicant was over 60 years of age and thereby cancel the policy on that
ground if it was minded to do so. If the private respondent failed to act, it
is either because it was willing to waive such disqualification; or, through
the negligence or incompetence of its employees for which it has only
itself to blame, it simply overlooked such fact. Under the circumstances,
the insurance corporation is already deemed in estoppel. It is usually
held that where the insurer, at the time of the issuance of a policy of
insurance, has knowledge of existing facts which, if insisted on, would
invalidate the contract from its very inception, such knowledge
constitutes a waiver of conditions in the contract inconsistent with the
known facts, and the insurer is stopped thereafter from asserting the
breach of such conditions. The law is charitable enough to assume, in
the absence of any showing to the contrary, that an insurance company
intends to execute a valid contract in return for the premium received;
and when the policy contains a condition which renders it voidable at its
inception, and this result is known to the insurer, it will be presumed to
have intended to waive the conditions and to execute a binding contract,
rather than to have deceived the insured into thinking he is insured when
in fact he is not, and to have taken is money without consideration.
THE CAPITAL INSURANCE & SURETY CO., INC., petitioner,
vs.
PLASTIC ERA CO., INC., AND COURT OF APPEALS, respondents.
G.R. No. L-22375 July 18, 1975
Facts:
On August 25, 1961, Plastic Era filed its complaint against Capital
Insurance for the recovery of the sum of P100,000.00 plus P25,000.00
for attorney's fees and P20,000.00 for additional expenses. Capital
Insurance filed a counterclaim of P25,000.00 as and for attorney's fees.
The trial court rendered judgment in favor of the plaintiff and against the
defendant for the sum of P88,325.63 with interest at the legal rate from
the filing of the complaint and to pay the costs. Court of appeals affirmes
lower court's decision. Thus, Capital Insurance elevated the case in the
Supreme Court.
Issue:
Whether or not a contract of insurance has been duly perfected between
the petitioner, Capital Insurance, and respondent Plastic Era.
Ruling: Yes
By accepting its promise to pay the insurance premium within thirty (30)
days from the effectivity date of the policy December 17, 1960 Capital
Insurance had in effect extended credit to Plastic Era. The payment of
the premium on the insurance policy therefore became an independent
obligation the non-fulfillment of which would entitle Capital Insurance to
recover. It could just deduct the premium due and unpaid upon the
satisfaction of the loss under the policy. It did not have the right to cancel
the policy for nonpayment of the premium except by putting Plastic Era
in default and giving it personal notice to that effect. This Capital
Insurance failed to do.
... Where credit is given by an insurance company for the payment of the
premium it has no right to cancel the policy for nonpayment except by
putting the insured in default and giving him personal notice....
Facts:
Plaintiffs, now appellants, filed this action in the Court of to recover the
sum of P5,000.00, corresponding to the face value of an insurance policy
issued by defendant on the life of Estefania A. Saturnino, and the sum of
P1,500.00 as attorney's fees.
Both the complaint and the counterclaim were dismissed by the trial
court; but appellants were declared entitled to the return of the premium
already paid; plus interest at 6% up to January 8, 1959, when a check for
the corresponding amount - P359.65 - was sent to them by appellee.
ISSUE:
Whether or not the insured made such false representations of material
facts as to avoid the policy.
RULING:
On August 15, 1983, herein private respondent Emilio Tan took from
herein petitioner a P300,000.00 property insurance policy to cover his
interest in the electrical supply store of his brother housed in a building in
Iloilo City. Four (4) days after the issuance of the policy, the building was
burned including the insured store. On August 20, 1983, Tan filed his
claim for fire loss with petitioner, but on February 29, 1984, petitioner
wrote Tan denying the latter's claim. On April 3, 1984, Tan wrote
petitioner, seeking reconsideration of the denial of his claim. On
September 3, 1985, Tan's counsel wrote the Insurer inquiring about the
status of his April 3, 1984 request for reconsideration. Petitioner
answered the letter on October 11, 1985, advising Tan's counsel that the
Insurer's denial of Tan's claim remained unchanged, enclosing copies of
petitioners' letters of February 29, 1984 and May 17, 1985 (response to
petition for reconsideration). On November 20, 1985, Tan filed Civil Case
with the Regional Trial Court but petitioner filed a motion to dismiss on
the alleged ground that the action had already prescribed. Said motion
was denied in an order dated November 3, 1987; and petitioner's motion
for reconsideration was also denied in an order dated January 14, 1988.
be brought by the insured while the evidence as to the origin and cause
of destruction have not yet disappeared.
In enunciating the above-cited principle, this Court had definitely settled
the rationale for the necessity of bringing suits against the Insurer within
one year from the rejection of the claim. The contention of the
respondents that the one-year prescriptive period does not start to run
until the petition for reconsideration had been resolved by the insurer,
runs counter to the declared purpose for requiting that an action or suit
be filed in the Insurance Commission or in a court of competent
jurisdiction from the denial of the claim. To uphold respondents'
contention would contradict and defeat the very principle which this
Court had laid down. Moreover, it can easily be used by insured persons
as a scheme or device to waste time until any evidence which may be
considered against them is destroyed.
It is apparent that Section 27 of the insurance policy was stipulated
pursuant to Section 63 of the Insurance Code, which states that:
Petitioner went to the Court of Appeals and sought the nullification of the
said Nov. 3, 1987 and January 14, 1988 orders, but the Court of Appeals,
in its June 20, 1989 decision denied the petition and held that the court a
quomay continue until its final termination. A motion for reconsideration
was filed, but the same was denied by the Court of Appeals in its
resolution of August 22, 1989.
FACTS:
Julio Aguilar owned and operated several jeepneys in the City of
Manila. . He entered into a contract with the Capital Insurance & Surety
Co., Inc. insuring the operation of his jeepneys against accidents with
third-party liability. Insurance policy was executed by the Capital
Insurance & Surety Co., Inc., it contains the following provision:
Section II LIABILITY TO THE PUBLIC
1. The Company, will, subject to the limits of liability, indemnify
the Insured in the event of accident caused by or arising out of
the use of the Motor Vehicle/s or in connection with the loading
or unloading of the Motor Vehicle/s, against all sums including
claimant's costs and expenses which the Insured shall become
legally liable to pay in respect of:
a. death of or bodily injury to any person
b. damage to property
During the effectivity of such insurance policy, Iluminado del Monte, one
of the drivers of the jeepneys operated by Aguilar, bumped with the
jeepney abovementioned one Gervacio Guingon who had just alighted
from another jeepney and as a consequence the latter died some days
thereafter. An information for homicide thru reckless imprudence was
filed against Iluminado del Monte, who pleaded guilty. A penalty of four
months imprisonment was imposed on him.
The heirs of Gervacio Guingon filed an action for damages to be paid to
them jointly and severally by the defendants, driver Iluminado del Monte,
owner and operator Julio Aguilar, and the Capital Insurance & Surety
Co., Inc.
The Court of First Instance of Manila rendered its judgment in favor of
the heirs of the deceased holding the defendants jointly liable for
damages.
ARGUMENT:
The case was appealed to the Court of Appeals contending that "no
action" clause in the policy closes the avenue to any third party which
may be injured in an accident wherein the jeepney of the insured might
have been the cause of the injury of third persons, alleging the freedom
of contracts. Will the mere fact that such clause was agreed upon by the
parties in an insurance policy prevail over the Rules of Court which
authorizes the joining of parties plaintiffs or defendants.
ISSUE:
Whether or not the plaintiffs being a third party can jointly sue the insurer
and the insured.
RULING:
Yes. The policy in the present case is one for indemnity against liability;
from the fact then that the insured is liable to the third person, such third
person is entitled to sue the insurer. And the "no action" clause in the
policy of insurance cannot prevail over the Rules of Court provision
aimed at avoiding multiplicity of suits.
The Rules of Court provides that; two causes of action are connected
with each other, or grow out of the same transaction, they may be
properly joined, and in such suit all parties against whom the plaintiff
asserts a common or an alternative liability may be joined as defendants.
. . . Even if appellants had presented any plea in abatement as to joinder
of damages arising from a tort with those arising from a contract, it could
not, under the facts of this case, be sustained, for the rule is that a suit
may include an action for breach of contract and one for tort, provided
they are connected with each other or grew out of the same transaction.
In the case at bar, Sec. 5 of Rule 2 on "Joinder of causes of action" and
Sec. 6 of Rule 3 on "Permissive joinder of parties" cannot be
superseded, at least with respect to third persons not a party to the
contract, as herein, by a "no action" clause in the contract of insurance.
First Insurance cannot evade its liability as insurer by hiding under the
cloak of the insured. Its liability is primary and not dependent on the
recovery of judgment from the insured.
The said jeepney driven by Blanco himself bumped a five-year old child,
Deogracias Advincula, causing the latter's death.Thereafter, a complaint
for damages was brought by the child's parents, the Advincula spouses,
against Silverio Blanco. First Insurance was also impleaded in the
complaint as the insurer.
FACTS:
Primitivo Perez had been insured with BF Lifeman Insurance
Corporation since 1980 for P20,000. In October 1987 , an agent of
Lifeman Insurance, Rodolfo Lalog, visited Perez in Quezon and
ISSUE:
Whether or not there was a perfected additional insurance contract.
RULING:
No. the contract was not perfected.
A contract of insurance, like all other contracts, must be assented to by
both parties, either in person or through their agents and so long as an
application for insurance has not been either accepted or rejected, it is
merely a proposal or an offer to make a contract.
FACTS:
The petitioners were the complainants in an administrative complaint
against private respondent Insular Life Assurance Company, Ltd. (Insular
Life), which was filed with the Insurance Commission. They prayed that
Insular Life "be ordered to pay the claimants their insurance claims" and
that "proper sanctions/penalties be imposed on" it "for its deliberate,
feckless violation of its contractual obligations to the complainants, and
of the Insurance Code.
Insular Life's motion to dismiss the complaint on the ground that "the
claims of complainants are all respectively beyond the jurisdiction of the
Insurance Commission as provided in Section 416 of the Insurance
Code." Having been denied it filed its answer, thereafter, hearings were
conducted.The Commission rendered its decision in favor of the
complainants.
Insular Life appealed the decision seeking that the appellate court to
reverse the decision because the Insurance Commission:
(a) had no jurisdiction over the case considering that the claims
exceeded
P100,000.00,
(b) erred in holding that the powers of attorney relied upon by Insular Life
were insufficient to convey absolute authority to Capt. Nuval to demand,
receive and take delivery of the insurance proceeds pertaining to the
petitioners, (c) erred in not giving credit to the version of Insular Life that
the power of attorney supposed to have been executed in favor of the
Alarcons
was
missing,
and
(d) erred in holding that Insular Life was liable for violating Section 180 of
the Insurance Code for having released to the surviving mothers the
insurance proceeds pertaining to the beneficiaries who were still minors
despite the failure of the former to obtain a court authorization or to post
a bond.
The Court of Appeals rendered its decision with modification. Hence this
petition.
ARGUMENT:
The Insurance Commission had jurisdiction over the case on the ground
that although some of the claims exceed P100,000.00, the petitioners
had asked for administrative sanctions against Insular Life which are
within the Commission's jurisdiction to grant; hence, "there was merely a
misjoinder of causes of action . . . and, like misjoinder of parties, it is not
a ground for the dismissal of the action as it does not affect the other
reliefs prayed for."
When the officers of respondent-appellant read these written powers,
they must have assumed Capt. Nuval indeed had authority to collect the
insurance proceeds in behalf of the beneficiaries who duly affixed their
signatures therein. The written power is specific enough to define the
authority of the agent to collect any sum of money pertaining to the
sinking of the fatal vessel. Respondent-appellant interpreted this power
to include the collection of insurance proceeds in behalf of the
beneficiaries concerned. We believe this is a reasonable interpretation
even by an officer of respondent-appellant unschooled in the law. Had
respondent appellant, consulted its legal department it would not have
received a contrary view. There is nothing in the law which mandates a
specific or special power of attorney to be executed to collect insurance
proceeds.
ISSUE:
"If the property hereby insured shall, at the breaking out of any
fire, be collectively of greater value than the sum insured thereon then
the insured shall be considered as being his own insurer for the
difference, and shall bear a ratable proportion of the loss accordingly.
Every item, if more than one, of the policy shall be separately subject to
this condition"
Whether or not the parents of the minors have a right in the policy in
behalf of their minor children.
ARGUMENTS FOR THE RESPONDENT
RULING:
Yes. The Insurance Code expressly provides that; In the absence of a
judicial guardian, the father, or in the latter's absence or incapacity, the
mother, of any minor, who is an insured or a beneficiary under a contract
of life, health or accident insurance, may exercise, in behalf of said
minor, any right under the policy, without necessity of court authority or
the giving of a bond, where the interest of the minor in the particular act
involved does not exceed twenty thousand pesos. Such a right, may
include, but shall not be limited to, obtaining a policy loan, surrendering
the policy, receiving the proceeds of the policy, and giving the minor's
consent to any transaction on the policy.
As amended by the Family Code which grants the father and mother
joint legal guardianship over the property of their unemancipated
common child without the necessity of a court appointment; however,
when the market value of the property or the annual income of the child
exceeds P50,000.00, the parent concerned shall be required to put up a
bond in such amount as the court may determine.
It is clear from the said Article that regardless of the value of the
unemancipated common child's property, the father and mother ipso
jure become the legal guardian of the child's property. However, if the
market value of the property or the annual income of the child exceeds
P50,000.00, a bond has to be posted by the parents concerned to
guarantee the performance of the obligations of a general guardian.
Wherefore, the instant petition is GRANTED. The Decision of the
Insurance Commission is reinstated.
ISSUE
represent the total indemnity due the insured from the insurer except
only that the total indemnity shall not exceed the face value of the policy.
ISSUE
DISCUSSION
Whether the commisioner has jurisdiction over the subject matter of the
complaint filed by the private respondent
The court in ruling that private respondent is entitled to an
indemnity if Php 508,867 instead of Php 67,629 as assessed by
petitioner noted that the building at the time of loss is still under
construction and not completed, furthermore it observed that the
insurance contract (policy RY/F-082) entered was an open policy based
from the contract itself
FACTS
DISCUSSION
Private respondent Ramon Paterno filed a letter of complaint
before the respondent commissioner alleging certain problems
encountered by agents, supervisors, managers and public consumers of
the Philippine American Life Insurance Company (Philamlife) as a result
of certain practices by said company. Petitioner asked for clarifications
on what specific acts are complained (Bill of Particulars) of by Paterno.
the commissioner took cognizance of the case and set the hearing.
INSURANCE
FACTS
CORPORATION
VS
COUR
OF
G.R. No. L-18965, October 30, 1964, 12 SCRA 213; Fireman's Fund
Insurance Company v. Jamilla & Company, Inc., G.R. No. L-27427, April
7, 1976, 70 SCRA 323].
DISCUSSION
The court explained that although there are a few recognized exceptions
to this rule. For instance, if the assured by his own act releases the
wrongdoer or third party liable for the loss or damage, from liability, the
insurer's right of subrogation is defeated [Phoenix Ins. Co. of Brooklyn v.
Erie & Western Transport, Co., 117 US 312, 29 L. Ed. 873 (1886);
Insurance Company of North America v. Elgin, Joliet & Eastern Railway
Co., 229 F 2d 705 (1956)]. Similarly, where the insurer pays the assured
the value of the lost goods without notifying the carrier who has in good
faith settled the assured's claim for loss, the settlement is binding on
both the assured and the insurer, and the latter cannot bring an action
against the carrier on his right of subrogation [McCarthy v. Barber
Steamship Lines, Inc., 45 Phil. 488 (1923)]. And where the insurer pays
the assured for a loss which is not a risk covered by the policy, thereby
effecting "voluntary payment", the former has no right of subrogation
against the third party liable for the loss [Sveriges Angfartygs Assurans
Forening v. Qua Chee Gan, G. R. No. L-22146, September 5, 1967, 21
SCRA 12].None of the exceptions are availing in the present case.
FACTS
On April 20, 1952, Rufino D. Andres filed a complaint in the Court of First
Instance of Ilocos Norte against the Crown Life Insurance Company for
the recovery of the amount of P5,000, as the face value of a joint 20-year
endowment insurance policy issued in favor of the plaintiff Rufino D.
Andres and his wife Severa G. Andres on the 13th of February, 1950, by
said insurance company. On Jun 7, 1951, Rufino Andres presented his
death claim as survivor-beneficiary of the deceased Severa G. Andres,
who died May 3, 1951. Payment having been denied by the insurance
company on April 20, 1952, this case was instituted.
Yes. Article 2207 of the Civil Code is founded on the well-settled principle
of subrogation. If the insured property is destroyed or damaged through
the fault or negligence of a party other than the assured, then the insurer,
upon payment to the assured, will be subrogated to the rights of the
assured to recover from the wrongdoer to the extent that the insurer has
been obligated to pay. Payment by the insurer to the assured operates
as an equitable assignment to the former of all remedies which the latter
may have against the third party whose negligence or wrongful act
caused the loss. The right of subrogation is not dependent upon, nor
does it grow out of, any privity of contract or upon written assignment of
claim. It accrues simply upon payment of the insurance claim by the
insurer [Compania Maritima v. Insurance Company of North America,
Petitioner contends that although the policy has lapsed, the company
waived its right to collect the payment of the premiums as communicated
by the latter in a letter;
If you cannot pay the full amount immediately, send as large an amount
as possible and advise us how soon you expect to be able to pay the
balance. Every consideration will be given to your request consistent
with the company's regulations (Exhibit 4).
If you are unable to cover this amount in full, send us as big an amount
as you are able and we will work out an adjustment most beneficial to
you
Furthermore petitioner paid a partial amount of the balance due
Respondent contends that since the policy has lapsed, the insured is no
longer protected by the policy the Company did not consider the partial
payment as sufficient consideration for the reinstatement. Petitioners
failure to remit the balance before the death of his wife operated to
deprive him of any right to waive the policy and recover the face value
thereof.
ISSUE
Whether there is a perfected contract of reinstatement after the policy
lapsed due to non-payment of premiums?
RULING OF THE COURT
No. in the case of James McGuire vs. The Manufacturer's Life Insurance
Co. (87 Phil,. 370, 48 Off. Gaz. [1], 114), it was held that The stipulation
in a life insurance policy giving the insured the privilege to reinstate it
upon written application does not give the insured absolute right to such
reinstatement by the mere filing of an application. The Company has the
right to deny the reinstatement if it is not satisfied as to the insurability of
the insured and if the latter does no pay all overdue premium and all
other indebtedness to the Company. After the death of the insured the
insurance Company cannot be compelled to entertain an application for
reinstatement of the policy because the conditions precedent to
reinstatement can no longer be determined and satisfied
DISCUSSION
The supreme court explained that the conditions set forth in
the policy for reinstatement are the following: (a) application shall be
made within three years from the date of lapse; (b) there should be a
production of evidence of the good health of the insured: (c) if the rate of
premium depends upon the age of the Beneficiary, there should likewise
be a production of evidence of his or her good health; (d) there should be
presented such other evidence of insurability at the date of application
for reinstatement; (e) there should be no change which has taken place
in such good health and insurability subsequent to the date of such
application and before the policy is reinstated; and (f) all overdue
premiums and other indebtedness in respect of the policy, together with
interest at six per cent, compounded annually, should first be paid.
The plaintiff-appellant did not comply with the last condition; for he only
paid P100 (on account of the overdue semi-annual premium of P165.15)
on February 20, 1951, before his wife's death (Stipulation, par. 7) ; and,
despite the Company's reminders on April 14 and 27, he remitted the
balance of P65 on May 5, 1951 (received by the Company's agency on
May 11), two days after his wife died. On the face of such facts, the
Company had the right to treat the contract as lapsed and refuse
payment of the policy.
GULF RESORT,INC
CORPORATION
VS
PHILIPPINE
CHARTER
INSURANCE
FACTS :
Gulf Resorts is the owner of the Plaza Resort situated at Agoo, La Union
and had its properties in said resort insured originally with the American
Home Assurance Company (AHAC). In the first 4 policies issued, the
risks of loss from earthquake shock was extended only to petitioners
two swimming pools. Gulf Resorts agreed to insure with Phil Charter the
properties covered by the AHAC policy provided that the policy wording
ISSUE: Whether or not the policy covers only the two swimming
the period of March 14, 1990 to March 14, 1991 for P10,700,600.00 for a
pools owned by Gulf Resorts and does not extend to all properties
damaged therein
HELD: Yes, All the provisions and riders taken and interpreted together,
to the contrary, that this insurance covers loss or damage to shock to any
of any premium payable for the other resort properties with regard to
earthquake
shock.
This
is
consistent
with
the
history
of
P393.00 against the peril of earthquake shock, the same premium it had
1. The insured has an insurable interest;
paid against earthquake shock only on the two swimming pools in all the
policies issued by AHAC.
ARGUMENTS:
Petitioner contends:
First, that the policys earthquake shock endorsement clearly covers all
of the properties insured and not only the swimming pools. It used the
words "any property insured by this policy," and it should be interpreted
as all inclusive.
Respondent Arguments:
None of the previous policies issued by AHAC-AIU from 1983 to 1990
explicitly extended coverage against earthquake shock to petitioners
insured properties other than on the two swimming pools. Petitioner
admitted that from 1984 to 1988, only the two swimming pools were
insured against earthquake shock. From 1988 until 1990, the provisions
in its policy were practically identical to its earlier policies, and there was
no increase in the premium paid. AHAC-AIU, in a letter 19 by its
FACTS:
As a result of a vehicular accident that happened on November 26,1976
whereby a Ford Pick-up with Plate No. UC-5925 Phil. '76 owned by
Marcos Olaso was bumped by a cargo truck with Plate No. OY-783 then
owned by Alberto Floralde, FGU insurance poration FGU by reason of
Motor Vehicle Insurance Policy No. IC-VF-07185 paid Olaso the sum of
P 2,817.50 as its share in the repair cost of the said Ford Pick-up.
Having thus been subrogated to the rights and causes of action of said
Olaso in the said amount FGU formally demanded payment of said
amount from Floralde and attempted to verify Floralde's insurance
carrier. Floralde failed to reveal his insurance carrier. In the early part of
1978 FGU was able to ascertain the Identity of Floralde's insurance
carrier to be the Summit Guaranty and Insurance Company, Inc.
(Summit). On February 22,1978 FGU wrote to the insurance
commissioner requesting for a conference with Summit and demanded
from Summit through counsel on February 28,1978 the payment of the
damages sustained by the car of Olaso but to no avail. Hence on May
22,1978 FGU filed IC Case No. 825 in the Insurance Commissioner's
Office against Summit for recovery of said amount.
ARGUMENTS:
Petitioner squarely brings into focus the provisions of Section 384 of PD
612, the Insurance Code, Petitioner company contends that the two
periods prescribed in the aforementioned law that is, the six-month
period for filing the notice of claim and the one-year period for bringing
an action or suit are mandatory and must always concur.
Respondent FGU, however, contends that the said one-year prescriptive
period can not apply to it because it was merely subrogated to the rights
of Olaso. Respondent Commissioner invites attention to the phrase "in
proper cases" in Section 384 of PD 612 and argues that the prescriptive
period was interrupted upon the extrajudicial demand for payment made
by FGU on petitioner
ISSUE:
Whether the claim of Insurance Corporation is barred by prescription
under section 384 of PD No. 612.
HELD:
In the present case, it is not denied that an extrajudicial demand for
payment was made by respondent FGU on petitioner but petitioner failed
to respond to the same. Nevertheless the complaint was filed even
before a denial of the claim was made by petitioner. For all legal
purposes, the one-year prescriptive period provided for in Section 384 of
the Insurance Code has not begun to run. The cause of action arises
only and starts to run upon the denial of the claim by the insurance
company.
FACTS:
The facts show that Caltex Philippines (Caltex for brevity) entered into a
contract of affreightment with the petitioner, Delsan Transport Lines, Inc.,
for a period of one year whereby the said common carrier agreed to
transport Caltexs industrial fuel oil from the Batangas-Bataan Refinery to
different parts of the country. Under the contract, petitioner took on board
its vessel, MT Maysun 2,277.314 kiloliters of industrial fuel oil of Caltex
to be delivered to the Caltex Oil Terminal in Zamboanga City. The
shipment was insured with the private respondent, American Home
Assurance Corporation.
On August 14, 1986, MT Maysum set sail from Batangas for Zamboanga
City. Unfortunately, the vessel sank in the early morning of August 16,
1986 near Panay Gulf in the Visayas taking with it the entire cargo of fuel
oil.
Subsequently, private respondent paid Caltex the sum of Five Million
Ninety-Six Thousand Six Hundred Thirty-Five Pesos and Fifty-Seven
Centavos (P5,096,635.67) representing the insured value of the lost
cargo. Exercising its right of subrogation under Article 2207 of the New
Civil Code, the private respondent demanded of the petitioner the same
amount it paid to Caltex.1wphi1.nt
Due to its failure to collect from the petitioner despite prior demand,
private respondent filed a complaint with the Regional Trial Court of
Makati City, Branch 137, for collection of a sum of money.
ARGUMENTS:
Petitioner Delsan Transport Lines, Inc. invokes the provision of Section
113 of the Insurance Code of the Philippines, which states that in every
marine insurance upon a ship or freight, or freightage, or upon any thin
which is the subject of marine insurance there is an implied warranty by
the shipper that the ship is seaworthy.
Private respondent argues that the vessel was not seaworthy
ISSUE: Whether or not the payment made by the private respondent to
Caltex for the insured value of the lost cargo amounted to an admission
that the vessel was seaworthy, thus precluding any action for recovery
against the petitioner.
HELD:
The payment made by the private respondent for the insured value of the
lost cargo operates as waiver of its (private respondent) right to enforce
the term of the implied warranty against Caltex under the marine
insurance policy. However, the same cannot be validly interpreted as an
automatic admission of the vessels seaworthiness by the private
respondent as to foreclose recourse against the petitioner for any liability
under its contractual obligation as a common carrier. The fact of payment
grants the private respondent subrogatory right which enables it to
exercise legal remedies that would otherwise be available to Caltex as
owner of the lost cargo against the petitioner common carrier.
DISCUSSION ON HOW THE SC RULED THE CASE
INC., petitioner,
AMERICAN
HOME
ISSUE: WHETHER OR NOT THE INSURER COMPANY SHOULD PAY THE SAID
CLAIM.
RULING: YES. WHERE THE INSUREDS CAR IS WRONGFULLY TAKEN WITHOUT
THE INSUREDS CONSENT FROM THE CAR SERVICE AND REPAIR SHOP TO
WHOM IT HAD BEEN ENTRUSTED FOR CHECK-UP AND REPAIRS (ASSUMING
THAT SUCH TAKING WAS FOR A JOY RIDE, IN THE COURSE OF WHICH IT WAS
TOTALLY SMASHED IN AN ACCIDENT), RESPONDENT INSURER IS LIABLE AND
MUST PAY INSURED FOR THE TOTAL LOSS OF THE INSURED VEHICLE UNDER
THE THEFT CLAUSE OF THE POLICY. ASSUMING, DESPITE THE TOTALLY
INADEQUATE EVIDENCE, THAT THE TAKING WAS TEMPORARY AND FOR A JOY
RIDE, THE COURT SUSTAINS AS THE BETTER VIEW THAT WHICH HOLDS THAT
WHEN A PERSON, EITHER WITH THE OBJECT OF GOING TO A CERTAIN PLACE,
OR LEARNING HOW TO DRIVE, OR ENJOYING A FREE RIDE, TAKES POSSESSION
OF A VEHICLE BELONGING TO ANOTHER, WITHOUT THE CONSENT OF ITS
OWNER, HE IS GUILTY OF THEFT BECAUSE BY TAKING POSSESSION OF THE
PERSONAL PROPERTY BELONGING TO ANOTHER AND USING IT, HIS INTENT TO
GAIN IS EVIDENT SINCE HE DERIVES THERE FROM UTILITY, SATISFACTION,
ENJOYMENT AND PLEASURE. ACCORDINGLY, THE APPEALED DECISION IS
SET ASIDE AND JUDGMENT IS HEREBY RENDERED SENTENCING PRIVATE
RESPONDENT TO PAY PETITIONER THE SUM OF P35,000.00 WITH LEGAL
INTEREST FROM THE FILING OF THE COMPLAINT UNTIL FULL PAYMENT IS MADE
AND TO PAY THE COSTS OF SUIT.
ISSUE:
WHETHER OR NOT PHILAMLIFE RECEIVED THE APPLICATION PRIOR TO THE
DEATH OF CHUANG AND THEREBY BE HELD LIABLE.
ISSUE:
WHETHER OR NOT FIELDMENS SHOULD BE HELD LIABLE.
RULING OF THE COURT:
YES.
IT IS A WELL-SETTLED JURISPRUDENCE THAT WHERE INEQUITABLE CONDUCT
IS SHOWN BY AN INSURANCE FIRM, IT IS "ESTOPPED FROM ENFORCING
FORFEITURES IN ITS FAVOR, IN ORDER TO FORESTALL FRAUD OR IMPOSITION
ON THE INSURED." AS ESTOPPEL IS PRIMARILY BASED ON THE DOCTRINE OF
GOOD FAITH AND THE AVOIDANCE OF HARM THAT WILL BEFALL THE
INNOCENT PARTY DUE TO ITS INJURIOUS RELIANCE, THE FAILURE TO APPLY IT
IN THIS CASE WOULD RESULT IN A GROSS TRAVESTY OF JUSTICE.
ARGUMENTS:
PETITIONER CONTENDS THAT THE MATTER ABOUT THE NOTICE IS DEEMED
THUS, THE MERE INACTION OF THE INSURER DOES NOT TERMINATE THE
CONTRACT. HAVING PROVED THAT PHILAMLIFE RECEIVED THE LETTER PRIOR
TO THE DEATH AND FAILURE ON THE PART OF THE LATTER TO PRODUCE
EVIDENCE AGAINST IT, PHILAMLIFE IS DEEMED TO HAVE RECEIVED THE
APPLICATION.
FIELDMENS INSURANCE CO. VS. VDA DE SONGCO
G.R. NO. 24833 SEPTEMBER 23, 1986
FACTS:
FEDERICO SONGCO, OWNER OF A PRIVATE JEEPNEY, WAS INDUCED BY THE
AGENT OF FIELDMENS INSURANCE CO. TO APPLY FOR A COMMON
CARRIERS INSURANCE POLICY WHICH WAS LATER RENEWED. DURING THE
EFFECTIVITY OF THE RENEWED POLICY, THE JEEPNEY COLLIDED WITH A CAR
RESULTING DEATH TO FEDERICO AND HIS SON. NOW, THE SURVIVING SPOUSE
OF FEDERICO SEEKS RELIEF TO FIELDMENS. THE COMPANY REFUSED TO
PAY.
ARGUMENTS:
THE AGENT OF FIELDMENS CONTENDS THAT SINCE THEY ARE NOT
GOVERNMENT-OWNED, THEY COULD DO WHAT THEY PLEASE WHENEVER THEY
ISSUE:
WHETHER OR NOT PETITIONER SHOULD HAVE APPLIED THE INSTALLMENT
PAYMENTS MADE BY PRIVATE RESPONDENTS FOR THE PAYMENT OF THE CAR
TO THE PAYMENT OF THE INSURANCE PREMIUMS WITHOUT PRIOR NOTICE TO
PRIVATE RESPONDENTS.
ISSUE:
WHETHER OR NOT MALAYAN HAS A RIGHT OF RELIEF AGAINST ATI.
RULING:
YES.
Non-presentation of the insurance contract or policy is not necessarily
fatal. The subrogation receipt, by itself, is sufficient to establish not only
the relationship of insurer and the assured shipper of the lost cargo, but
also the amount paid to settle the insurance claim. The right of
subrogation accrues simply upon payment by the insurance company of
the insurance claim.
Since there was no issue regarding the validity of the insurance contract
or policy, or any provision thereof, respondent had no reason to present
the insurance contract or policy as evidence during the trial.
THE
MANUFACTURERS
LIFE
INSURANCE
CO
vs.
BIBIANO L. MEER, in the capacity as Collector of Internal Revenue
ISSUE/S:
(a) Whether or not premium advances made by plaintiffappellant under the automatic premium loan clause of its policies are
"premium collected" by the Company subject to tax
(b) Whether or not, in the application of the automatic premium
loan clause of plaintiff-appellant's policies, there is "payment in money,
notes, credit, or any substitutes for money
FACTS:
Manufacturer Life Insurance Company is a corporation duly
organized in Canada with head office at Toronto. It is duly registered and
licensed to engage in life insurance business in the Philippines, and
maintains a branch office in Manila. It was engaged in such business in
the Philippines for more than five years before and including the year
1941. But due to the exigencies of the war it closed the branch office at
Manila during 1942 up to September 1945.
In the course of its operations before the war, plaintiff issued a
number of life insurance policies in the Philippines containing stipulations
referred to as non-forfeiture clauses.
Since the insured failed to pay from 1942 to 1946, the
company applied the provision of the automatic premium loan clauses;
and the net amount of premiums so advanced or loaned totaled
P1,069,254.98. On this sum the defendant Collector of Internal Revenue
assessed P17,917.12. The assessment was made pursuant to section
255 of the NIRC which put taxes on insurance premiums paid by money,
notes, credits or any substitutes for money.
There was new credit for the advances made. True, the company could
not sue the insured to enforce that credit. But it has means of satisfaction
assets. Cash surrender value "as applied to life insurance policy, is the
amount of money the company agrees to pay to the holder of the policy if
he surrenders it and releases his claims upon it. The more premiums the
insured has paid the greater will be the surrender value; but the
2.
condition is always a part of the policy, but, like any other part of an
express contract, may be written in the margin, or contained in proposals
or documents expressly referred to in the policy, and so made a part of
it."
FACTS:
Ang Giok Chip doing business under the name and style of
Hua Bee Kong Si was formerly the owner of a warehouse situated at No.
643 Calle Reina Regente, City of Manila. The contents of the warehouse
were insured with the three insurance companies for the total sum of
P60,000. One insurance policy, in the amount of P10,000, was taken out
with the Springfield Fire & Marine Insurance Company. The warehouse
was destroyed by fire on January 11, 1928, while the policy issued by the
latter company was in force.
The insurance company interposed its defense on a rider in
the policy in the form of Warranty F, fixing the amount of hazardous good
that can be stored in a building to be covered by the insurance. They
claimed that Ang violated the 3 percent limit by placing hazardous goods
to as high as 39 percent of all the goods stored in the building. His suit to
recover was granted by the trial court.
ISSUE:
Other insurance without the consent of Pioneer would avoid the contract.
It required no affirmative act of election on the part of the company to
make operative the clause avoiding the contract, wherever the specified
conditions should occur. Its obligations ceased, unless, being informed of
the fact, it consented to the additional insurance.
PIONEER
INSURANCE
&
SURETY
CORPORATION
vs.
over "MV Asilda" together with her freight and appurtenances for the
purpose of limiting and extinguishing its liability under Art. 587 of the
Code of Commerce. 2
ISSUE:
Whether or not Pioneer is the real party in interest with regard
to the portion of the indemnity paid.
Issue:
It is clear from the records that Pioneer sued in its own name
and not as an attorney-in-fact of the reinsurer.
Facts:
Coca-Cola Bottlers Philippines, Inc., loaded on board "MV Asilda," a
vessel owned and operated by respondent Felman Shipping Lines
(FELMAN for brevity), 7,500 cases of 1-liter Coca-Cola soft drink bottles
to be transported from Zamboanga City to Cebu City for consignee
Coca-Cola Bottlers Philippines, Inc., Cebu. 1 The shipment was insured
with petitioner Philippine American General Insurance Co., Inc.
(PHILAMGEN for brevity), under Marine Open Policy No. 100367-PAG.
"MV Asilda" left the port of Zamboanga in fine weather at eight o'clock in
the evening of the same day. At around eight forty-five the following
morning, the vessel sank in the waters of Zamboanga del Norte bringing
down her entire cargo with her including the subject 7,500 cases of 1liter Coca-Cola soft drink bottles. The consignee Coca-Cola Bottlers
Philippines, Inc., Cebu plant, filed a claim with respondent FELMAN.
Respondent denied the claim thus prompting the consignee to file an
insurance claim with PHILAMGEN.Claiming its right of subrogation
PHILAMGEN sought recourse against respondent FELMAN which
disclaimed any liability for the loss. Consequently, PHILAMGEN sued the
ship owner.
Arguments:
In its complaint PHILAMGEN alleged that the sinking and total loss of
"MV Asilda" and its cargo were due to the vessel's unseaworthiness as
she was put to sea in an unstable condition. It further alleged that the
vessel was improperly manned and that its officers were grossly
negligent in failing to take appropriate measures to proceed to a nearby
port or beach after the vessel started to list.FELMAN filed a motion to
dismiss based on the affirmative defense that no right of subrogation in
favor of PHILAMGEN was transmitted by the shipper, and that, in any
event, FELMAN had abandoned all its rights, interests and ownership
Documentary stamp taxes were paid based only on the par value
of P5,000,000.00 and not on the book value.
Facts:
On 22 Januar y 1987, For tune Life and Genera l
In surance Co., In c. (For tune) issued Fire Insuran ce Policy
136171 in favor of Violeta R. Tibay and/or Nicolas Roraldo on their twostorey residential building located at 5855 Zobel Street, Makati City,
together with all their personal effects therein. The insurance was for
P600, 000.00 covering the period from 23 January 1987 to 23 January
1988. On 23 January 1987, of the total premium of P2,983.50, petitioner
Violeta Tibay only paid P600.00 thus leaving a considerable balance
unpaid. On 8 March 1987 the insured build ing wa s
comple tel y destro ye d by fire . Two days late r Violeta Tibay paid
the balance of the premium. On the same day, she filed with Fortune a
claim on the fire insurance policy. Her claim was accordingly referred
to its adjuster, Goodwill Adjustment Services,Inc. (GASI), which
immediately wrote Violeta requesting her to furnish it with the necessary
documents for the investigation and processing of her claim. Petitioner
forthwith complied. On 28 March 1987 she signed a non-waiver
agreement with GASI to the effect that any action taken by the
companies or their representatives in investigating the claim made by the
claimant for his loss which occurred at 5855 Zobel Roxas, Makati on
8March 1987, or in the investigating or ascertainment of the amount of
actual cash value and loss, shall not waive or invalidate any condition of
the policies of such companies held by said claimant, nor the rights of
either or any of the parties to this agreement, and such action shall not
be, or be claimed to be, an admission of liability on the part of said
companies or any of them. In a letter Fortune denied the claim of Violeta
for violation of Policy Condition 2 and of Section 77 of the Insurance
Code. Efforts to settle the case before the Insurance Commission proved
futile. Violeta and the other petitioners( Antonio Tibay, Ofel ia M .
Roraldo, Victo rina M. Roraldo , Virgil io M. Roraldo, M yr na M .
Roraldo, and Rosabella M . Rora ldo) sued For tune for
damages
in
the
amoun t
of
the
total
coverage of the fire insurance policy plus 12% inter
est per annum, P100,000.00 moral damages, and
attorney's fees equivalent to 20% of the total claim
Argument:
Petitioners maintain otherwise. Insisting that
FORTUNE is liable on the policy despite partial payment of the premium
due and the express stipulation thereof to the contrary, petitioners rely
heavily on the 1967 case of Philippine Phoenix and Insurance Co.,
Inc. v. Woodworks, Inc. 8 where the Court through Mr. Justice Arsenio P.
Dizon sustained the ruling of the trial court that partial payment of the
premium made the policy effective during the whole period of the policy.
In that case, the insurance company commenced action against the
insured for the unpaid balance on a fire insurance policy. In its defense
the insured claimed that nonpayment of premium produced the
cancellation of the insurance contract.
i.
Facts:
August 1982 and this time was found to have "acute bronchitis."
Canilang was issued ordinary life insurance with the face value of
P19,700.
On 5 August 1983, Canilang died of "congestive heart failure,"
"anemia," and "chronic anemia." The wife as beneficiary, filed a claim
with Grepalife which the insurer denied on the ground that the insured
had concealed material information from it.
Argument:
ii.
Issue:
the contract.
the diagnosis made and the medicines prescribed by such doctor, in the
insurance application, it may be reasonably assumed that Grepalife
would have made further inquiries and would have probably refused to
issue a non-medical insurance policy or, at the very least, required a
higher premium for the same coverage.
RESPONDENT:
The defendant denied the claim, on the ground they
defendant's investigation revealed that the entire shipment of logs
covered by the two marines policies No. 53 110 1032 and 713 HO 1033
were received in good order at their point of destination. It was further
stated that the said loss may be considered as covered under Cover
Note No. 1010 because the said Note had become 'null and void by
virtue of the issuance of Marine Policy Nos. 53 HO 1032 and 1033.
PETITIONER:
Petitioner contendd that the Cover Note was issued
with a consideration when, by express stipulation, the cover note is
made subject to the terms and conditions of the marine policies, and the
payment of premiums is one of the terms of the policies.
not depend upon the state of mind of Jaime Canilang. A man's state of
mind or subjective belief is not capable of proof in our judicial process,
ISSUE:
RULING: It is not disputed that petitioner paid in full all the premiums as
called for by the statement issued by private respondent after the
issuance of the two regular marine insurance policies, thereby leaving no
account unpaid by petitioner due on the insurance coverage, which must
be deemed to include the Cover Note. If the Note is to be treated as a
separate policy instead of integrating it to the regular policies
subsequently issued, the purpose and function of the Cover Note would
be set at naught or rendered meaningless, for it is in a real sense a
contract, not a mere application for insurance which is a mere offer.
DISCUSSION:
It may be true that the marine insurance policies
issued were for logs no longer including those which had been lost
during loading operations. This had to be so because the risk insured
against is not for loss during operations anymore, but for loss during
transit, the logs having already been safely placed aboard. This would
make no difference, however, insofar as the liability on the cover note is
concerned, for the number or volume of logs lost can be determined
independently as in fact it had been so ascertained at the instance of
private respondent itself when it sent its own adjuster to investigate and
assess the loss, after the issuance of the marine insurance policies.
Case # 57
FACTS: The plaintiff secured temporary insurance from the defendant
for its exportation of 1,250,000 board feet logs.The defendant issued
Cover Note No. 1010, insuring the said cargo of the plaintiff. The regular
marine cargo policies were issued by the defendant in favor of the
plaintiff. The two marine policies bore the numbers 53 HO 1032 and 53
HO 1033. After the issuance of Cover Note No. 1010, but before the
issuance of the two marine policies Nos. 53 HO 1032 and 53 HO 1033,
some of the logs intended to be exported were lost during loading
operations.
The plaintiff subsequently submitted a 'Claim Statement
demanding payment of the loss under Policies Nos. 53 HO 1032 and 53
HO 1033.
ARGUMENTS:
Case # 58
FACTS: Fire Policy, an open policy, was issued to the Paramount Shirt
Manufacturing Co. by which private respondent Oriental Assurance
Corporation bound itself to indemnify the insured for any loss or damage
caused by fire to its property.
Said policy was duly endorsed to petitioner as mortgagee/ trustor of the
properties insured, with the knowledge and consent of private
respondent to the effect that "loss if any under the policy is payable to
the Pacific Banking Corporation".
While the aforesaid policy was in full force and effect, a fire broke out on
the subject premises destroying the goods . Petitioner sent a letter of
demand to private respondent for indemnity .
At the trial, petitioner presented evidence, a communication of the
insurance adjuster to Asian Surety Insurance Co., Inc., revealing
undeclared co-insurances with the following: with Wellington Insurance;
with Empire Surety and with Asian Surety; undertaken by insured
Paramount on the same property covered by its policy with private
ISSUE:
RULING: It is not disputed that the insured failed to reveal before the
loss three other insurances. By reason of said unrevealed insurances,
the insured had been guilty of a false declaration; a clear
misrepresentation and a vital one because where the insured had been
asked to reveal but did not, that was deception. Otherwise stated, had
the insurer known that there were many co-insurances, it could have
hesitated or plainly desisted from entering into such contract. Hence, the
insured was guilty of clear fraud
DISCUSSION:
Concrete evidence of fraud or false declaration by
the insured was furnished by the petitioner itself when the facts alleged
in the policy under clauses "Co-Insurances Declared" and "Other
Insurance Clause" are materially different from the actual number of coinsurances taken over the subject property. Consequently, "the whole
foundation of the contract fails, the risk does not attach and the policy
never becomes a contract between the parties. Representations of facts
are the foundation of the contract and if the foundation does not exist,
the superstructure does not arise. Falsehood in such representations is
not shown to vary or add to the contract, or to terminate a contract which
has once been made, but to show that no contract has ever existed.
TAN vs. CA and THE PHILIPPINE AMERICAN LIFE INSURANCE
COMPANY
G.R. No. 48049
Case no. 60
FACTS: Qua Chee Gan owned four warehouses or bodegas used for
the storage of stocks of copra and of hemp, baled and loose, in which
the appellee dealth extensively. They had been, with their contents,
insured with the defendant Company.
Fire of undetermined origin that broke out and lasted almost
one week, gutted and completely destroyed Bodegas Nos. 1, 2 and 4,
with the merchandise stored theren. Plaintiff-appellee informed the
insurer by telegram, the fire adjusters engaged by appellant insurance
company arrived and proceeded to examine and photograph the
premises, pored over the books of the insured and conducted an
extensive investigation. The plaintiff having submitted the corresponding
fire claims, the Insurance Company resisted payment.
Case # 59
FACTS: Tan Lee Siong, applied for life insurance with respondent
company, with petitioners the beneficiaries thereof. Tan Lee Siong died
of hepatoma. Petitioners then filed with respondent company their claim
for the proceeds of the life insurance policy. However, respondent
company denied petitioners' claim and rescinded the policy .
ARGUMENTS:
RESPONDENT:
Alleged misrepresentation and concealment of
material facts made by the deceased Tan Lee Siong in his application for
insurance.
PETITIONERS:
Contend that the respondent company no longer
had the right to rescind the contract of insurance as rescission must
allegedly be done during the lifetime of the insured within two years and
prior to the commencement of action.
ISSUE:
RULING: Sec. 48. xxx After a policy of life insurance made payable on
the death of the insured shall have been in force during the lifetime of the
insured for a period of two years from the date of its issue or of its last
reinstatement, the insurer cannot prove that the policy is void ab initio or
is rescindable by reason of the fraudulent concealment or
misrepresentation of the insured or his agent.
ARGUMENTS:
RESPONDENT:
warranty.
DISCUSSION:
It is usually held that where the insurer, at the time
of the issuance of a policy of insurance, has knowledge of existing facts
which, if insisted on, would invalidate the contract from its very inception,
such knowledge constitutes a waiver of conditions in the contract
inconsistent with the facts, and the insurer is estopped thereafter from
asserting the breach of such conditions. The law is charitable enough to
assume, in the absence of any showing to the contrary, that an insurance
Facts:
Enrique Mora, owner of an Oldsman sedan mortgaged the same to the
HS Reyes Inc. Thereafter, the automobile was insured with the State
Bonding & Insurance Co., Inc with the provision that Loss, if any, is
payable to HS Reyes Inc. by virtue of the fact that said Oldsman sedan
was mortgaged in favor of the latter.
During the effectivity of the insurance contract, the car met with an
accident. Enrique Mora, without the knowledge and consent of HS
Reyes Inc. authorized Bonifacio Bros. Inc. to furnish the labor and
materials and some of which were supplied by the Ayala Auto Parts Co.
Proceeds of the insurance policy was not given to Bonifacio Bros. Inc.
and Ayala Auto Parts Co., hence, complaint was filed before Municipal
Court of Manila against Enrique Mora and the insurance company for the
labor and materials supplied.
The appellants argued that they are privy to the contract. On the other
hand, the insurance company maintains that appellants are not
mentioned in the contract as parties thereto nor is there any clause or
provision from which it can be inferred that there is an obligation on the
part of the insurance company to pay the cost of repairs directly to them.
Issue: Whether there is privity of contract between the Bonifacio Bos.
Inc and the Ayala Auto Parts Co. on the one hand and the insurance
company on the other.
Ruling:
The appellants are not privy to the contract, hence, they have no right of
action against the insurance company.
case of repair of the car in question. The loss payable clause of the
insurance policy stipulates that Loss, if any, is payable to HS Reyes,
Inc indicating that it was only the HS Reyes Inc. which they intended to
benefit.
Malayan Insurance Co., Inc (MICO) vs Gregoria Cruz Arnaldo and
Coronacion Pinca
that the cancellation was actually sent to and received by the insured.
Adora, incidentally, had not been informed of the cancellation either and
saw no reason not to accept the said payment. As to the authority of
Adora to receive payment, Payment to an agent having the authority to
receive or collect payment is equivalent to payment to the principal
himself; such payment is complete when the money delivered is into the
agents hand and is a discharge of the indebtedness owing to the
principal
On December 24, 1981, payment of the premium for Pinca was received
by Domingo Adora, agent of MICO.
Facts:
On January 15, 1982, Adora remitted this payment to MICO, together
with other payments.
On January 18, 1982, Pincas property was completely burned.
On February 5, 1982, Pincas payment was returned by MICO to Adora
on the ground that her policy had been cancelled earlier but Adora
refused to accept.
Pinca made demands for payment but MICO rejected. Such demand
was sustained by the respondent Insurance Commission, hence this
petition. The petitioner argues that there was no payment of premium
and that the policy had been cancelled before the occurrence of the loss.
Also, Adora was not authorized to accept the premium payment because
six months had elapsed since the issuance of the insurance policy and
such acceptance was prohibited by the policy itself. It is also argued that
this prohibition was binding upon Pinca, who made the payment to Adora
at her own risk as she was bound to first check his authority to receive it.
On May 12, 1962, Kwong Nam applied for a 20-year endowment insurance on his life
for the sum of P20,000.00, with his wife, appellee Ng Gan Zee, as beneficiary. On the
same date, appellant, upon receipt of the required premium from the insured, approved
the application and issued the corresponding policy.
Upon Kwong Nams death due to cancer of the liver with metastasis, appellant denied
the claim on the ground that the answers given by the insured to the questions
appearing in his application for life insurance were untrue. Appellant further maintain
that when the insured was examined in connection with his application for life insurance
he gave the appellants medical examiner false and misleading information as to his
aliment and previous operation. Appellant argues that the insureds statement in hi
application that a tumor hard and of a hens egg size was removed during said
operation, constituted material concealment.
Issue:
Issue: Whether there exists an insurance contract at the time of the loss
sustained by Pinca.
Whether the insurance company, because of the insureds representation, was mislead
or deceived into entering the contract.
Ruling:
Yes. There exists a valid contract of insurance.
Ruling:
No. It bears emphasis that Kwong Nam had informed the appellants medical examine
that the tumor for which he was operated on was associated with ulcer of the stomach
and in the absence of evidence that the insured had sufficient medical knowledge as to
enable him to distinguish between peptic ulcer and a tumor, his statement should be
construed as an expression made in good faith of his belief as to the nature of hi
ailment and operation. Thus, concealment exists where the assured had knowledge o
a fact material to the risk, and honesty, good faith and fair dealing requires that he
should communicate it to the assurer, but he designedly and intentionally withholds the
same. Indeed kwong Nams statement must be presumed to have been made by him
without knowledge of its incorrectness and without any deliberate intent on his part to
mislead the appellant.
Also, it has been held that where, upon the face of the application, a question appear
to be not answered at all or to be imperfectly answered, and the insurer issued a polic
without any further inquiry, they waive the imperfection of the answer and render the
omission to answer more fully immaterial.
Ruling:
The Philippine American Life Insurance Co. vs Hon. Gregorio
Pineda and Dimayuga
G.R. No. 54216. July 19, 1989
Facts:
No. The applicable law in the instant case is the Insurance Act,
otherwise known as Act No. 2427 as amended, the policy having been
procured in 1968. Under the said law, the beneficiary designated in a life
insurance contract cannot be changed without the consent of the
beneficiary because he has a vested interest in the policy (Gercio v. Sun
Life Ins. Co. of Canada, 48 Phil. 53; Go v. Redfern and the International
Assurance Co., Ltd., 72 Phil. 71).
The contract between the parties is the law binding on both of them and
for so many times, this court has consistently issued pronouncements
upholding the validity and effectivity of contracts. Where there is nothing
in the contract which is contrary to law, good morals, good customs,
public policy or public order the validity of the contract must be
sustained. Likewise, contracts which are the private laws of the
contracting parties should be fulfilled according to the literal sense of
their stipulations, if their terms are clear and leave no room for doubt as
to the intention of the contracting parties, for contracts are obligatory, no
matter in what form they may be, whenever the essential requisites for
their validity are present (Phoenix Assurance Co., Ltd. vs. United States
Lines, 22 SCRA 675, Phil. American General Insurance Co., Inc. vs.
Mutuc, 61 SCRA 22.)