Part 2 - Insurance Digested Cases

Embed Size (px)

Citation preview

  • 8/11/2019 Part 2 - Insurance Digested Cases

    1/31

    1

    Gallardo vs. Morales

    G.R. No. L-12189 April 29, 1960Lessons Applicable: Definition and Coverage of Life

    Insurance (Insurance)

    Laws Applicable: Rule 39, section 12, subdivision (k) of the Rules ofCourt (old law)

    FACTS:

    CFI: Hermenegilda S. Morales to pay P7,000 to a creditorFrancisca Gallardo

    writ of execution was issued and delivered to the Sheriffwho garnished and levied execution on the sum of P7,000 outof the P30,000 due from the CapitalInsurance & Surety Co. Inc.,to Morales as beneficiary whose husband Luis Morales diedby assassination.

    Morales asked the sheriff to quash and lift said garnishment orlevy on execution invoking Rule 39, section 12, subdivision (k)of the Rules of Court but it was denied.

    All moneys, benefits, privileges, or annuities accruing or in anymanner growing out of any life insurance, if the annualpremiums paid do not exceedfive hundred pesos, and if theyexceed that sum a like exemption shall exist which shall bearthe same proportion to the moneys, benefits, privileges, andannuities so accruing or growing out of such insurance thatsaid five hundredpesos bears to the whole annual premiumspaid.

    Morales appealed maintaining that it was a life insurance for itinsured her husband for injuries and/or death as a result ofmurder or assault or attempt thereat

    ISSUE: W/N the insurance is a life insurance and not an

    accident insurance

    HELD: NO. order appealed from is reversed, and the garnishment indispute hereby set aside and quashed

    the annual premium was for P15 If it were an ordinary life insurance policy, taking into account

    that the insured, Luis G. Morales, was 38 years of age and theamount of the policy was for P50,000.00 the annual premium

    would have been around P1,206 the period for the policy was stipulated for one year, andconsiderations as to age, health, occupation and other personalcircumstances were not taken into account in an accidentinsurance policy

    Annex "1" of the opposition, shows that theCapital Insurance and Surety Company Inc. is a non-lifeinsurance company and that the only authority granted to it totransact business covers fire, marine, surety, fideli ty, accident,

    motor car, and miscellaneous insurance, except life insurance Accident vs Life Insurance Policy accident policy - merely insures the person from injury and or

    death resulting from murder, assault, or an attempt thereat Accident insurance indemnity or casualty contract life insurance policy - what is insured is the life of the subject for

    a definite number of years

    http://www.philippinelegalguide.com/2011/11/jurisprudence-gr-no-l-12189_7310.htmlhttp://www.philippinelegalguide.com/2011/11/jurisprudence-gr-no-l-12189_7310.html
  • 8/11/2019 Part 2 - Insurance Digested Cases

    2/31

    2

    life insurance investment contract contract by which the insurer, for a stipulated sum, engages to

    pay a certain amount of money if another dies within the time

    limited by the policy contract for insurance for one year in consideration of an

    advanced premium, with the right of assured to continue itfrom year to year upon payment of a premium as stipulated

    includes accident insurance, since life is insured under eithercontract

    includes all policies of insurance in which paymentof insurance money is contingent upon loss of life

    "any life insurance"

    applies to ordinary life insurance contracts, as well as to thosewhich, although intended primarily to indemnify for risks arisingfrom accident, likewise, insure against loss of life due, either toaccidental causes, or to the willful and criminal act of another,which, as such, is not strictly accidental in nature

    1. statutes of this nature seek to enable the head of the family tosecure his widow and children from becoming a burden upon thecommunity and, accordingly, should merit a liberal interpretation1 .

    throw or drop (something) from an ai rcraft or ship."six aircraft jettisoned their loads in the sea"

    o

    noun

    Calanoc vs. CA (98 PHIL 79)

    Facts: Basilio was a watchman of the Manila Auto Supply located atthe corner of Avenida Rizal and Zurbaran. He secured a lifeinsurance policy from the Philippine American Life Insurance Company in the amount of P2,000 to which was attached asupplementary contract covering death by accident.On January 25, 1951, he died of a gunshot wound on the occasionof a robbery committed in the house of Atty. Ojeda at the corner ofOroquieta and Zurbaran streets.

    Calanoc, the widow, was paid the sum of P2,000, face value of thepolicy, but when she demanded the payment of the additional sumof P2,000 representing the value of the supplemental policy, thecompany refused alleging, as main defense , that the deceased diedbecause he was murdered by a person who took part in thecommission of the robbery and while making an arrest as an officerof the law which contingencies were expressly excluded in thecontract and have the effect of exempting the company fromliability.

    It is contended in behalf of the company that Basilio was killedwhich "making an arrest as an officer of the law" or as a result of an"assault or murder" committed in the place and therefore his deathwas caused by one of the risks excluded by the supplementary

    contract which exempts the company from liability. This contentionwas upheld by the Court of Appeals. Hence, this petition.

    http://coffeeafficionado.blogspot.com/2012/02/calanoc-vs-ca-98-phil-79.htmlhttp://coffeeafficionado.blogspot.com/2012/02/calanoc-vs-ca-98-phil-79.html
  • 8/11/2019 Part 2 - Insurance Digested Cases

    3/31

  • 8/11/2019 Part 2 - Insurance Digested Cases

    4/31

  • 8/11/2019 Part 2 - Insurance Digested Cases

    5/31

    5

    proviso that excludes the (insurer's) liability, in case death or injuryis intentionally inflicted by any other person, applies to this case."

    G.R. No. L-21574 June 30, 1966

    Dela Cruz vs. Capital

    Lessons Applicable: Liability of Insurer for Suicide and AccidentalDeath (Insurance)Laws Applicable:

    FACTS:

    Eduardo de la Cruz, employed as a mucker in the Itogon-SuyocMines, Inc. in Baguio, was the holder of an accident insurancepolicy "against death or disability caused by accidental means"

    January 1, 1957: For the celebration of the New Year, theItogon-Suyoc Mines, Inc. sponsored a boxing contest for generalentertainment wherein Eduardo, a non-professional boxerparticipated

    In the course of his bout with another non-professional boxer ofthe same height, weight, and size, Eduardo slipped and was hit

    by his opponent on the left part of the back of the head, causingEduardo to fall, with his head hitting the rope of the ring He was brought to the Baguio General Hospital the following

    day. He died due to hemorrhage, intracranial. Simon de la Cruz, the father of the insured and who was named

    beneficiary under the policy, thereupon filed a claim with theinsurance company

    The Capital Insurance and Surety co., inc denied stating thatthe death caused by his participation in a boxing contest wasnot accidental

    RTC: favored Simon

    ISSUE: W/N the cause of death was accident

    HELD:YES.

    Eduardo slipped, which was unintentional The terms "accident" and "accidental" as used in insurance contracts, have not acquired any

    technical meaning and are construed by the courts in their

    ordinary and common acceptation happen by chance or fortuitously, without intention and design,

    and which is unexpected, unusual, and unforeseen event that takes place without one's foresight or expectation event that proceeds from an unknown cause, or is an unusual

    effect of a known cause and, therefore, not expected where the death or injury is not the natural or probable result

    of the insured's voluntary act, or if something unforeseenoccurs in the doing of the act which produces the injury, the

    resulting death is within the protection ofpoliciesinsuring against death or injury from accident

    while the participation of the insured in the boxing contest isvoluntary, the injury was sustained when he slid, givingoccasion to the infliction by his opponent of the blow thatthrew him to the ropes of the ring is not

    http://www.philippinelegalguide.com/2011/11/jurisprudence-gr-no-l-21574_5011.htmlhttp://www.philippinelegalguide.com/2011/11/jurisprudence-gr-no-l-21574_5011.html
  • 8/11/2019 Part 2 - Insurance Digested Cases

    6/31

    6

    The fact that boxing is attended with some risks of externalinjuries does not make any injuries received in the course of thegame not accidental

    In boxing as in other equally physically rigorous sports, such as

    basketball or baseball, death is not ordinarily anticipated toresult. If, therefore, it ever does, the injury or death can onlybe accidental or produced by some unforeseen happening orevent as what occurred in this case

    Furthermore, the policy involved herein specifically excludedfrom its coverage (e) Death or disablement consequent upon the Insuredengaging in football, hunting, pigsticking, steeplechasing, polo-playing, racing of any kind, mountaineering, or motorcycling.

    Death or disablement resulting from engagement in boxingcontests was not declared outside of the protection ofthe insurance contract

    Sun Insurance Office Ltd. vs. Court of Appeals [GR

    92383, 17 July 1992]

    Facts: Sun Insurance Office Ltd. issued Personal Accident Policy05687 to Felix Lim, Jr. with a face value of P200,000.00. Two monthslater, he was dead with a bullet wound in his head. As beneficiary,his wife NerissaLim sought payment on the policy but her claim was rejected. SunInsurance agreed that there was no suicide.It argued, however, that there was no accident either. Pilar Nalagon,Lim's secretary, was the only eyewitness

    Commercial Law Insurance Law, 2006 ( 47 )Narratives (BerneGuerrero)to his death. It happened on 6 October 1982, at about 10 p.m., after

    his mother's birthday party. According to Nalagon, Lim was in ahappy mood (but not drunk) and was playing with his handgun,from which he had previously removed the magazine. As shewatched the television, he stood in front of her and pointed the gunat her. She pushed it aside and said it might be loaded. He assuredher it was not and then pointed it to his temple. The next momentthere was an explosion and Lim slumped to the floor. He was deadbefore he fell.

    The widow sued Sun Insurance in the Regional Trial Court ofZamboanga City and was sustained. Sun Insurance was sentenced topay her P200,000.00, representing the face value of the policy, withinterest at the legal rate; P10,000.00 as moral damages; P5,000.00as exemplary damages; P50,000.00 as actual and compensatorydamages; and P5,000.00 as attorney's fees, plus the cost of the suit.

    This decision was affirmed on appeal, and the motion forreconsideration was denied. Sun Insurance then came to the

    Supreme Court.Issue: Whether the insured willfully exposed himself to needlessperil and thus removed himself from the coverage of the insurancepolicy.Held: NO. An accident is an event which happens without anyhuman agency or, if happening through human agency, an eventwhich, under the circumstances, is unusual to and not expected bythe person to whom it

  • 8/11/2019 Part 2 - Insurance Digested Cases

    7/31

    7

    happens. It has also been defined as an injury which happens byreason of some violence or casualty to the insured without hisdesign, consent, or voluntary co-operation. Herein, the incident thatresulted in Lim's

    death was indeed an accident. On the other hand, the parties agreethat Lim did not commit suicide.

    Nevertheless, Sun Insurance contends that the insured willfullyexposed himself to needless peril and thus removed himself fromthe coverage of the insurance policy. It should be noted at theoutset that suicide andwillful exposure to needless peril are in pari materia because theyboth signify a disregard for one's life.

    The only difference is in degree, as suicide imports a positive act ofending such life whereas the second act indicates a reckless riskingof it that is almost suicidal in intent. The posture -- that by the mereact of pointing the gun to his temple, Lim had willfully exposedhimself to needless peril and so came under the exception -- isarguable. But what is not is that Lim had removed the magazinefrom the gun and believed it was no longer dangerous. Heexpressed assured her that the gun was not loaded. It is submitted

    that Lim did not willfully expose himself to needless peril when hepointed the gun to his temple because the fact is that hethought it was not unsafe to do so.

    The act was precisely intended to assure Nalagon that the gun wasindeedharmless. Lim was unquestionably negligent and that negligencecost him his own life. But it should not prevent his widow from

    recovering from the insurance policy he obtained precisely againstaccident. There isnothing in the policy that relieves the insurer of the responsibility topay the indemnity agreed upon if the insured is shown to have

    contributed to his own accident. Indeed, most accidents are causedby negligence.

    There are only four exceptions expressly made in the contract torelieve the insurer from liability, and none of these exceptions isapplicable in the present case. It bears noting that insurancecontracts are as a rule supposed to be interpreted liberally in favorof the assured. There is no reason to deviate from this rule,especially in view of the circumstances of the case.

    Jarque v Smith G.R. No. L-32986 November 11, 1930J. Ostrand

    Facts:The plaintiff was the owner of the motorboat Pandan and held amarine insurance policy for the sum of P45,000 on the boat, thepolicy being issued by the National Union Fire Insurance Companyand according to the provisions of a "rider" attached to the policy,the insurance was against the "absolute total loss of the vesselonly."

    The ship ran into very heavy sea off the Islands of Ticlin, and itbecame necessary to jettison a portion of the cargo. As a result ofthe jettison, the National Union Fire Insurance Company was

  • 8/11/2019 Part 2 - Insurance Digested Cases

    8/31

    8

    assessed in the sum of P2,610.86 as its contribution to the generalaverage. The insurance company, insisting that its obligation did notextend beyond the insurance of the "absolute total loss of thevessel only, and to pay proportionate salvage of the declared

    value," refused to contribute to the settlement of the generalaverage.

    The present action was thereupon instituted,and after t rial thecourt below rendered judgment in favor of the plaintiff and orderedthe company to pay the plaintiff the sum of P2,610.86 as its part ofthe indemnity The insurance company appealed to this court.

    Issues:

    1. WON the lower court erred in disregarding the typewritten clauseendorsed upon the policy, Exhibit A, expressly limiting insurer'sliability thereunder of the total loss of the wooden vesselPandan and to proportionate salvage charges

    2. WON the lower court erred in concluding that defendant andappellant, National Union Fire Insurance Company is liable tocontribute to the general average resulting from the jettison of apart of said vessel's cargo.

    Held: No to both. Petition dismissed.

    Ratio:1. One of the clauses of the document originally read as follows:Touching the Adventures and Perils which the said National UnionFire Insurance Company is content to bear, and to take upon themin this Voyage; they are of the Seas, Men-of-War, Fire, Pirates,

    Rovers, Thieves, Jettison, Letters of Mart and Countermart,Surprisals, and Takings at Sea. Arrest, Restraint and Detainments, ofall Kings Princes and People of what Nation, Condition or Quality soever; Barratry of the Master and Marines, and of all other Perils,

    Losses and Misfortunes, that have or shall come to the Hurt,Detriment, or Damage of the said Vessel or any part thereof; and incase of any Loss or Misfortunes, it shall be lawful for the Assured,his or their Factors, Servants, or assigns, to sue, labor and travel for,in and about the Defense. Safeguard, and recovery of the saidVessel or any Charges whereof the said Company, will contribute,according to the rate and quantity of the sum herein assured shallbe of as much force and Virtue as the surest Writing or Policy ofInsurance made in LONDON. Attached to the policy over and above

    the said clause is a "rider" containing typewritten provisions, amongwhich appears in capitalized type the followingclause:

    AGAINST THE ABSOLUTE TOTAL LOSS OF THE VESSEL ONLY, AND TOPAY PROPORTIONATE SALVAGE CHARGES OF THE DECLARED VALUE.

    At the bottom of the same rider following the type writtenprovisions therein set forth are the following words: "Attaching to

    and forming part of the National Union Fire Insurance Co., HullPolicy No. 1055."

    It is a well settled rule that in case repugnance exists betweenwritten and printed portions of a policy, the written portionprevails, and there can be no question that as far as anyinconsistency exists, the above-mentioned typed "rider" prevailsover the printed clause it covers. Section 291 of the Code of Civil

  • 8/11/2019 Part 2 - Insurance Digested Cases

    9/31

    9

    Procedure provides that "when an instrument consists partly ofwritten words and partly of a printed form and the two areinconsistent, the former controls the latter.

    2. In the absence of positive legislation to the contrary, the liabilityof the defendant insurance company on its policy would, perhaps,be limited to "absolute loss of the vessel only, and to payproportionate salvage of the declared value."But the policy was executed in this jurisdiction and "warranted totrade within the waters of the Philippine Archipelago only." Herethe liability for contribution in general average is not based on theexpress terms of the policy, but rest upon the theory that from therelation of the parties and for their benefit, a quasi contract is

    implied by law. Article 859 of the Code of Commerce is still in forceand reads as follows:

    ART. 859. The underwriters of the vessel, of the freight, and of thecargo shall be obliged to pay for the indemnity of the gross averagein so far as is required of each one of these objects respectively. Thearticle is mandatory in i ts terms, and the insurers, whether for thevessel or for the freight or for the cargo, is bound to contribute tothe indemnity of the general average. It simply places the insurer on

    the same footing as other persons who have an interest in thevessel, or the cargo therein at the time of the occurrence of thegeneral average and who are compelled to contribute.

    In the present case it is not disputed that the ship was in grave periland that the jettison of part of the cargo was necessary. If the cargowas in peril to the extent of call for general average, the ship mustalso have been in great danger, possibly sufficient to cause its

    absolute loss. The jettison was therefore as much to the benefit ofthe underwriter as to the owner of the cargo. If no jettison had takeplace and if the ship by reason thereof had foundered, theunderwriter's loss would have been many times as large as the

    contribution now demanded.

    Fortune Insurance and Surety Co., Inc., vs. CA [G.R. No.115278, May 23, 1995]

    Facts: On June 29, 1987, Producers Bank of the Philippines armoredvehicle was robbed, in transit, of seven hundred twenty-five

    thousand pesos (Php 725,000.00) that it was transferring from itsbranch in Pasay to its main branch in Makati. To mitigate their loss,they claim the amount from their insurer, namely Fortune Insuranceand Surety Co..

    Fortune Insurance, however, assails that thegeneral exemptionclause in the Casualty Insurance coverage had ageneral exemptionclause, to wit:

    GENERAL EXCEPTIONS

    The company shall not be liable under this policy in respect of

    xxx xxx xxx

    (b) any loss caused by any dishonest, fraudulent or criminal act ofthe insured or any officer, employee, partner, director, trustee orauthorized representative of the Insured whether acting alone or inconjunction with others. . . .

    http://coffeeafficionado.blogspot.com/2012/02/fortune-insurance-and-surety-co-inc-vs.htmlhttp://coffeeafficionado.blogspot.com/2012/02/fortune-insurance-and-surety-co-inc-vs.htmlhttp://coffeeafficionado.blogspot.com/2012/02/fortune-insurance-and-surety-co-inc-vs.htmlhttp://coffeeafficionado.blogspot.com/2012/02/fortune-insurance-and-surety-co-inc-vs.html
  • 8/11/2019 Part 2 - Insurance Digested Cases

    10/31

  • 8/11/2019 Part 2 - Insurance Digested Cases

    11/31

  • 8/11/2019 Part 2 - Insurance Digested Cases

    12/31

    12

    that Herdman had any authority to make any contract, either parolor in writing, that would bind the company. There is no evidence toshow that he had any policies in his possession.

    Nor is there any evidence that Herdman ever undertook to makeany parol contract with Badger for this insurance. There had beensome correspondence between the parties prior to the making ofthe application on July 5. On that day Herdman, writing to Badger inregard to the medical examination, said:

    I will send you an official receipt when your remittancereaches the office, and then a new examination will not benecessary when the policies are delivered; otherwise this

    would be necessary.

    After Badger had received the receipt of Herdman for the moneysent to him and on July 11, he wrote to Herdman, saying:

    Yours of the 9th instant received. Is the receipt you sentofficial or not? I do not wish to take another examination,and so desire an official receipt.

    xxx xxx xxx

    Shall I be obliged to wait until you receive an answer fromthe office in New York, or do you have authority to issuepolicies at the Manila office?

    xxx xxx xxx

    If my application is accepted does insurance begin July 5,1902?

    In reply to this letter, Herdman, on July 15, wrote, saying:

    The receipt I sent you is official, being signed by me ascashier and not personally, and of course there will not beanother examination required.

    xxx xxx xxx

    We issue an interim policy from our Shanghai office, whichstands until the definite policy comes from New York. Wehope soon to have an advisory board here in Manila, so thatwe will be entirely free from Shanghai, all our otherbusiness being transacted directly with the home officer atNew York.

    If your examination is acceptable, your policy will date fromJuly 5, the date of your application.

    This evidence shows conclusively that there was no parolagreement between the parties that the insurance had commencedon July 5, 1902. In fact, the claim of the appellant reduced to itslowest terms is that the mere signing of an application for lifeinsurance and the payment of a first premium, without any parolagreement as to when the insurance shall commence, constitutes acontract between the parties binding from that date. Such acontention as this can not be sustained.

  • 8/11/2019 Part 2 - Insurance Digested Cases

    13/31

  • 8/11/2019 Part 2 - Insurance Digested Cases

    14/31

    14

    ENRIQUEZ V. SUNLIFE- INSURANCE POLICY 41 PHIL 269

    Facts: > On Sept. 24 1917, Herrer made an application to SunLife throughits office in Manila for life annuity.> 2 days later, he paid the sum of 6T to the companys anager in itsManila office and was given a receipt.> On Nov. 26, 1917, the head office gave notice of acceptance bycable to Manila. On the same date, the Manila office prepared aletter notifying Herrer that his application has been accepted andthis was placed in the ordinary channels of transmission, but as faras known was never actually mailed and never received by Herrer.> Herrer died on Dec. 20, 1917. The plaintiff as administrator ofHerrers estate brought this action to recover the 6T paid by thedeceased.

    Issue:

    Whether or not the insurance contract was perfected.

    Held: NO. The contract for life annuity was NOT perfected because it had NOTbeen proved satisfactorily that the acceptance of the applicationever came to the knowledge of the applicant. An acceptance of anoffer of insurance NOT actually or constructively communicated tothe proposer does NOT make a contract of insurane, as the locus

    poenitentiae is ended when an acceptance has passed beyond thecontrol of the party.

    NOTE: Life annuity is the opposite of a life insurance. In life annuity,

    a big amount is given to the insurance company, and if after acertain period of time the insured is stil living, he is entitled toregular smaller amounts for the rest of his life. Examples of Lifeannuity are pensions. Life Insurance on the other hand, the insuredduring the period of the coverage makes small regular paymentsand upon his death, the insurer pays a big amount to hisbeneficiaries.

    Vda de Sindayen v Insular September 4, 1935G.R. No. 41702J. Butte

    Facts:

    Sindayen, employed in the Bureau of Printing at Manila went toTarlac, to spend the Christmas vacation with his aunt. There heapplied for for life insurance in the sum of P1,000 and paid to the

    agent P15 cash as part of the first premium. It was agreed with theagent that the policy, when and if issued, should be delivered to hisaunt with whom he left sum of P26.06 to complete the payment ofthe first annual premium of P40.06. Sindayen returned to Manilaand resumed his work a linotype operator. The company acceptedthe risk after examining Sindayen and issued a policy and to thesame agent for delivery to the insured. Sindayen abruptly passedaway.

  • 8/11/2019 Part 2 - Insurance Digested Cases

    15/31

    15

    The policy which the company issued was received by its agent inTarlac. The agent delivered the policy to Felicidad Estrada upon herpayment of the balance of the first years annual premium. Theagent asked Felicidad Estrada if her nephew was in good health and

    she replied that she believed so. He gave her the policy. The agentlearned of the death of Arturo Sindayen and the aunt to return thepolicy. He did not return or offer to return the premium paid. Theaunt gave him the policy.

    The company obtained from the beneficiary, the widow of ArturoSindayen, her signature to alegal document entitled ACCORD,SATISFACTION AND RELEASE In consideration of the sum of P40.06paid to her by a check of the company, she discharged the companyfor all claims . The said check for P40.06 was never cashed butreturned to the company. The widow brought action to enforcepayment of the policy. The first premium was already paid by theinsured covering the period from December 1 , 1932. It is toDecember 1, 1933. Hence, this appeal.

    Issue: WON the said policy never took effect because of paragraph 3of the application for at the time of its delivery by the agent the

    insured was not in good health.

    Held: No. Petition granted.

    Ratio:

    The application which the insured signed in Tarlac, containedamong others the following provisions:

    3. That the said policy shall not take effect until the first premiumhas been paid and the policy has been delivered to and accepted byme, while I am in good health.

    There is one line of cases which holds that the stipulation containedin paragraph 3 is in the nature of a condition precedent, that is tosay, that there can be no valid delivery to the insured unless he is ingood health at the time. A number of these cases, on the otherhand, go to the of holding that the delivery of the policy by theagent to the insured consummates the contract even though theagent knew that the insured was not in good health at the time, thetheory being that his knowledge is the companys knowledge and

    his delivery of the policy is the companys delivery.

    We are inclined to the view that it is more consonant with the wellknown practice of life insurancec ompanies and the evidence in thepresent case to rest our decision on the proposition that Mendozawas authorized by the company to make the delivery of the policywhen he received the payment of the first premium and he wassatisfied that the insured was in good health.

    In the case of MeLaurin vs. Mutual Life Insurance Co. -It is plain,therefore, that upon the facts it is not necessarily a case of waiver

    or of estoppel, but a case where the local agents, in the exercise ofthe powers lodged in them, accepted the premium and deliveredthe policy. That act binds their principal, the defendant.

    The evidence in the record shows that Mendoza had the authority,given him by the company, to withhold the delivery of the policy tothe in sured until the first premium has been paid and the policyhas been delivered to and accepted by me (the insured) while

  • 8/11/2019 Part 2 - Insurance Digested Cases

    16/31

    16

    I am in good health. Mendozas decision that the condition hadbeen met by the insured and that it was proper to make a deliveryof the policy to him is just as binding on the company as if thedecision had been made by its board of directors.

    It is the interest not only the applicant but of all insurancecompanies as well that there should be some act which gives theapplicant the definite assurance that the contract has beenconsummated. A cloud will be thrown over the entire insurancebusiness if the condition of health of the insured at the time ofdelivery of the policy may be required into years afterwards withthe view to avoiding the policy on the ground that it never tookeffect because of an alleged lack of good health, at the time ofdelivery.

    When the policy is issued and delivered it is plainly not within theintention of the parties that there should be any questions held inabeyance or reserved for future determination. It would be a mostserious handicap to business if the very existence of the contractremains in doubt even though the policy has been issued anddelivered with all the formalities required by the law. The deliveryof the policy to the insured by an agent is the final act which bindsthe company and insured in the absence of fraud or other legal

    ground for rescission. The fact that the agent to whom it hasentrusted this duty is derelict or negligent or even dishonest inthe performance of the duty which has been entrusted to himwould create a liability of the agent to the company but does notresolve the companys obligation based upon the authorized acts ofthe agent toward a third party who was not in collusion with theagent.

    4. That the agent taking this application has no authority to make,

    modify or discharge contracts, or to waive any of the Companysright or requirements .

    Paragraph 4 of the application to the effect is not in point. Mendozaneither waived nor pretended to waive any right or requirement ofthe company. In fact, his inquiry as to the state of health of theinsured discloses that he was endeavoring to assure himself thatthis requirement of the company had been satisfied. In doing so, heacted within the authority conferred on him by his agency and hisacts within that authority bind the company. The companytherefore having decided that all the conditions precedent to thetaking effect of the policy had been complied with, it is nowestopped to assert that it never intended that the policy should takeeffect.

    G.R. No. 105562 September 27, 1993

    Lessons Applicable: Who Exercises Rights of Minor Insured orBeneficiaries (Insurance)

    Laws Applicable: Art. 225 Family Code

    FACTS:

    Prime Marine Services, Inc. (PMSI), a crewing/manning outfit,procured Group PoIicyfrom Insular Life Assurance Co., Ltd. to provide life insurancecoverage to its sea-based employees enrolled under the plan.

    http://www.philippinelegalguide.com/2011/11/jurisprudence-gr-no-105562_5555.htmlhttp://www.philippinelegalguide.com/2011/11/jurisprudence-gr-no-105562_5555.html
  • 8/11/2019 Part 2 - Insurance Digested Cases

    17/31

  • 8/11/2019 Part 2 - Insurance Digested Cases

    18/31

    18

    of Capt. Nuval for the collection and receipt of such proceedswas a deviation from its practice with respect to group policies.

    Group Insurance coverage terms for group insurance are usually stated in a

    master agreement or policy that is issued by the insurer to arepresentative of the group or to an administrator of theinsurance program

    employer acts as a functionary in the collection and payment ofpremiums and in performing related duties

    falling within the ambit of administration of a group policy is thedisbursement of insurance payments by the employer to theemployees

    employee is in the position of a real party to the master policy

    employees is the true source of the benefits, which are a formof additional compensation to them

    enables the employees to carry a larger amount of insurancethan they could otherwise, and helps to attract and hold apermanent class of employees

    Even granting for the sake of argument that the special powersof attorney were in due form, Insular Life was grossly negligentin delivering the checks, drawn in favor of the petitioners, to aparty who is not the agent mentioned in the special power of

    attorney Nor can we agree with the opinion of the public respondent

    that since the shares of the minors in the insurance proceedsare less than P50,000.00, then under Article 225 of the FamilyCode their mothers could receive such shares without need ofeither court appointments as guardian or the posting of a bond

    Art. 225. The father and the mother shall jointly exercise legalguardianship over the property of their unemancipated

    common child without the necessity of a court appointment. Incase of disagreement, the father's decision shall prevail, unlessthere is judicial order to the contrary.

    Where the market value of the property or the annual income ofthe child exceeds P50,000, the parent concerned shall be requiredto furnish a bond in such amount as the court may determine, butnot less than ten per centum (10%) of the value of the property orannual income, to guarantee the performance of the obligationsprescribed for general guardians.

    It is clear from the said Article that regardless of the value of theunemancipated 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 incomeof the child exceeds P50,000.00, a bond has to be posted by theparents concerned to guarantee the performance of the obligationsof a general guardian.

    It must, however, be noted that the second paragraph of Article225 of the Family Code speaks of the "market value of theproperty or the annual income of the child," which means,

    therefore, the aggregate of the child's property or annualincome; if this exceeds P50,000.00, a bond is required.

    There is no evidence that the share of each of the minors in theproceeds of the group policy in question is the minor's onlyproperty. Without such evidence, it would not be safe toconclude that, indeed, that is his only property.

  • 8/11/2019 Part 2 - Insurance Digested Cases

    19/31

    19

    GREPALIFE V. CA 89 SCRA 543

    Facts: > On March 14, 1957, respondent Ngo Hing filed an applicationwith Grepalife for a 20-yr endowment policy for 50T on the life ofhis one year old daughter Helen Go.

    > All the essential data regarding Helen was supplied by Ngo toLapu-Lapu Mondragon, the branch manager of Grepalife-Cebu.Mondragon then typed the data on the application form which waslater signed by Ngo.

    > Ngo then paid the insurance premium and a binding depositreceipt was issued to him. The binding receipt contained thefollowing provision: If the applicant shall not have been insurable

    xxx and the Company declines to approve the application, theinsurance applied for shall not have been in force at any time andthe sum paid shall be returned to the applicant upon the surrenderof thi s receipt. > Mondragon wrote on the bottom of the application form hisstrong recommendation for the approval of the insuranceapplication.> On Apr 30, 1957, Mondragon received a letter from GrepalifeMain office disapproving the insurance application of Ngo for thesimple reason that the 20yr endowment plan is not available forminors below 7 yrs old.> Mondragon wrote back the main office again stronglyrecommending the approval of the endowment plan on the life of

    Helen, adding that Grepalife was the only insurance company NOTselling endowment plans to children.> On may 1957, Helen died of influenza with complication ofbroncho pneumonia. Ngo filed a claim with Gepalife, but the latter

    denied liability on the ground that there was no contract betweenthe insurer and the insured and a binding receipt is NOT evidence ofsuch contract.

    Issue: Whether or not the binding deposit receipt, constituted atemporary contract of life insurance.

    Held:

    NO. The binding receipt in question was merely an acknowledgement onbehalf of the company, that the latters branch office had receivedfrom the applicant, the insurance premium and had accepted theapplication subject for processing by the insurance company, andthat the latter will either approve or reject the same on the basis ofwhether or not the applicant is insurable on standard rates.

    Since Grepalife disapproved the insurance application of Ngo, thebinding deposit receipt had never became on force at any time,pursuant to par. E of the said receipt. A binding receipt is manifestlymerely conditional and does NOT insure outright. Where anagreement is made between the applicant and the agent, NOliability shall attach until the principal approves the risk and areceipt is given by the agent.

  • 8/11/2019 Part 2 - Insurance Digested Cases

    20/31

    20

    The acceptance is merely conditional, and is subordinated to the actof the company in approving or rejecting the application. Thus inlife insurance, a binding slip or binding receipt does NOT insure byitself.

    TANG V. CA- INSURANCE FRAUD OR MISTAKE 90 SCRA 236

    Facts: > On Sept. 25, 2965, Lee Su Guat, widow, 61 years old and illiteratewho spoke only Chinese, applied for life insurance for 60T withPhilamlife. The application was in two parts, both in English.> The second part dealt with her state of health. Her answershaving shown that she was health, Philamlife issued her a policyeffective Oct. 23, 1965 with her nephew Vicente Tang asbeneficiary.> On Nov. 15, 1965, Lee again applied for additional insurance ofher life for 40T. Since it was only recent from the time she firstapplied, no further medical exam was made but she accomplishedPart 1 (which certified the truthfulness of statements made in Part.2)> The policy was again approved. On Apri 20 1966, Lee Su Guatdied of Lung cancer.> Tang claimed the amount o 100T but Philamlife refused to pay onthe ground that the insured was guilty of concealment andmisrepresentation.> Both trial court and CA ruled that Lee was guilty of concealment.> Tang s position, however, is that because Lee was illiterate andspoke only Chinese, she could not be held guilty of concealment of

    her health history because the application for insurance wasEnglish, and the insurer has not proven that the terms thereof hadbeen fully explained to her as provided by Art. 1332 of CC.

    Issue:

    Whether or not Art. 1332 applies.

    Held: NO. Art. 1332 is NOT applicable. Under said article, the obligation toshow that the terms of the contract had been fully explained to theparty who is unable to read or understand the language of the

    contract, when fraud or mistake is alleged, devolves on the partyseeking to enforce it. Here, the insurance company is NOT seekingto enforce the contract; on the contrary, it is seeking to avoid itsperformance.

    It is petitioner who is seeking to enforce it, even as fraud or mistakeis NOT alleged. Accordingly, Philamlife was under no obligation toprove that the terms of the insurance contract were fully explainedto the other party. Even if we were to say that the insurer is the

    one seeking the performance of the cont contracts by avoidingpaying the claim, it has to be noted as above stated that there hasbeen NO imputation of mistake of fraud by the illiterate insuredwhose personality is represented by her beneficiary. In sum, Art.1332 is inapplicable, and considering the findings of both the trialcourt and the CA as to the Concealment of Lee, the SC affirms theirdecisions.

  • 8/11/2019 Part 2 - Insurance Digested Cases

    21/31

    21

    Concurring: J., AntonioIn a contract of insurance, each party must communicate to theother, in good faith, all facts within his knowledge which arematerial to the contract, and which the other has no means of

    ascertaining. As a general rule, the failure by the insured to discloseconditions affecting the risk of which he is aware makes thecontract voidable at the option of the insurer.

    The reason for this rule is that insurance policies are traditionallycontracts uberrimae fidei, which means most abundant goodfaith, absolute and perfect candor or openness and honesty,absence of any concealment or deception however slight. Herethe CA found that the insured deliberately concealed material facts

    about her physical condition and history and/or concealed withwhoever assisted her in relaying false information to the medicalexaminer. Certainly, the petitioner cannot assume inconsistentpositions by attempting to enforce the contract of insurance for thepurpose of collecting the proceeds of the policy and at the sametime nullify the contract by claiming that it was executed throughfraud or mistake.

    NOTE: Art. 1332: When one of the parties is unable to read or if the

    contract is in a language not understood by him, and mistake orfraud is alleged, the person enforcing the contract must show thatthe terms thereof have been fully explained to him.

    G.R. No. L-18529

    FRANCISCO G. ALEJA, FELICITACION GAMBOA-ALEJA andDOMINADOR ALEJA, plaintiffs-appellants,vs.GOVERNMENT SERVICE INSURANCE SYSTEM, defendant-appellee.Restituto L. Joson for plaintiffs-appellants. Bartolome S. Palma fordefendant-appellee. Barrera, J.: This is an appeal by Francisco G. Aleja, et al., from the decision ofthe Court of First Instance of Nueva Ecija (in Civil Case No. 3335)dismissing their complaint against the Government ServiceInsurance System (GSIS) and denying their claim to the proceeds ofthe insurance policy No. 310973 issued to the late Rosauro G. Aleja,on the ground that the deceased was not yet covered by insuranceat the time of his death.

    As found by the lower court, the deceased Rosauro G. Aleja wasappointed as temporary classroom teacher in the Bureau of PublicSchools, Division of Nueva Ecija, on July 8, 1958. Thereafter, a

    compulsory term insurance policy, No. 310973, was issued in hisname, said policy to take effect on February 1, 1959. Thecorresponding premium therefor was deducted for the first timefrom his salary on January 31, 1959. However, two days before thator on January 29, 1959, while guarding the rice stack in front of theirhouse, Rosauro Aleja died of a gunshot wound inflicted by his owngun. Plaintiffs, as beneficiaries named in the policy, filed a claimwith the GSIS to collect the proceeds of the said policy, but the

  • 8/11/2019 Part 2 - Insurance Digested Cases

    22/31

  • 8/11/2019 Part 2 - Insurance Digested Cases

    23/31

  • 8/11/2019 Part 2 - Insurance Digested Cases

    24/31

    24

    August 6, 1985 had filed a complaint for breach ofcontract with damages before the lower court

    August 13, 1985: Santos received through Carlito Ang the leeterof Assistant Vice-President Mariano M. Ampil III finding error

    on their part since premiums were notremitted Malapit, proposed to extend its lifetime to December17, 1985

    RTC: favored Santos - Prudential in Bad Faith CA: Reversed - not motivated by negligence, malice or bad faith

    in cancelling subject policyISSUE: W/N the Areolas can file against damages despite the effortto rectify the cancellation

    HELD: YES. RTC reinstated

    Malapit's fraudulent act of misappropriating the premiums paidis beyond doubt directly imputable to Prudential

    Art. 1910. The principal must comply with all the obligationswhich the agent may have contracted within the scope of hisauthority.

    As for any obligation wherein the agent has exceeded his power,the principal is not bound except when he ratifies it expressly ortacitly.

    Subsequent reinstatement could not possibly absolvePrudential there being an obvious breach of contract

    a contract of insurance creates reciprocal obligations for bothinsurer and insured

    Article 1191

    choice between fulfillment or rescission of the obligation incase one of the obligors fails to comply with what is incumbentupon him

    entitles the injured party to payment of damages, regardless of

    whether he demands fulfillment or rescission of the obligation Nominal damages are "recoverable where a legal right is

    technically violated and must be vindicated against an invasionthat has produced no actual present loss of any kind, or wherethere has been a breach of contract and no substantial injury oractual damages whatsoever have been or can be shown.

    CONSTANTINO V. ASIA LIFE- NON-PAYMENT OFINSURANCE PREMIUMS 87 PHIL 248

    Facts: > Appeal consolidates two cases.> Asia life insurance Company (ALIC) was incorporated in Delaware.> For the sum of 175.04 as annual premium duly paid to ALIC, itissued Policy No. 93912 whereby it insured the life of ArcadioConstantino for 20 years for P3T with Paz Constantino asbeneficiary. First premium covered the period up to Sept. 26, 1942. No

    further premiums were paid after the first premium andArcadio died on Sept. 22, 1944.

    > Due to Jap occupation, ALIC closed its branch office in Manilafrom Jan. 2 1942-1945.> On Aug. 1, 1938, ALIC issued Policy no. 78145 covering the lives ofSpouses Tomas Ruiz and Agustina Peralta for the sum of P3T for 20

  • 8/11/2019 Part 2 - Insurance Digested Cases

    25/31

  • 8/11/2019 Part 2 - Insurance Digested Cases

    26/31

  • 8/11/2019 Part 2 - Insurance Digested Cases

    27/31

    27

    Establecido y convenido que el nombramiento de Gomez era detemporero, la cuestion que tenemos que resolver essi al tiempo de sumuerte tenia tales cualificaciones quepodia ser considerado comoempleado regular y permanente para los efectos del cobro del importe desu poliza de seguro por la beneficiaria. Decidimos que si, tenia talescualificaciones.

    Resulta establecido en autos, sin discusion, que Gomez, acogiendose a lasdisposiciones del articulo 672 del Codigo Administrativo tal como fueenmendado por la ley del Commonwealth No. 177, se sometio a examende 2.ogrado enel servicio civil el 16 de Octubre, 1937, y fue aprobadoenaquel examen, si bien este favorable resultado no se anunciosinodespues ya de su muerte. Es obvio que los efectos de la aprobacion debenretrotraerse a la fecha del examen. La prueba de la competencia, de laidoneidad del examinando, se realizo antes de su muerte; por tanto, hayque darle efectividad desde la fecha en que tuvo lugar laprueba. Hastaparece superfluo que esto se discuta.

    Sin embargo, se arguye que no cabe dar efecto retroactivo a la aprobacionde Gomez en su examen, puesto que el articulo 663 (d) del CodigoAdministrativo Revisado, tal como ha sido enmendado, dispone que "aperiod of trial service shall be required before appointment oremploymentis made permanent;" y es claro que Gomez, habien domuertodespues del examen y antes de que su resultado seanunciara, mal pudo sersometido a dicho periodo de pruebapor 6 meses.

    Esta manera de interpretar la ley tiene el defecto deser demasiado literal,y "la letra mata (a veces), mientrasque el espiritu vivifica." Tengase encuenta que Gomez habia servido como tasador provincial delegado por 25aos consecutivos hasta el dia de su muerte. Cuando portan largo tiempopudo superar la prueba de su competencia, en el ejercicio cotidiano de susdeberes, hay que presumir que sus superiores estaban satisfechos de suidoneidad. Por tanto, el periodo de prueba de 6 meses no rezabacon el.

    Para los efectos, por lo menos, de la validez de su poliza de seguro, se debeconcluir que el exito desu examen le capacitaba y cualificabaautomaticamente para un nombramiento regular y permanente desde lafechade dicho examen. Por tanto, el era asegurable y, dehecho, estabaasegurado en el dia de su muerte, bajo losterminos de la Ley No. 186. Estaconclusion es tanto masjusta cuanto que el "Government Service InsuranceSystem" acepto practicamente la prima pagada, librando porella elcorrespondiente recibo.

    Nos sentimos perfectamente autorizados para interpretarla ley lo masliberalmente posible, toda vez que, prescindiendo ya de que en el presentecaso se trata de la viuday familia de un pequeo empleado, es evidenteque el Sistema Nacional de Seguro de Vida del Gobierno se hacreado parafines sociales y humanitarios, siendo parte deese generoso movimientouniversal que tiende a mejorarcada dia la suerte de los hijos del trabajomediante la promulgacion en todos los paises cultos y civilizados de leyesprogresivas y liberales sobre seguridad social y economica. El articulo 3 dela ley del Commonwealth No. 186 que crea y reglamenta dicho Sistema,dice positivamente que el mismose establece "en orden a promover laeficiencia y bien estarde los empleados del Gobierno de Filipinas yreemplazar los sistemas de pensiones actualmente establecidos . . .".Como se sabe, aquellos sistemas de pensioneseran fundamentalmente debeneficencia, tanto que si noha sido posible continuarlos era porque elgobierno no disponia de tanto dinero para capitalizarlos y sostener losporsi solo. Asi que se ha ideado el Sistema Nacional de Seguro sobre basesmas cientificas y con adecuadas aportaciones de los empleados mismos.Con todo, es innegableque el sucesor ha heredado parte de los rasgosbeneficos y humanitarios de sus antecesores.

    En meritos de lo expuesto, se revoca la sentencia del Juzgado y se condenaa la demandada y apelada a pagara la demandante y apelante la suma deP1,052, importe de la poliza de seguro del difunto Andres A. Gomez,

  • 8/11/2019 Part 2 - Insurance Digested Cases

    28/31

    28

    maslos intereses legales desde la interposicion de la demanda, y las costasdel juicio. Asi se ordena.

    Moran, Pres., Paras, Feria, Pablo, Hilado, Bengzon, Padilla, and Tuason ,

    MM., estan conformes.

    [G.R. No. 42874. October 22, 1935.]

    THE INSULAR LIFE ASSURANCE CO., LTD.,Plaintiff-Appellant , v.MARIA NARCISA SUVA, as administratrix of the intestate estate ofBenito Patrocinio Suva, defendant and appellee. FELICIDAD CRUZ,

    intervenor and appellant, MARIA NARCISA SUVA, Intervenor- Appellee .

    Araneta, Zaragoza & Araneta for plaintiff.

    Jose Gutierrez David for intervenors.

    SYLLABUS

    LIFE INSURANCE POLICY; ATTEMPTED CHANGE OF BENEFICIARY. The conclusion of the trial court is sustained by the decision in the

    case of Gercio v. Sun Life Assurance Co. of Canada (48 Phil., 53), andthe American authorities therein cited. The attempted change ofbeneficiary made by the insured on August 16, 1933, no right to

    change having been reserved, and endorsed by the company on theback of the policy on August 24, 1933, was due to a mutual mistake.

    The application in which the insured, over his personal signature,renounced the right to change the beneficiary, should prevail overthe printed phrase "WITH RIGHT OF REVOCATION" which occurs in

    the policy. It is to be noted that the application itself is made a partof the contract.

    D E C I S I O N

    BUTTE, J.:

    This is an appeal from a judgment of the Court of First Instance ofManila in an action brought by the Insular Life Assurance Co., Ltd.,for the cancellation of two policies of P5,000 each issued anddelivered by it upon the life of Benito Patrocinio Suva, nowdeceased. The action was originally brought only against theadministratrix of the estate of the insured, but by leave of court,

    Maria Narcisa Suva, in her own right, and Felicidad Cruz filed theirinterventions claiming to be the beneficiaries of the two policiesinvolved in this action.

    The first of the policies, numbered 47726, bears date of December1, 1932, and names as beneficiary Isabel Simbulan, the wife of theinsured. The second of the said policies, numbered 48819, bearsdate of February 1, 1933, and names as beneficiary the appellee,Maria Narcisa Suva, sister of the insured. The company

    acknowledges having received the premium due on said policies forthe first year and tenders the return of the same in its petition. Theintervenors, besides praying for judgment for the amount due onsaid policies, also pray for P1,000 each as damages.

    The ground alleged by the plaintiff for the cancellation of saidpolicies is that the insured made false statements as to the past andpresent state of his health in his applications which, by the terms of

  • 8/11/2019 Part 2 - Insurance Digested Cases

    29/31

    29

    the policies themselves, are made a part of the contract. Theapplicant was examined on October 17, 1932, by Dr. G. Ocampo,one of the physicians of the company. He was again examined onDecember 28, 1932, by Dr. M. Llora, a physician of the company

    sent out from the home office for that purpose. In connection withhis first application for pol icy No. 47726, among the numerousquestions with relation to specific diseases, the following questionsand answers appear in the report of Dr. Ocampo (ExhibitB):jgc:chanrobles.com.ph

    " Ha padecido V.2 alguna vez de las siguientes enfermedades . . .del pulmon, pleuriesia, pulomia, asma? No.

    " Ha escupido V. sangre? Por quecausa? No." No doubt israised as to the correctness of any other statements of theapplicant.

    The report of Dr. Ocampo is a detailed account of the completeexamination made by him. Item No. 30 of his report is as follows:"Encuentra V., despues de una cuidadosa interrogacion yreconocimiento, algn sintoma de padecimiento actual o anterior . .. de los pulmones? to which the doctor answered "No." Item 33 of

    his report is as follows:" Ha revisado V. cuidadosamente todas lascontestaciones de este reconocimiento y esta V. seguro de que sonclaras y completas?" to which the doctor answered "Si." Item 34 isas follows:" Cree V. que los informes dados por le solicitante sonverdaderos y completos en todos los conceptos?" to which thedoctor answered "Si." Item 35 is as follows:" Recomienda V., comorepresentante fiel de la compaia, que se acepte este riesgo comoexcelente, bueno, o que no se acepte?" to which the doctor

    answered "Si, que se acepte como excelente."cralaw virtua1awlibrary

    On December 28, 1932, when the applicant was examined by Dr. M.

    Llora, he was asked the same questions as were put to him by Dr.Ocampo. In the questions relating to his clinical history he wasasked: "Have you ever suffered from any ailment or disease of (c)the lungs, pleurisy, pneumonia or asthma? The applicant answered"Yes, trancazo 1918" and (h) "Have you ever spat blood? What wasit due to?" to which the applicant answered "No." No other answersmade by him are called in question in this litigation.

    In Dr. Lloras detailed report which appears on the back of said

    application, Exhibit C, appear the following:jgc:chanrobles.com.ph

    "Item 30: Do you find after careful inquiry and physical examinationany evidence of past or present disease . . . (d) of the lungs?

    "Answer: No."cralaw virtua1aw library

    "Item 34: Do you believe the party has given full and trueinformation in all respects?

    "Answer: Si.

    "Item 35: Would you classify applicant as first class, good, averageor poor risk?

    "Answer: Creo que es aceptable." His report concludes with thefollowing certificate:jgc:chanrobles.com.ph

  • 8/11/2019 Part 2 - Insurance Digested Cases

    30/31

    30

    "I CERTIFY that I have carefully examined Benito Patrocinio Suva ofArayat, Pampanga, in private, and not in the presence of any thirdperson, at Arayat, Pampanga, this 28th day of December, 1932, at

    5.15 oclock P. M. for an insurance of P5,000 for 20 C. P. years onthe applicants life; that I have asked each question exactly as s etforth on the other side of this sheet and that the applicantsanswers thereto are in my handwriting, and are exactly as made bythe applicant to me and that the applicant signed them in mypresence.

    (Sgd.) "M. LLORA, Med. Ex."cralaw virtua1aw library

    The insured died of pulmonary tuberculosis in the Chinese GeneralHospital in Manila on September 23, 1933.

    The substance of the plaintiffs cause of action is that thestatements made by the insured in his applications as abovequoted, were false and that the applicant was not in good healtheither at the time he presented his applications or on the date whensaid policies were delivered.

    Upon this issue of fact the learned trial judge made a complete andcareful analysis of the evidence. We accept his conclusions as to thecredibility of the witnesses. We have carefully re-examined theentire record and see no reason to disturb his findings of fact. Itseems to us the companys physicians were entirely warranted intheir conclusion that the insured was an acceptable risk. Thepreponderance of the evidence discloses that the applicant, a youngman 27 years of age and recently married, was devoted to vigorous

    athletic sports and regularly carried on his business as a farmer andcontractor up to May, 1933.

    In reply to the question in the printed application, "Are you in good

    health? he replied "Yes." If two qualified physicians, not selected byhim, independently examine a man with critical attention and in theinterest of their employer, the insurance company, and theypronounce him to be in good health, we should find it difficult todeclare that he knowingly made a false statement when he said hebelieved the same thing himself. "Good health" is a relative term. Aperson with sound body may honestly believe himself to be in"good health" although at the moment he may have a terrificheadache, or a running cold, or an attack of diarrhea, or indigestion,

    or any other of a host of minor common ailments which maypossibly develop later into a serious illness. A hemorrhage may bedue to any one of a variety of causes, grave or slight, having nonecessary relation with pulmonary tuberculosis. Even if we gavecredence to the testimony that Benito Patrocinio Suva spat bloodon one occasion in May, 1932, and another in August, 1932, there isno evidence whatever in the record as to the cause of the allegedhemorrhage. We have no right to jump at the conclusion that it wasgrave and could only be due to pulmonary tuberculosis, especially

    as it left no trace, for Drs. Ocampo and Llora found nothing wrongwith the applicant in October or December, 1932. No serious illnessprior to May, 1933, is established by the evidence. We agree withthe trial court that the applicant was in good health when thepolicies were delivered and that it is not proved that he made anymaterial false statement in his said applications for insurance.

    The appellant company complains that the trial court failed to

  • 8/11/2019 Part 2 - Insurance Digested Cases

    31/31

    31

    consider the death certificate signed by Dr. Tablante. This certificate(Exhibit J) states that Suva died in the Chinese General Hospital ofManila on September 23, 1933; that the cause of the death waspulmonary tuberculosis; that the duration of the disease was one

    year and five months. The source information of the latterstatement is not mentioned. Suva entered the hospital in August1933, and the certificate itself recites that Dr. Tablante treated himonly from August 18, 1933, to September 23, 1933. The plaintiff didnot offer Dr. Tablante as a witness and none of the hospital recordswere put in evidence. The statement of Dr. Tablante as to theduration of the disease is apparently hearsay and, under thecircumstances, we cannot give that recital in the certificate of deaththe conclusiveness which the plaintiff claims for it. (U.S. v. Que Ping,

    40 Phil., 17.)

    Felicidad Cruz appeals from that part of the judgment which holdsthat the insured, Benito Patrocinio Suva, having renounced in hisapplication the right to change the beneficiary in policy No. 47726,his wife, Isabel Simbulan, acquired a vested interest in the policywhich neither the insured nor the company could take from herwithout her consent. The conclusion of the trial court is sustainedby our decision in the case of Gercio v. Sun Life Assurance Co. of

    Canada (48 Phil., 53), and the American authorities therein cited.(We think that the attempted change of beneficiary made by theinsured on August 16, 1933, and endorsed by the company on theback of the policy on August 24, 1933, was due to a mutual mistake.The application in which the insured, over his personal signature,renounced the right to change the beneficiary, should prevail overthe printed phrase "WITH RIGHT OF REVOCATION" which occurs inthe policy. It is to be noted that the application itself is made a part

    of the contract.

    In view of the premises, the judgment is affirmed with costs againstthe appellant insurance company as to the appellee Maria Narcisa

    Suva and without special pronouncement as to costs in the appealof Felicidad Cruz.