Insurance Digests

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IGNACIO SATURNINO, in his own behalf and as the JUDICIAL GUARDIAN OF CARLOS SATURNINO, minor vs. THE PHILIPPINE AMERICAN LIFE INSURANCE COMPANY G.R. No. L-16163 - February 28, 1963 FACTS: Two months prior to the issuance of the policy or on September 9, 1957, Saturnino was operated on for cancer, involving complete removal of the right breast, including the pectoral muscles and the glands found in the right armpit. She stayed in the hospital for a period of eight days, after which she was discharged, although according to the surgeon who operated on her she could not be considered definitely cured, her ailment being of the malignant type. Notwithstanding the fact of her operation Estefania A. Saturnino did not make a disclosure thereof in her application for insurance. ISSUE: Whether or not the insured made such false representations of material facts as to avoid the policy. HELD: The Insurance Law (Section 30) provides that "materiality is to be determined not by the event, but solely by the probable and reasonable influence of the facts upon the party to whom the communication is due, in forming his estimate of the proposed contract, or in making his inquiries." It seems to be the contention of appellants that the facts subject of the representation were not material in view of the "non-medical" nature of the insurance applied for, which does away with the usual requirement of medical examination before the policy is issued. The contention is without merit. If anything, the waiver of medical examination renders even more material the information required of the applicant concerning previous condition of health and diseases suffered, for such information necessarily constitutes an important factor which the insurer takes into consideration in deciding whether to issue the policy or not. It is logical to assume that if appellee had been properly apprised of the insured's medical history she would at least have been made to undergo medical examination in order to determine her insurability. In this jurisdiction a concealment, whether intentional or unintentional, entitles the insurer to rescind the contract of insurance, concealment being defined as "negligence to communicate that which a party knows and ought to communicate"

PIONEER INSURANCE AND SURETY CORPORATION vs. OLIVA YAP, represented by her attorney-in-fact, CHUA SOON POON G.R. No. L-36232 - December 19, 1974 FACTS: Respondent Oliva Yap was the owner of a store in a two-storey building where she sold shopping bags and footwear, such as shoes, sandals and step-ins. Chua Soon Poon Oliva Yap's son-in-law, was in charge of the store. Respondent Yap took out Fire Insurance Policy No. 4216 from petitioner Pioneer Insurance & Surety Corporation covering her stocks, office furniture, fixtures and fittings of every kind and description. At the time of the insurance,an insurance policy was issued by the Great American Insurance Company covering the same properties was noted on said policy as co-insurance. Still later, respondent Oliva Yap took out another fire insurance policy covering the same properties, this time from the Federal Insurance Company, Inc., which new policy was, however, procured without notice to and the written consent of petitioner Pioneer Insurance & Surety Corporation and, therefore, was not noted as a co-insurance in Policy No. 4219. A fire broke out in the building housing respondent Yap's above-mentioned store, and the said store was burned. Respondent Yap filed an insurance claim, but the same was denied, on the ground of "breach and/or violation of any and/or all terms and conditions" of Policy No. 4219. ISSUE: Whether or not petitioner should be absolved from liability on Fire Insurance Policy No. 4219 on account of any violation by respondent Yap of the co-insurance clause therein. HELD: There was a violation by respondent Oliva Yap of the co-insurance clause contained in Policy No. 4219 that resulted in the avoidance of petitioner's liability. By the plain terms of the policy, other insurance without the consent of petitioner would ipso facto 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. The validity of a clause in a fire insurance policy to the effect that the procurement of additional insurance without the consent of the insurer renders ipso facto the policy void. The obvious purpose of the aforesaid requirement in the policy is to prevent over-insurance and thus avert the perpetration of fraud. The public, as well as the insurer, is interested in preventing the situation in which a fire would be profitable to the insured.

MELECIO COQUIA, MARIA ESPANUEVA and MANILA YELLOW TAXICAB CO., INC., vs. FIELDMEN'S INSURANCE CO., INC., G.R. No. L-23276 - November 29, 1968 FACTS: Fieldmen's Insurance Company, Inc. issued, in favor of the Manila Yellow Taxicab Co., Inc. a common carrier accident insurance policy, covering the period from December 1, 1961 to December 1, 1962. It was stipulated in said policy that: The Company will, subject to the Limits of Liability and under the Terms of this Policy, indemnify the Insured in the event of accident caused by or arising out of the use of Motor Vehicle against all sums which the Insured will become legally liable to pay in respect of: Death or bodily injury to any fare-paying passenger including the Driver, Conductor and/or Inspector who is riding in the Motor Vehicle insured at the time of accident or injury. 1 While the policy was in force, or on February 10, 1962, a taxicab of the Insured, driven by Carlito Coquia, met a vehicular accident at Mangaldan, Pangasinan, in consequence of which Carlito died. ISSUE: Whether or not the heirs of Coquia cannot claim from the policy. HELD: Pursuant to the stipulations, the Company "will indemnify any authorized Driver who is driving the Motor Vehicle" of the Insured and, in the event of death of said driver, the Company shall, likewise, "indemnify his personal representatives." In fact, the Company "may, at its option, make indemnity payable directly to the claimants or heirs of claimants ... it being the true intention of this Policy to protect ... the liabilities of the Insured towards the passengers of the Motor Vehicle and the Public" — in other words, third parties. Thus, the policy under consideration is typical of contracts pour autrui, this character being made more manifest by the fact that the deceased driver paid fifty percent (50%) of the corresponding premiums, which were deducted from his weekly commissions. Under these conditions, it is clear that the Coquias — who, admittedly, are the sole heirs of the deceased — have a direct cause of action against the Company,3 and, since they could have maintained this action by themselves, without the assistance of the Insured, it goes without saying that they could and did properly join the latter in filing the complaint herein.

TAURUS TAXI CO., INC., FELICITAS V. MONJE, ET AL, vs. THE CAPITAL INSURANCE & SURETY CO., INC., G.R. No. L-23491 - July 31, 1968 FACTS: Alfredo Monje, was employed as taxi driver by the plaintiff Taurus Taxi Co., Inc. On December 6, 1962, the taxi he was driving collided with a Transport Taxicab resulting in his death. At the time of the accident, there was subsisting and in force Commercial Vehicle Comprehensive Policy No. 101, 737 ... issued by the defendant to the Taurus Taxi Co., Inc. After the issuance of policy No. 101, 737, the defendant issued the Taurus Taxi Co., Inc. Indorsement No. 1 which forms part of the policy. Reference was then made to plaintiff-appellee Felicitas Monje being the widow of the taxi driver, the other plaintiffs-appellees with the exception of the Taurus Taxi Co., Inc., being the children of the couple. After which it was noted that plaintiff Taurus Taxi Co., Inc. made representations for the payment of the insurance benefit corresponding to her and her children since it was issued in its name, benefit corresponding to her and her children, but despite demands the defendant refused and still refuses to pay them. ISSUE: Whether or not a provision in the insurance contract that defendant-appellant will indemnify any authorized driver provided that [he] is not entitled to any indemnity under any other policy, it being shown that the deceased was paid his workman's compensation from another insurance policy, should defeat such a right to recover under the insurance contract subject of this suit. HELD: Since what is prohibited by the insurance policy in question is that any "authorized driver of plaintiff Taurus Taxi Co., Inc." should not be "entitled to any indemnity under any policy", it would appear indisputable that the obligation of defendant-appellant under the policy had not in any wise been extinguished. It is too well-settled to need the citation of authorities that what the law requires enters into and forms part of every contract. The Workmen's Compensation Act, explicitly requires that an employee suffering any injury or death arising out of or in the course of employment be compensated. The fulfillment of such statutory obligation cannot be the basis for evading the clear, explicit and mandatory terms of a policy. Assuming however that there is a doubt concerning the liability of defendant-appellant insurance firm, nonetheless, it should be resolved against its pretense and in favor of the insured. It was the holding in Eagle Star Insurance, Ltd. v. Chia Yu 6 that courts are to regard "with extreme jealousy" limitations of liability found in insurance policies and to construe them in such a way as to preclude the insurer from non-compliance with his obligation. In other words, to quote a noted authority on the subject, "a contract of insurance couched in language chosen by the insurer is, if open to the construction contended for by the insured, to be construed most strongly, or strictly, against the insurer and liberally in favor of the contention of the insured, which means in accordance with the rule contra proferentem."

QUA CHEE GAN, vs. LAW UNION AND ROCK INSURANCE CO., LTD., represented by its agent, WARNER, BARNES AND CO., LTD., G.R. No. L-4611 - December 17, 1955 FACTS: Plaintiff-appellee 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 since 1937, and the lose made payable to the Philippine National Bank as mortgage of the hemp and crops, to the extent of its interest. Fire of undetermined origin that broke out in the early morning of July 21, 1940, 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 on the same date; and on the next day, 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. Insurance Company resisted payment, claiming violation of warranties and conditions, filing of fraudulent claims, and that the fire had been deliberately caused by the insured or by other persons in connivance with him. ISSUE: Whether or not the policies be avoided for breach of warranty, specifically the one appearing on a rider pasted (with other similar riders) on the face of the policies. HELD: It is argued that since the bodegas insured had an external wall perimeter of 500 meters or 1,640 feet, the appellee should have eleven (11) fire hydrants in the compound, and that he actually had only two (2), with a further pair nearby, belonging to the municipality of Tabaco. The insurance company was aware, even before the policies were issued, that in the premises insured there were only two fire hydrants installed by Qua Chee Gan and two others nearby, owned by the municipality of TAbaco, contrary to the requirements of the warranty in question. Such fact appears from positive testimony for the insured that appellant's agents inspected the premises; and the simple denials of appellant's representative (Jamiczon) can not overcome that proof. That such inspection was made is moreover rendered probable by its being a prerequisite for the fixing of the discount on the premium to which the insured was entitled, since the discount depended on the number of hydrants, and the fire fighting equipment available.

SPS. MARIO & CORAZON VILLALVA vs. RCBC SAVINGS BANK G.R. No. 165661 - August 28, 2006 FACTS: Petitioner spouses issued forty-eight (48) checks to cover installment payments due on promissory notes in favor of Toyota, Quezon Avenue (TQA) for the purchase of a ’93 Toyota Corolla. The promissory notes were secured by a Chattel Mortgage. Under the Deed of Chattel Mortgage, petitioner spouses were to insure the vehicle and endorse and deliver the policies to the mortgagor The promissory notes and chattel mortgage were assigned to Rizal Commercial Banking Corporation (RCBC). They were later assigned by RCBC to RCBC Savings Bank. Petitioner spouses procured the necessary insurance but did not deliver the same to the respondent. As a consequence, respondent had the mortgaged vehicle insured and paid insurance premium. The insurance policy obtained by respondent was later cancelled due to the insurance policy secured by petitioner spouses over the mortgaged vehicle, and respondent bank was reimbursed by Malayan Insurance Company. The premium paid by respondent bank exceeded the reimbursed amount paid by Malayan Insurance Company. Respondent sent a letter of demand to the petitioners for allegedly unpaid obligations on the promissory notes and. In lieu thereof, respondent demanded that petitioner spouses surrender the mortgaged vehicle within five days from notice. The petitioner spouses ignored the demand letter. ISSUE: Whether petitioners failed to comply with their obligation to insure the subject vehicle under the Deed of Chattel Mortgage. HELD: Due to the mortgagee’s failure to notify the mortgagors prior to application of the latter’s payments to the insurance premiums, this Court held that the mortgagors had not defaulted on their obligation to secure insurance over the mortgaged vehicle, and affirmed the Regional Trial Court’s decision dismissing the mortgagee’s complaint for replevin. In the case at bar, the respondent failed to demand that petitioners comply with their obligation to secure insurance coverage for the mortgaged vehicle. Following settled jurisprudence, we rule that the petitioners had not defaulted on their obligation to insure the mortgaged vehicle and the condition sine qua non for respondent to exercise its right to pay the insurance premiums over the subject vehicle has not been established.

FORTUNE INSURANCE AND SURETY CO., INC., vs. COURT OF APPEALS and PRODUCERS BANK OF THE PHILIPPINES G.R. No. 115278 May 23, 1995 FACTS: The plaintiff was insured by the defendants and an insurance policy was issued. An armored car of the plaintiff, while in the process of transferring cash under the custody of its teller, Maribeth Alampay, from its Pasay Branch to its Head Office was robbed of the said cash. The said armored car was driven by Benjamin Magalong Y de Vera, escorted by Security Guard Saturnino Atiga Y Rosete. Driver Magalong was assigned by PRC Management Systems with the plaintiff by virtue of an Agreement. The Security Guard Atiga was assigned by Unicorn Security Services, Inc. with the plaintiff by virtue of a contract of Security Service. Demands were made by the plaintiff upon the defendant to pay the amount of the loss of P725,000.00, but the latter refused to pay as the loss is excluded from the coverage of the insurance policy, attached hereto. ISSUE: whether the petitioner is liable under the Money, Security, and Payroll Robbery policy it issued to the private respondent or whether recovery thereunder is precluded under the general exceptions clause thereof. HELD: It should be noted that the insurance policy entered into by the parties is a theft or robbery insurance policy which is a form of casualty insurance. Section 174 of the Insurance Code provides: Sec. 174. Casualty insurance is insurance covering loss or liability arising from accident or mishap, excluding certain types of loss which by law or custom are considered as falling exclusively within the scope of insurance such as fire or marine. It includes, but is not limited to, employer's liability insurance, public liability insurance, motor vehicle liability insurance, plate glass insurance, burglary and theft insurance, personal accident and health insurance as written by non-life insurance companies, and other substantially similar kinds of insurance. (emphases supplied) Except with respect to compulsory motor vehicle liability insurance, the Insurance Code contains no other provisions applicable to casualty insurance or to robbery insurance in particular. These contracts are, therefore, governed by the general provisions applicable to all types of insurance. Outside of these, the rights and obligations of the parties must be determined by the terms of their contract, taking into consideration its purpose and always in accordance with the general principles of insurance law.

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