Professional Documents
Culture Documents
Facts:
Ang Ka Yu had a piece of property in his possession. He insured it with Phoenix. The
property was lost, so Ang Ka Yu sought to claim the proceeds. Phoenix denied liability on the
ground that Ang was not the owner but a mere possessor and as such, had no insurable
interest over the property.
Issue:
Whether or not a mere possessor has insurable interest over the property.
Held:
Yes.
A person having a mere right or possession of property may insure it to its full value and in his
own name, even when he is not responsible for its safekeeping. The reason is that even if a
person is NOT interested in the safety and preservation of material in his possession because
they belong to 3rd parties, said person still has insurable interest, because he stands either to
benefit from their continued existence or to be prejudiced by their destruction.
Poe vs. Malayan Insurance Co., G.R. No. 156302, April 7, 2009
FACTS:
Vicenta Maramag and Odessa, Karl Brian, and Trisha Angelie (heirs of Loreto Maramag)
and his concubine Eva de Guzman Maramag, also suspected in the killing of Loreto and his
illegitimate children are claiming for his insurance.
Page 1 of 20
ISSUE: W/N Eva can claim even though prohibited under the civil code against donation
Any person who is forbidden from receiving any donation under Article 739 cannot be
named beneficiary of a life insurance policy of the person who cannot make any donation
to him
If a concubine is made the beneficiary, it is believed that the insurance contract
will still remain valid, but the indemnity must go to the legal heirs and not to the
concubine, for evidently, what is prohibited under Art. 2012 is the naming of the improper
beneficiary.
SECTION 53. The insurance proceeds shall be applied exclusively to the proper interest
of the person in whose name or for whose benefit it is made unless otherwise specified in
the policy.
GR: only persons entitled to claim the insurance proceeds are either the insured,
if still alive; or the beneficiary, if the insured is already deceased, upon the maturation of
the policy.
EX: situation where the insurance contract was intended to benefit third persons
who are not parties to the same in the form of favorable stipulations or indemnity. In such
a case, third parties may directly sue and claim from the insurer
It is only in cases where the insured has not designated any beneficiary, or when the
designated beneficiary is disqualified by law to receive the proceeds, that the insurance
policy proceeds shall redound to the benefit of the estate of the insured
The Insular Life Assurance Co. vs. Ebrado, G.R. No. L-44059, Oct. 28, 1977
Facts:
Buenaventura Ebrado was issued by Insular Life Assurance Co. a whole life plan for
P5,882.00 with a rider for Accidental Death Benefits for the same amount.
Ebrado designated Carponia Ebrado as the revocable beneficiary in his policy, referring to
her as his wife.
Ebrado died when he was accidentally hit by a falling branch of tree.
Insurer by virtue of the contract was liable for 11,745.73, and Carponia filed her claim,
although she admitted that she and the insured were merely living as husband and wife
without the benefit of marriage.
Pascuala Ebrado also filed her claim as the widow of the deceased insured.
Insular life filed an interpleader case and the lower court found in favor of Pascuala.
Issue: Between Carponia and Pascuala, who is entitled to the proceeds?
Held: Pascuala.
It is quite unfortunate that the Insurance Act or our own Insurance Code does not
contain a specific provision grossly resolutory of the prime question at hand. Rather, the
general rules of civil law should be applied to resolve this void in the insurance law. Art. 2011
of the NCC states: The contract of insurance is governed by special laws. Matters not
expressly provided for in such special laws shall be regulated by this Code. When not
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otherwise specifically provided for in the insurance law, the contract of life insurance is
governed by the general rules of civil law regulating contracts.
Under Art. 2012, NCC: Any person who is forbidden from receiving any donation under
Art. 739 cannot be named beneficiary of a life insurance policy by a person who cannot make
any donation to him, according to said article. Under Art. 739, donations between persons
who were guilty of adultery or concubinage at the time of the donation shall be void.
In essence, a life insurance policy is no different from civil donations insofar as the
beneficiary is concerned. Both are founded on the same consideration of liberality. A
beneficiary is like a donee because from the premiums of the policy which the insured pays,
the beneficiary will receive the proceeds or profits of said insurance. As a consequence, the
proscription in Art. 739 should equally operate in life insurance contracts.
Therefore, since common-law spouses are barred from receiving donations, they are
likewise barred from
receiving proceeds of a life insurance contract.
enforceable, and since the insured goods were burned after December 10, 1941, and during
the war, the respondent was not entitled to any indemnity under said policy from the
petitioner. However, elementary rules of justice (in the absence of specific provision in the
Insurance Law) require that the premium paid by the respondent for the period covered by its
policy from December 11, 1941, should be returned by the petitioner
Tongko vs. The Manufacturers Life Insurance, G.R. No. 167622, June 29, 2010
FACTS:
In 1983, Tongko was named as a Unit Manager in Manulife's Sales Agency Organization. In
1990, he became a Branch Manager. As the CA found, Tongko's gross earnings from his work
at Manulife, consisting of commissions, persistency income, and management overrides. The
problem started sometime in 2001, when Manulife instituted manpower development
programs in the regional sales management level. Relative thereto, De Dios addressed a letter
dated November 6, 2001 to Tongko regarding an October 18, 2001 Metro North Sales
Managers Meeting. Stating that Tongkos Region was the lowest performer (on a per Manager
basis) in terms of recruiting in 2000 and, as of today, continues to remain one of the laggards
in this area. Other issues were:"Some Managers are unhappy with their earnings and would
want to revert to the position of agents." And "Sales Managers are doing what the company
asks them to do but, in the process, they earn less." Tongko was then terminated.
ISSUES:
Is there an employer-employee relationship between Tongko and Manulife?.
HELD:
NO.
In the determination of whether an employer-employee relationship exists
between 2 parties, this court applies the four-fold test todetermine the existence of the
elements of such relationship. Jurisprudence is firmly settled that whenever the existence of
an employment relationshipis in dispute, four elements constitute the reliable yardstick: (a)
the selection and engagement of the employee; (b) the payment of wages; (c) the powerof
dismissal; and (d) the employers power to control the employees conduct. IT is the so-called
control test which constitutes the most important indexof existence of the employeremployee relationship that is, whether the employer controls or has reserved the right to
control the employee not only asto the result of the work to be done but also as to the means
and methods by which the same is to be accomplished. Stated otherwise, an employeremployee relationship exists where the person for whom the services are performed reserves
the right to control not only the end to be achieved butalso the means to be used in reaching
such end. In the case at bar, the absence of evidence showing Manulifes control over
Tongkos contractualduties points to the absence of any employer-employee relationship
between Tongko and Manulife. In the context of the established evidence, Tongkoremained an
agent all along; although his subsequent duties made him a lead agent with leadership role,
he was nevertheless only an agent whose basic contract yields no evidence of means-andmanner control. Claimant clearly failed to substantiate his claim of employment relationship
by thequantum of evidence the Labor Code requires.
Tongkos failure to comply with the guidelines of de Dios letter, as a ground for
termination of Tongkos agency, is a matter that the labortribunals cannot rule upon in the
absence of an employer-employee relationship. Jurisdiction over the matter belongs to the
courts applying the laws ofinsurance, agency and contracts.
Page 5 of 20
Page 6 of 20
Issues:
other four sustained physical injuries. The car, as well, suffered extensive damage.
Complainant, thereafter, filed a claim for total loss with the respondent company but claim
was denied. Hence, complainant, was compelled to institute the present action.
Issue:
WON the Insurance Company is liable.
Held:
Yes. 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 therefrom utility, satisfaction,
enjoyment and pleasure.
Page 8 of 20
Fortune Insurance and Surety Co., Inc. vs. CA, 244 SCRA 308
Yes, the insurer is still liable. Contracts of insurance are to be construed liberally in favor of
the insured and strictly against the insurer. Thus ambiguity in the words of an insurance
contract should be interpreted in favor of its beneficiary. 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. Thus, the terms have been
taken to mean that which happen by chance or fortuitously, without intention and design, and
which is unexpected, unusual, and unforeseen. Where the death or injury is not the natural or
probable result of the insured's voluntary act, or if something unforeseen occurs in the doing
of the act which produces the injury, the resulting death is within the protection of the policies
insuring against death or injury from accident. In the case at bar, it cannot be pretended that
Carlie Surposa died in the course of an assault or murder as a result of his voluntary act
considering the very nature of these crimes. Neither can it be said that where was a
capricious desire on the part of the accused to expose his life to danger considering that he
was just going home after attending a festival. Furthermore, the personal accident insurance
policy involved herein specifically enumerated only ten (10) circumstances wherein no liability
attaches to petitioner insurance company for any injury, disability or loss suffered by the
insured as a result of any of the stimulated causes. The principle of " expresso unius exclusio
alterius" the mention of one thing implies the exclusion of another thing is therefore
applicable in the instant case since murder and assault, not having been expressly included in
the enumeration of the circumstances that would negate liability in said insurance policy
cannot be considered by implication to discharge the petitioner insurance company from
liability for, any injury, disability or loss suffered by the insured. Thus, the failure of the
petitioner insurance company to include death resulting from murder or assault among the
prohibited risks leads inevitably to the conclusion that it did not intend to limit or exempt itself
from liability for such death.
Virginia Perez vs. CA, 323 SCRA 613
Facts:
Primitivo Perez has been isured with the BF Lifeman Insurance Corporation since 1980
for P20,000. Sometime in 1987, Rodolfo Lalog, an agent of BF, convinced him to apply for
additional insurance coverage of P50, 000. Perez accomplished the application form
and passed the required medical exam. He also paid P2,075 to Lalog for premium. On Nov.
25, 1987, Perez died while riding a banca which capsized during a storm. During this time his
application papers for the additional insurance coverage was still in the office of BF. Without
knowing that Perez died, BF approved Perezs application and issued the corresponding policy
for P50,000.Virginia Perez, his wife, claimed the benefits of the insurance policy for her
deceased husband but she was only able to obtain P40,000 under the first
insurance policy. BF refused to pay the proceeds amounting to P150,000 under the additional
policy coverage of P50,000 because they maintain that such policy had not been perfected.
On Sept. 21, 1990, BF filed a complaint against Mrs. Perez seeking rescission and declaration
of nullity of the insurance contract in question. Mrs. Perez file a counterclaim for the collection
of P150,000 plus damages.
Issue:
Whether or not there was a consummated contract of insurance between Perez and BF.
Held:
No. An essential requisite of a valid contract is consent. Consent must be manifested by the
meeting of the offer and acceptance upon the thing and the cause which are to constitute the
contract. The offer must be certain and the acceptance absolute. When Perez filed the
application, it was subject to the acceptance of BF. The perfection was also further
conditioned upon 1) issuance of the policy; 2) payment of the premium and; 3) the delivery to
and acceptance by the applicant in good health. The delivery and acceptance by the
applicant was a suspensive condition which was not fulfilled in as much as the applicant
was already dead at the time the policy was issued. The non-fulfillment of the condition
resulted in the non-perfection of the contract. An application for insurance is merely an offer
which requires the overt act of the insurer for it to ripen to a contract. Delay in acting on
Page 10 of 20
the application does not constitute acceptance even though the insured has forwarded his
first premium with his application. Delay, in this case, does not constitute gross negligence
because the application was granted within the normal processing time. WHEREFORE, the
decision rendered by the Court of Appeals in CA-G.R. CV No. 35529 is AFFIRMED insofar as it
declared Insurance Policy No. 056300 for P50,000.00 issued by BF Lifeman Insurance
Corporation of no force and effect and hence null and void. No costs.
Page 11 of 20
Qua Chee Gan vs. Law Unin and Rock Ins. Co., 98 Phil 85
Facts:
Before the last war, Qua Chee Gan owned 4 warehouses or bodegas (designated as
Bodegas nos. 1 to 4) in Tabaco, Albay, used for the storage of stocks of copra and of hemp,
baled and loose, in which he dealt extensively. They had been, with their contents, insured
with Law Union since 1937, and the loss made payable to the Philippine National Bank as
mortgagee of the hemp and copra, to the extent of its interest. Fire broke out in, 1940, and
lasted almost one week, gutted and completely destroyed Bodegas Nos. 1, 3 and 4, with the
merchandise stored therein.
Qua informed the insurer by telegram on the same date; and on the next day, the insurer
sent fire adjusters to estimate the loss. The loss was estimated at 370T. Law Union refused to
pay contending that Qua purposely set fire to his bodegas and violation of warranties and
conditions as agreed.
Law Union then filed a criminal case for arson, but the same was dismissed by the trial
court. Qua Chee thereafter instituted this civil case for the collection of the proceeds of
insurance. As defense, Law Union Rock contends that Qua Chee violated the provisions
agreed upon in a rider in the insurance policy where:
a fire hydrants should be placed every 150 feet of the external wall measurement,
since there are only 2 and another 2 in a further area owned by the municipality.
Qua Chee failed to maintain the agreed water pressure and the 100 feet of fire hose
He did maintain 20 fire brigade men within the premises
Insurer also averred that Qua Chee violated the provision of the Hemp Warranty which
prohibits the storage of oils when he stored gasoline in bodega 2.
Issue: WON the company can rescind the contract on the basis of such alleged violation.
Page 12 of 20
Held: NO.
Law Union is barred by waiver (or rather estoppel) to claim violation of the so- called
fire hydrants warranty, for the reason that knowing fully all that the number of hydrants
demanded therein never existed from the very beginning, the Law Union nevertheless issued
the policies in question subject to such warranty, and received the corresponding premiums. It
would be perilously close to conniving at fraud upon the insured to allow Law Union to claim
now as void ab initio the policies that it had issued to the plaintiff without warning of their
fatal defect, of which it was informed, and after it had misled the defendant into believing that
the policies were effective.
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
The alleged violation of the warranty of 100 feet of fire hose for every two hydrants,
must be equally rejected, since the appellant's argument thereon is based on the assumption
that the insured was bound to maintain no less than eleven hydrants (one per 150 feet of
wall), which requirement appellant is estopped from enforcing. The supposed breach of the
water pressure condition is made to rest on the testimony of witness Serra, that the water
supply could fill a 5-gallon can in 3 seconds; appellant thereupon inferring that the maximum
quantity obtainable from the hydrants was 100 gallons a minute, when the warranty called for
200 gallons a minute. The transcript shows, however, that Serra repeatedly refused and
professed inability to estimate the rate of discharge of the water, and only gave the "5-gallon
per 3-second" rate because the insistence of appellant's counsel forced the witness to hazard
a guess. Obviously, the testimony is worthless and insufficient to establish the violation
claimed, specially since the burden of its proof lay on appellant.
As to maintenance of a trained fire brigade of 20 men, the record is preponderant that
the same was organized, and drilled, from time to give, although not maintained as a
permanently separate unit, which the warranty did not require. Anyway, it would be
unreasonable to expect the insured to maintain for his compound alone a fire fighting force
that many municipalities in the Islands do not even possess. There is no merit in appellant's
claim that subordinate membership of the business manager (Co Cuan) in the fire brigade,
while its direction was entrusted to a minor employee, renders the testimony improbable. A
business manager is not necessarily adept at fire fighting, the qualities required being
different for both activities.
It is well to note that gasoline is not specifically mentioned among the prohibited
articles listed in the so called "hemp warranty." The cause relied upon by the insurer speaks of
"oils (animal and/or vegetable and/or mineral and/or their liquid products having a flash point
below 300 Fahrenheit", and is decidedly ambiguous and uncertain; for in ordinary parlance,
"Oils" mean "lubricants" and not gasoline or kerosene. And how many insured, it may well be
wondered, are in a position to understand or determine "flash point below 003 Fahrenheit.
Here, again, by reason of the exclusive control of the insurance company over the terms and
phraseology of the contract, the ambiguity must be held strictly against the insurer and
liberally in favor of the insured, specially to avoid a forfeiture
Fieldmen's Insurance Co., Inc. vs. Vda. De Songco, 25 SCRA 70
Facts:
Page 13 of 20
Sunlife Assurance of Canada vs. CA, GR No. 105135, June 22, 1995
Facts:
Robert John B. Bacani procured a life insurance contract for himself from Sunlife. He was
issued a Policy valued at P100,000.00, with double indemnity in case of accidental death. The
designated beneficiary was his mother, Bernarda Bacani.
In his application for insurance Robert was asked if within 5 years he (a) consulted any doctor
or other health practitioner (b) subjected to different test i.e. blood, x-rays etc. (c) attended or
been admitted to any hospital or other medical facility. Robert answered yes in letter a. but
limited his answer to a consultation with a certain Dr. Reinaldo D. Raymundo of the Chinese
General Hospital on February 1986, for cough and flu complications.
Sunlife discovered that two weeks prior to Roberts application for insurance, that Robert was
examined and confined at the Lung Center of the Philippines, where he was diagnosed for
renal failure. During his confinement, the deceased was subjected to urinalysis, ultrasonography and hematology tests.
Robert died in a plane crash. Bernarda filed a claim with Sunlife, seeking the benefits of the
insurance policy taken by her son. Sunlife conducted an investigation and its findings
prompted it to reject the claim.
Sunlife informed Bernarda that Robert did not disclose material facts relevant to the issuance
of the policy, thus rendering the contract of insurance voidable. A check representing the total
premiums paid in the amount of P10,172.00 was attached to said letter.
Bernarda subsequently filed an action for specific performance against Sunlife. Sunlife filed a
counter claim and a list of exhibits consisting of medical records furnished by the Lung Center
Page 14 of 20
of the Philippines. Bernarda filed a "Proposed Stipulation with Prayer for Summary Judgment"
where they manifested that they "have no evidence to refute the documentary evidence of
concealment/misrepresentation by the decedent of his health condition. Sunlife also filed a
motion for summary judgement.
Trial court ruled in favor of Bernarda and concluded that although there was concealment and
misrepresentation the facts concealed by the insured were made in good faith and under a
belief that they need not be disclosed. Moreover, it held that the health history of the insured
was immaterial since the insurance policy was "non-medical". Court of Appeals affirmed the
decision and stated that the cause of death was unrelated to the facts concealed by the
insured.
Issue: WON there was concealment and can good faith be used as a defense.
Ruling: Yes there was concealment and No the defense of goodfaith is not applicable
Section 26 of the Insurance Code is explicit in requiring a party to a contract of insurance to
communicate to the other, in good faith, all facts within his knowledge which are material to
the contract and as to which he makes no warranty, and which the other has no means of
ascertaining. Said Section provides that "a neglect to communicate that which a party knows
and ought to communicate, is called concealment."
Great Pacific Life Assurance Co. vs. CCA, GR No. L-31845, April 30, 1977
Facts:
On 14 March 1957, Ngo Hing filed an application with the Great Pacific Life Assurance
Company for a 20-year endowment policy in the amount of P50,000.00 on the life of his oneyear old daughter Helen Go. Ngo Hing supplied the essential data which Lapulapu D.
Mondragon, Branch Manager of the Pacific Life in Cebu City wrote on the corresponding form
in his own handwriting. Mondragon finally type-wrote the data on the application form which
was signed by Ngo Hing. The latter paid the annual premium, the sum of P1,077.75 going
over to the Company, but he retained the amount of P1,317.00 as his commission for being a
duly authorized agent of Pacific Life. Upon the payment of the insurance premium, the binding
deposit receipt was issued to Ngo Hing. Likewise, Mondragon handwrote at the bottom of the
back page of the application form his strong recommendation for the approval of the
insurance application. Then on 30 April 1957, Mondragon received a letter from Pacific Life
disapproving the insurance application. The letter stated that the said life insurance
application for 20-year endowment plan is not available for minors below 7 years old, but
Pacific Life can consider the same under the Juvenile Triple Action Plan, and advised that if the
offer is acceptable, the Juvenile Non-Medical Declaration be sent to the Company. The nonacceptance of the insurance plan by Pacific Life was allegedly not communicated by
Mondragon to Ngo Hing. Instead, on 6 May 1957, Mondragon wrote back Pacific Life again
strongly recommending the approval of the 20-year endowment life insurance on the ground
that Pacific Life is the only insurance company not selling the 20- year endowment insurance
plan to children, pointing out that since 1954 the customers, especially the Chinese, were
asking for such coverage. It was when things were in such state that on 28 May 1957 Helen
Go died of influenza with complication of broncho-pneumonia. Thereupon, Ngo Hing sought
the payment of the proceeds of the insurance, but having failed in his effort, he filed the
action for the recovery of the same before the Court of First Instance of Cebu, which rendered
a decision against Pacific Life and Mondragon, orderig them to solidarily pay Ngo Hing the
amount of P50,000.00 with interest at 6% from the date of the filing of the complaint, and the
sum of P10,000.00 as attorney's fees plus costs of suits. On appeal, the Court of Appeals set
aside the appealed decision of the Court of First Instance of Cebu, and absolved Pacific Life
and Mondragon from liability on the insurance policy, but ordered the reimbursement to Ngo
Hing the amount of P1,077.75, without interest. On reconsideration, however, the appellate
court affirmed in toto the decision of the Court of First Instance of Cebu, ordering Pacific Life
Page 15 of 20
and Mondragon jointly and severally to pay Ngo Hing. Two petitions for certiorari by way of
appeal were filed by Pacific Life and Mondragon. The petitons were consolidated by the
Supreme Court in a resolution dated 29 April 1970.
Issue:
Whether the binding deposit receipt constituted a temporary contract of the life insurance in
question, and thus negate the claim that the insurance contract was perfected.
Held:
YES. The provisions printed on the binding deposit receipt show that the binding deposit
receipt is intended to be merely a provisional or temporary insurance contract and only upon
compliance of the following conditions: (1) that the company shall be satisfied that the
applicant was insurable on standard rates; (2) that if the company does not accept the
application and offers to issue a policy for a different plan, the insurance contract shall not be
binding until the applicant accepts the policy offered; otherwise, the deposit shall be
refunded; and (3) that if the applicant is not insurable according to the standard rates, and
the company disapproves the application, the insurance applied for shall not be in force at
any time, and the premium paid shall be returned to the applicant. Clearly implied from the
aforesaid conditions is that the binding deposit receipt in question is merely an
acknowledgment, on behalf of the company, that the latter's branch office had received from
the applicant the insurance premium and had accepted the application subject for processing
by the insurance company; and that the latter will either approve or reject the same on the
basis of whether or not the applicant is "insurable on standard rates." Since Pacific Life
disapproved the insurance application of Ngo Hing, the binding deposit receipt in question
had never become in force at any time. Upon this premise, the binding deposit receipt is,
manifestly, merely conditional and does not insure outright. Where an agreement is made
between the applicant and the agent, no liability shall attach until the principal approves the
risk and a receipt is given by the agent. The acceptance is merely conditional, and is
subordinated to the act of the company in approving or rejecting the application. Thus, in life
insurance, a "binding slip" or "binding receipt" does not insure by itself. It bears repeating that
through the intra-company communication of 30 April 1957, Pacific Life disapproved the
insurance application in question on the ground that it is not offering the 20-year endowment
insurance policy to children less than 7 years of age. What it offered instead is another plan
known as the Juvenile Triple Action, which Ngo Hing failed to accept. In the absence of a
meeting of the minds between Pacific Life and Ngo Hing over the 20-year endowment life
insurance in the amount of P50,000.00 in favor of the latter's one-year old daughter, and with
the non-compliance of the abovequoted conditions stated in the disputed binding deposit
receipt, there could have been no insurance contract duly perfected between them.
Accordingly, the deposit paid by Ngo Hing shall have to be refunded by Pacific Life.
Had Canilang disclosed his visits to his doctor, the diagnosis made and medicines prescribed by such doctor, in the
insurance application, it may be reasonably assumed that Great Pacific 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. The materiality of the information withheld by Great Pacific did not depend upon the state of mind of
Jaime Canilang. A mans state of mind or subjective belief is not capable of proof in our judicial process, except
through proof of external acts or failure to act from which inferences as to his subjective belief may be reasonably
drawn. Neither does materiality depend upon the actual or physical events which ensure. Materiality relates rather to
the probable and reasonable influence of the facts upon the party to whom the communication should have been
made, in assessing the risk involved in making or omitting to make further inquiries and in accepting the application for
insurance; that probable and reasonable influence of the facts concealed must, of course, be determined objectively,
by the judge ultimately. WHEREFORE, the Petition for Review is DENIED for lack of merit and the Decision of the
Court of Appeals dated 16 October 1989 in C.A.-G.R. SP No. 08696 is hereby AFFIRMED. No pronouncement as to
the costs.
Ng Gan Zee vs. Asian Crusader Life Assn Corp., GR No. L-30685, May 30, 1983
Facts:
In 1962, Kwon Nam applied for a 20yr endowment insurance on his life with his wife, Ng Gan
Zee as the beneficiary.
He stated in his application that he was operated on for tumor of the stomach associated with
ulcer. In 1963, Kwong died of cancer of the liver with metastasis. Asian refused to pay on the
ground of false information. It was found that prior to his application, Kwong was diagnosed
to have peptic ulcers, and that during the operation what was removed from Kwongs body
was actually a portion of the stomach and not tumor.
Issue: WON the contract may be rescinded on the ground of the imperfection in the
application form.
Held: NO.
Kwong did not have sufficient knowledge as to distinguish between a tumor and a peptic
ulcer. His statement therefore was made in good faith. Asian should have made an inquiry as
to the illness and operation of Kwong when it appeared on the face of the application that a
question appeared to be imperfectly answered. Asians failure to inquire constituted a waiver
of the imperfection in the answer.
Page 17 of 20
Page 18 of 20
The purpose of the present action is to recover the sum of P3,000 upon an insurance policy. The lower court rendered a
judgment in favor of the plaintiff and against the defendant for the sum of P2,708.78, and costs. From that judgment the
defendant appealed to this court.
The undisputed facts upon which said action is based are as follows:
1.
The plaintiff conducted a candy and fruit store on the Escolta, in the city of Manila, and occupied a building at
321 Calle Claveria, as a residence and bodega (storehouse).
2.
On the 29th of May, 1912, the defendant, in consideration of the payment of a premium of P60, entered into a
contract of insurance with the plaintiff (policy No. 509105) by the terms of which the defendant company, upon
certain conditions, promised to pay to the plaintiff the sum of P3,000, in case said residence and bodega and
contents should be destroyed by fire.
3.
One of the conditions of said contract of insurance is found in "warranty B" and is as follows: "Warranty B. It is
hereby declared and agreed that during the pendency of this policy no hazardous goods be stored or kept for
sale, and no hazardous trade or process be carried on, in the building to which this insurance applies, or in any
building connected therewith."
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4.
On the 4th or 5th of February, 1913, the plaintiff placed in said residence and bodega three boxes, 18 by 18 by
20 inches measurement, which belonged to him and which were filled with fireworks.
5.
On the 18th day of March, 1913, said residence and bodega and the contents thereof were partially destroyed.
6.
Said fireworks had been given to the plaintiff by the former owner of the Luneta Candy Store; that the plaintiff
intended to use the same in the celebration of the Chinese new year; that the authorities of the city of Manila
had prohibited the use of fireworks on said occasion, and that the plaintiff then placed the same in said bodega,
where they remained from the 4th or 5th of February, 1913, until after the fire of the 18th of March, 1913.
7.
Both of the parties agree that said fireworks come within the phrase "hazardous goods," mentioned in said
"warranty B" of the policy.
8.
That said fireworks were found in a part of the building not destroyed by the fire; that they in no way contributed
to the fire, or to the loss occasioned thereby.
The only question presented by the parties is whether or not the placing of said fireworks in the building insured, under
the conditions above enumerated, they being "hazardous goods," is a violation of the terms of the contract of insurance
and especially of "warranty B." "Warranty B" provides that "no hazardous goods be stored" in the building insured. It is
admitted by both parties that the fireworks are "hazardous goods." The defendant alleged that they were "stored." The
plaintiff contends that under all the facts and circumstances of the case, they were not "stored" in said building, and that
the placing of them in the building was not a violation of the terms of the contract. Both the plaintiff and defendant agree
that if they were "hazardous goods," and if they were "stored," then the act of the plaintiff was a violation of the terms of
the contract of insurance and the defendant was justified in repudiating its liability thereunder.
This leads us to a consideration of the meaning of the word "stored" as used in said "warranty B." While the word
"stored" has been variously defined by authors, as well as by courts, we have found no case exactly analogous to the
present. The plaintiff says that he placed said fire- works in the bodega after he had been notified that he could not use
them on the Chinese new year, in order that he might later send them to a friend in the provinces. Whether a particular
article is "stored" or not must, in some degree depend upon the intention of the parties. The interpretation of the word
"stored" is quite difficult, in view of the many decisions upon the various conditions presented. Nearly all of the cases
cited by the lower court are cases where the article was being put to some reasonable and actual use, which might easily
have been permitted by the terms of the policy, and within the intention of the parties and excepted from the operation
of
the
warranty,
like
the
present.
Said
decisions
are
upon
cases
like:
chanrob1es
virtual
1aw
library
1. Where merchants have had or kept the "hazardous" articles in small quantities, and for actual daily use, for sale, .such
as gasoline, gunpowder, etc.;
2. Where such articles have been brought on the premises for actual use thereon, and in small quantities, such as oil,
paints, etc; and
3. Where such articles or goods were used for lighting purposes, and in small quantities.
The author of the Century Dictionary defines the word "store" to be a deposit in a store or warehouse for preservation or
safe keeping; to put away for future use, especially for future consumption; to place in a warehouse or other place of
deposit for safe keeping. See also the definitions given by the Standard Dictionary, to the same effect.
Said definitions, of course, do not include a deposit in a store, in small quantities, for daily use. "Daily use" precludes the
idea of a deposit for preservation or safe keeping, as well as a deposit for future consumption, or safe keeping.
In the present case no claim is made that the "hazardous goods" were placed in the bodega for present or daily use. It is
admitted that they were placed in the bodega "for future use," or for future consumption, or for safe keeping. The
plaintiff makes no claim that he deposited them there with any other idea than "for future use" for future consumption.
It seems clear to us that the "hazardous goods" in question were "stored" in the bodega, as that word is generally
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defined. That being true, suppose the defendant had made an examination of the premises, even in the absence of a fire,
and had found the "hazardous goods" there, under the conditions above described, would it not have been justified, then
and there, in declaring the policy null and of no effect by reason of a violation of its terms on the part of the plaintiff? If it
might, then may it not repudiate its liability, even after the fire? If the "warranty" is a term of the contract, will not its
violation cause a breach and justify noncompliance or a repudiation?
Contracts of insurance are contracts of indemnity upon the terms and conditions specified in the policy. The parties have
a right to impose such reasonable conditions at the time of the making of the contract as they may deem wise and
necessary. The rate of premium is measured by the character of the risk assumed. The insurance company, for a
comparatively small consideration, undertakes to guarantee the insured against loss or damage, upon the terms and
conditions agreed upon, and upon no other, and when called upon to pay, in case of loss, the insurer, therefore, may
justly insist upon a fulfillment of these terms. If the insured cannot bring himself within the conditions of the policy, he is
not entitled to recover for the loss. The terms of the policy constitute the measure of the insurers liability, and in order to
recover the insured must show himself within those terms; and if it appears that the contract has been terminated by a
violation, on the part of the insured, of its conditions, then there can be no right of recovery. The compliance of the
insured with the terms of the contract is a condition precedent to the right of recovery. 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 function 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.
(Imperial Fire Ins. Co. v. County of Coos, 151 U. S., 452; Kyte v. Commercial Union Assurance Co., 149 Mass., 116, 122.)
The conditions of contracts of insurance, when plainly expressed in a policy, are binding upon the parties and should be
enforced by the courts, if the evidence brings the case clearly within their meaning and intent. It tends to bring the law
itself into disrepute when, by astute and subtle distinctions, a plain case is attempted to be taken without the operation
of a clear, reasonable, and material obligation of the contract. (Mack v. Rochester German Ins. Co., 106 N. Y., 560, 564.)
The appellant argues, however, that in view of the fact that the "storing" of the fireworks on the premises of the insured
did not contribute in any way to the damage occasioned by the fire, he should be permitted to recover that the
"storing" of the "hazardous goods" in no way caused injury to the defendant company. That argument, however, is beside
the question, if the "storing" was a violation of the terms of the contract. The violation of the terms of the contract, by
virtue of the provisions of the policy itself, terminated, at the election of either party, the contractual relations. (Kyte v.
Commercial Union Assurance Co., 149 Mass., 116, 122.) The plaintiff paid a premium based upon the risk at the time the
policy was issued. Certainly it cannot be denied that the placing of the firecrackers in the building insured increased the
risk. The plaintiff had not paid a premium based upon the increased risk, neither had the defendant issued a policy upon
the theory of a different risk. The plaintiff was enjoying, if his contention may be allowed, the benefits of an insurance
policy upon one risk, whereas, as a matter of fact, it was issued upon an entirely different risk. The defendant had
neither been paid nor had issued a policy to cover the increased risk. An increase of risk which is substantial and which is
continued for a considerable period of time, is a direct and certain injury to the insurer, and changes the basis upon
which the contract of insurance rests. (Kyte v. Commercial Union Assurance Co. (supra); Frosts Detroit Lumber Works v.
Millers Mutual Ins. Co., 37 Minn., 300, 302; Moore v. Phoenix Ins. Co., 62 N. H., 240; Ferree v. Oxford Fire & Life Ins.
Co., 67 Pa. State, 373.)
Therefore and for the foregoing reasons, the judgment of the lower court is hereby revoked and the defendant is hereby
relieved from any responsibility under said complaint, and, without any finding as to costs, it is so ordered.
Page 20 of 20