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Insurance Angel Aguinaldo Notes

Insurance Angel Aguinaldo Notes

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Published by lex libertadore
Insurance Reviewer by Angela Aguinaldo
Insurance Reviewer by Angela Aguinaldo

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Published by: lex libertadore on May 15, 2009
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INSURANCE(ATTY.QUIMSON)
1
MA.ANGELAAGUINALDOATENEOLAW2010
Sec.1.ThisDecreeshallbeknownas"TheInsuranceCode".LAWSGOVERNINGINSURANCE
1.
 
PD14602.
 
Articles2011and2012,CC3.
 
Articles2021to2027,CC4.
 
Article2186CC5.
 
Article43,par.4,50,64FC6.
 
LawsandrelatedactscreatingandgoverningtheSSSandGSIS
CONSTANTINOV.ASIALIFE87PHIL248
FACTS:Twocasesareinvolvedinthiscase.AsiaLifeisanAmericaninsurancecompanywhichissuedtwodifferentinsurancepolicies.Onthefirstpolicy,afterthefirstpayment,nofurtherpaymentwasmadebytheinsured.Hediedlateron.Onthesecondpolicy,premiumswerepaid,nonetheless,atacertainperiod,hewasn'tabletocontinuepayment.BothinsurancepolicytransactionswereaffectedbytheJapaneseoccupationwhereintheAmericancompanywasforcedtoleave.Now,thebeneficiariesareseekingthepaymentofproceedsminusallsumsdueforpremiumsinarrears.HELD:Americancasesmaybedividedintothreegroups,accordingastheysupporttheso‐calledConnecticutRule,theNewYorkRule,ortheUnitedStatesRule.Thefirstholdstheviewthat"therearetwoelementsintheconsiderationforwhichtheannualpremiumispaid
 � 
First,themereprotectionfortheyear,andsecond,theprivilegeofrenewingthecontractforeachsucceedingyearbypayingthepremiumforthatyearatthetimeagreedupon.Accordingtothisviewofthecontract,thepaymentofpremiumsisaconditionprecedent,thenon‐performancewouldbeillegalnecessarilydefeatstherighttorenewthecontract."Thesecondrule,apparentlyfollowedbythegreaternumberofdecisions,holdthat"warbetweenstatesinwhichthepartiesresidemerelysuspendsthecontractsofthelifeinsurance,andthat,upontenderofallpremiumsduebytheinsuredorhisrepresentativesafterthewarhasterminated,thecontractrevivesandbecomesfullyoperative."TheUnitedStatesruledeclaresthatthecontractisnotmerelysuspended,butisabrogatedbyreasonofnon‐paymentsispeculiarlyoftheessenceofthecontract.Itadditionallyholdsthatitwouldbeunjusttoallowtheinsurertoretainthereservevalueofthepolicy,whichistheexcessofthepremiumspaidovertheactualriskcarriedduringtheyearswhenthepolicyhadbeeninforce.Thisrulewasannouncedinthewell‐knownStathamcasewhich,intheopinionofProfessorVance,isthecorrectrule.AfterperusingtheInsuranceAct,wearefirmlypersuadedthatthenon‐paymentofpremiumsissuchavitaldefenseofinsurancecompaniesthatsincetheverybeginning,saidActno.2427expresslypreservedit,byprovidingthatafterthepolicyshallhavebeeninforcefortwoyears,itshallbecomeincontestable(i.e.theinsurershallhavenodefense)exceptforfraud,non‐paymentofpremiums,andmilitaryornavalserviceintimeofwar(sec.184[b],InsuranceAct).AndwhenCongressrecentlyamendedthissection(Rep.ActNo.171),thedefenseoffraudwaseliminated,whilethedefenseofnonpaymentofpremiumswaspreserved.Thusthefundamentalcharacteroftheundertakingtopaypremiumsandthehighimportanceofthedefenseofnon‐paymentthereof,wasspecificallyrecognized.Inkeepingwithsuchlegislativepolicy,wefeelnohesitationtoadopttheUnitedStatesRule,whichisineffectavariationoftheConnecticutruleforthesakeofequity.Inthisconnection,itappearsthatthefirstpolicyhadnoreservevalue,andthattheequitablevaluesofthesecondhadbeenpracticallyreturnedtotheinsuredintheformofloanandadvanceforpremium.
INSULARLIFEV.EBRADO80SCRA181
FACTS:Buenaventurasecuredforhimselfalifeinsurancepolicy,namingthereinCarponiaashisrevocablebeneficiary.Thereafter,hemethisdeaththroughanaccident.Carponiamovedtoreceivetheproceedsandadmittingthereinthatshewasthecommon‐lawwifeofinsured.Thetruewidowalsofiledfortheproceeds.HELD:
 
INSURANCE(ATTY.QUIMSON)
2
MA.ANGELAAGUINALDOATENEOLAW2010
Inessence,alifeinsurancepolicyisnodifferentfromacivildonationinsofarasthebeneficiaryisconcerned.Botharefoundeduponthesameconsideration:liberality.Abeneficiaryislikeadonee,becausefromthepremiumsofthepolicywhichtheinsuredpaysoutofliberality,thebeneficiarywillreceivetheproceedsorprofitsofsaidinsurance.Asaconsequence,theproscriptioninArticle739ofthenewCivilCodeshouldequallyoperateinlifeinsurancecontracts.ThemandateofArticle2012cannotbelaidaside:anypersonwhocannotreceiveadonationcannotbenamedasbeneficiaryinthelifeinsurancepolicyofthepersonwhocannotmakethedonation.PolicyconsiderationsanddictatesofmoralityrightlyjustifytheinstitutionofabarrierbetweencommonlawspousesinrecordtoPropertyrelationssincesuchhipultimatelyencroachesuponthenuptialandfilialrightsofthelegitimatefamilyThereiseveryreasontoholdthatthebarindonationsbetweenlegitimatespousesandthosebetweenillegitimateonesshouldbeenforcedinlifeinsurancepoliciessincethesamearebasedonsimilarconsiderationAsabovepointedout,abeneficiaryinafifeinsurancepolicyisnodifferentfromadonee.Botharerecipientsofpurebeneficence.Solongasmanageremainsthethresholdoffamilylaws,reasonandmoralitydictatethattheimpedimentsimposeduponmarriedcoupleshouldlikewisebeimposeduponextra‐maritalrelationship.Iflegitimaterelationshipiscircumscribedbytheselegaldisabilities,withmorereasonshouldanillicitrelationshipberestrictedbythesedisabilities.
INTERPRETATIONOFINSURANCECONTRACTS
 
Ambiguitiesandobscuritiesshouldbestrictlyconstruedagainstthepartywhocausedthem
QUACHEEGANV.LAWUNION52OG1982
FACTS:Plaintiffsoughttheproceedsofitsfireinsurancewiththecompany.theinsurancecompanydeniespaymentduetomanyreasons—one,theviolationofcertainprovisionsofthepolicy.Itallegedthattheclaimantwasguiltyofarsonalso.HELD:TakingintoaccountthewellknownrulethatambiguitiesorobscuritiesmustbestrictlyinterpretedagaInstthepartythatcausedthem,1the"memoofwarranty"invokedbyappellantbarsthelatterfromquestioningtheexistenceoftheappliancescalledforintheinsuredpremises,sinceitsinitialexpression,"theundernotedappliancesfortheextinctionoffirebeingkeptonthepremisesinsuredhereby,...itisherebywarranted...",admistsofinterpretationasanadmissionoftheexistenceofsuchapplianceswhichappellantcannotnowcontradict,shouldtheparolevidenceruleapply.Thisrigidapplicationoftheruleonambiguitieshasbecomenecessaryinviewofcurrentbusinesspractices.Thecourtscannotignorethatnowadaysmonopolies,cartelsandconcentrationsofcapital,endowedwithoverwhelmingeconomicpower,managetoimposeuponpartiesdealingwiththemcunninglyprepared"agreements"thattheweakerpartymaynotchangeonewhit,hisparticipationinthe"agreement"beingreducedtothealternativetotakeitorleaveit"labelledsinceRaymondBaloilles"contractsbyadherence"(contractsd'adhesion),incontrasttotheseenteredintobypartiesbargainingonanequalfooting,suchcontracts(ofwhichpoliciesofinsuranceandinternationalbillsofladingareprimeexamples)obviouslycallforgreaterstrictnessandvigilanceonthepartofcourtsof justicewithaviewtoprotectingtheweakerpartyfromabusesandimposition,andpreventtheirbecomingtrapsfortheunwary.
TYV.FILIPINASCIA.DESEGUROS17SCRA364
FACTS:Tyfiledaclaimagainstseveralinsurancecompaniesforcompensationduetotheinjuryheincurredtohislefthand.Hewasamachineoperatorinacompanyandhetookapersonalaccidentinsurancefromseveralcompanies.Inthesaidpolicies,forittobeconsidereddisability,theremustbeseveranceoramputationoftheaffectedmemberfromthebodyoftheinsured.Whathappenedinhiscasewasthatduringafire,aheavyobjectcausedhishandtobefractured.HELD:Tycannotclaimtohavebeenmisledbythetermsofthecontract.Theprovisionisclearenoughtoinformthepartyenteringintothecontractthatthelosstobeconsideredadisabilityentitledtoindemnitymustbeseveranceoramputationfromthebodyoftheinsured.
GULFRESORTSV.PHIL.CHARTERINSURANCECORP.
 
INSURANCE(ATTY.QUIMSON)
3
MA.ANGELAAGUINALDOATENEOLAW2010
458SCRA550
FACTS:GulfResorts’propertieswaspreviouslyinsuredwithAmericanHomeAssurance.Inthesaidearthquakeinsurance,whatwerecoveredonlywerethecompany’stwoswimmingpools.Thiswasincludedintheearthquakeendorsementclause.WhenthecompanydecidedtobeinsuredinsteadbyPCIC,itorderedthatthesamepolicywithAHACbecopied.Thereafter,anearthquakebrokeout,causingmagnanimousdamagetotheproperties.AfterassessmentbyPCIC,itdeniedclaimsofGulfResortsexcepttothosepertainingtotheswimmingpoolsasitwasallegedlynotcoveredbytheearthquakeinsuranceclause.HELD:Itisbasicthatalltheprovisionsoftheinsurancepolicyshouldbeexaminedandinterpretedinconsonancewitheachother.Allitspartsarereflectiveofthetrueintentoftheparties.Thepolicycannotbeconstruedpiecemeal.Certainstipulationscannotbesegregatedandthenmadetocontrol;neitherdoparticularwordsorphrasesnecessarilydetermineitscharacter.Petitionercannotfocusontheearthquakeshockendorsementtotheexclusionoftheotherprovisions.Alltheprovisionsandriders,takenandinterpretedtogether,indubitablyshowtheintentionofthepartiestoextendearthquakeshockcoveragetothetwoswimmingpoolsonly.Acarefulexaminationofthepremiumrecapitulationwillshowthatitistheclearintentofthepartiestoextendearthquakeshockcoverageonlytothetwoswimmingpools.Section2(1)oftheInsuranceCodedefinesacontractofinsuranceasanagreementwherebyoneundertakesforaconsiderationtoindemnifyanotheragainstloss,damageorliabilityarisingfromanunknownorcontingentevent.Thus,aninsurancecontractexistswherethefollowingelementsconcur:1.Theinsuredhasaninsurableinterest;2.Theinsuredissubjecttoariskoflossbythehappeningofthedesignatedperil;3.Theinsurerassumestherisk;4.Suchassumptionofriskispartofageneralschemetodistributeactuallossesamongalargegroupofpersonsbearingasimilarrisk;and5.Inconsiderationoftheinsurer'spromise,theinsuredpaysapremium.Aninsurancepremiumistheconsiderationpaidaninsurerforundertakingtoindemnifytheinsuredagainstaspecifiedperil.Infire,casualty,andmarineinsurance,thepremiumpayablebecomesadebtassoonastheriskattaches.Inthesubjectpolicy,nopremiumpaymentsweremadewithregardtoearthquakeshockcoverage,exceptonthetwoswimmingpools.Thereisnomentionofanypremiumpayablefortheotherresortpropertieswithregardtoearthquakeshock.Thisisconsistentwiththehistoryofpetitioner’spreviousinsurancepoliciesfromAHAC‐AIU.Thereisnoambiguityinthetermsofthecontractanditsriders.Thegeneralrulethatinsurancecontractsarecontractsofadhesionwhichshouldbeliberallyconstruedinfavoroftheinsuredandstrictlyagainsttheinsurercompanycannotbeapplied.
Sec.2.WheneverusedinthisCode,thefollowingtermsshallhavetherespectivemeaningshereinaftersetforthorindicated,unlessthecontextotherwiserequires:(1)A"contractofinsurance"isanagreementwherebyoneundertakesforaconsiderationtoindemnifyanotheragainstloss,damageorliabilityarisingfromanunknownorcontingentevent.Acontractofsuretyshipshallbedeemedtobeaninsurancecontract,withinthemeaningofthisCode,onlyifmadebyasuretywhoorwhich,assuch,isdoinganinsurancebusinessashereinafterprovided.(2)Theterm"doinganinsurancebusiness"or"transactinganinsurancebusiness",withinthemeaningofthisCode,shallinclude:(a)makingorproposingtomake,asinsurer,anyinsurancecontract;(b)makingorproposingtomake,assurety,anycontractofsuretyshipasavocationandnotasmerelyincidentaltoanyotherlegitimatebusinessoractivityofthesurety;

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