Professional Documents
Culture Documents
now rely on the fact that the insured owned a private vehicle,
not a common carrier, something which it knew all along when
not once but twice its agent, no doubt without any objection in
its part, exerted the utmost pressure on the insured, a man of
scant education, to enter into such a contract.
WHEREFORE, the decision of respondent Court of Appeals of
July 20, 1965, is affirmed in its entirety. Costs against petitioner
Fieldmens Insurance Co., Inc.
ISSUE:
1) Whether or not the designation of the irrevocable
beneficiaries could be changed or amended without the
consent of all the irrevocable beneficiaries.
2) Whether or not the irrevocable beneficiaries, one of
whom is already deceased while the others are all
minors, could validly give consent to such amendment
HELD:
Concealment
SUNLIFE ASSURANCE COMPANY OF CANADA vs. COURT OF
APPEALS
G.R. No. 105135, 22 June 1995
FACTS:
Robert John Bacani procured a life insurance contract for
himself from petitioner-company, designating his mother
Bernarda Bacani, herein private respondent, as the beneficiary.
He was issued a policy valued at P100,000.00 with double
indemnity in case of accidental death. Sometime after, the
insured died in a plane crash. Bernarda filed a claim with
petitioner, seeking the benefits of the insurance policy taken by
her son. However, said insurance company rejected the claim
on the ground that the insured did not disclose material facts
relevant to the issuance of the policy, thus rendering the
contract of insurance voidable. Petitioner discovered that two
weeks prior to his application for insurance, the insured was
examined and confined at the Lung Center of the Philippines,
where he was diagnosed for renal failure. The RTC, as affirmed
by the CA, this fact was concealed, as alleged by the petitioner.
But the fact that was concealed was not the cause of death of
the insured and that matters relating to the medical history of
the insured is deemed to be irrelevant since petitioner waived
the medical examination prior to the approval and issuance of
the insurance policy.
ISSUE:
Whether or not the concealment of such material fact, despite
it not being the cause of death of the insured, is sufficient to
render the insurance contract voidable
HELD:
YES. 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.
Anent the finding that the facts concealed had no bearing to the
cause of death of the insured, it is well settled that the insured
need not die of the disease he had failed to disclose to the
insurer. It is sufficient that his non-disclosure misled the insurer
in forming his estimates of the risks of the proposed insurance
policy or in making inquiries.
LIFE
FACTS:
Estefania Saturnino obtained a 20-year endowment non-medical
insurance. This kind of policy dispenses with the medical
examination of the applicant usually required in ordinary life
policies. However, two months prior to the issuance of the
policy, Saturnino was operated on for cancer, involving
mastectomy of the right breast. She did not make a disclosure
thereof in her application for insurance. On the contrary, she
stated therein that she did not have, nor had she ever had,
among other ailments listed in the application, cancer or other
tumors.
Sometime after, Saturnino died of pneumonia, secondary to
influenza. Appellants here, who are her surviving husband and
minor child, respectively, demanded payment of the face value
of the policy. The claim was rejected and hence an action was
subsequently instituted.
ISSUE:
Whether or not the insured made such false representations of
material facts as to avoid the policy
HELD:
YES. The Insurance Law 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. 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 insureds medical history she would at least have been
made to undergo medical examination in order to determine
her insurability.
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
INSURANCE,
INC.
vs.
FACTS:
Plaintiff Philippine Phoenix Surety issued to defendant company
a fire insurance policy for the amount of P300,000.00. The
defendant was obligated to pay P6,051.95 as premium of the
said policy. However, the defendant was only able to pay
P3,000.00. Despite several demands made by the plaintiff on
the defendant to pay the amount of P3,522.09, the latter failed
to pay.
ISSUE:
Incontestability Clause
EMILIO TAN vs. COURT OF APPEALS
G.R. No. 48049, 29 June 1989
FACTS:
Tan Lee Siong, father of herein petitioners, applied for life
insurance in the amount of P80,000.00 with respondent
company Philippine American Life Insurance Company. Said
application was approved and a corresponding policy was
issued effective November 5, 1973, with petitioners as the
beneficiaries.
On April 26, 1975, Tan Lee Siong died of hepatoma. Hence,
petitioners filed with respondent company their claim for the
proceeds of the life insurance policy. However, the insurance
company denied the said claim and rescinded the policy by
reason of the alleged misrepresentation and concealment of
material facts made by the deceased Tan Lee Siong in his
application for insurance. The premiums paid on the policy were
thereupon refunded.
The petitioners contend that the respondent company no longer
had the right to rescind the contract of insurance as rescission
must allegedly be done during the lifetime of the insured within
two years and prior to the commencement of action.
ISSUE:
Whether or not the insurance company has the right to rescind
the contract of insurance despite the presence of an
incontestability clause
HELD:
YES. The so-called incontestability clause precludes the
insurer from raising the defenses of false representations or
concealment of material facts insofar as health and previous
diseases are concerned if the insurance has been in force for at
least two years during the insureds lifetime. The phrase
during the lifetime found in Section 48 of the Insurance Law
simply means that the policy is no longer considered in force
after the insured has died. The key phrase in the second
paragraph of Section 48 is for a period of two years.
The policy was issued on November 6, 1973 and the insured
died on April 26, 1975. The policy was thus in force for a period
of only one year and five months. Considering that the insured
died before the two-year period has lapsed, respondent
company is not, therefore, barred from proving that the policy is