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Notice of Loss Cases

Go Lu v. Yorkshire Insurance Company G.R. No. 18090 July 25, 1922


Insurer: Yorkshire Insurance Company
Insured: Go Lu
Type/Kind of Insurance: Fire
Fire Insurance Policy:
1. Northern Assurance Company. Policy against loss from fire for the period of
one year to and in favor of the plaintiff for P10,000 on his stock of piece
goods in the bodega.
2. Yorkshire Insurance Company issued its policy on the same goods for
another P10,000 for the same period.
3. Scottish Union and National Insurance Company also issued its policy to him
on the same goods for P10,000 for the period of one year.
Loss: A fire occurred in that portion of the building occupied by the Eastern Asia
Commercial Company, resulting in a loss and damage to the plaintiff's goods, which
were insured. At the time of the fire, he claims that he was the owner of 66 cases of bolt
goods in the bodega, and that there was a total loss of 50 cases, and that the remaining
16 were seriously damage.
The insurance companies disagreed with Lus proof of claims and amount of loss.
Issue: Amount and value of the goods which plaintiff had in the building at the time of
the fire and that Go Lu submitted fraudulent proof of the amount of his loss, and that, for
such reason, he is not entitled to recover anything.
Held: Under all of the surrounding facts and circumstances, it is the opinion of the writer
thatthe plaintiff should have judgment for the amount of his actual loss. Be that as it
may, the majority of the court are of the opinion that theanalysis of the facts not only
establishes the amount of plaintiff's actual loss, but that it also is conclusive that
plaintiff's claim was fraudulent, and that he knew it was fraudulent when he made it. His
proof of claim was for 66 cases of piece goods of the actual loss to be P7,594.67.
Here, the facts existing at and after the fire are conclusive evidence that there were only
16 cases of goods in the bodega at the time of the fire, and the majority of this court are
of the opinion that plaintiff's claim is not only fraudulent, but that he knew it was
fraudulent at the time it was made, and that, for such reason, he is not entitled to
recover anything.

Pacific Banking Corporation v. Court of Appeals and Oriental Assurance


Corporation
G.R. No. L-41014 November 28, 1988
Insurer: Oriental Assurance Corporation
Insured: Paramount Shirt Manufacturing Co.
So, who is petitioner(?):The insured was at the time of the issuance of the policy and is
up to this time, a debtor of petitioner in the amount of not less than Eight Hundred
Thousand Pesos (P800,000.00) and the goods described in the policy were held in trust
by the insured for the petitioner under thrust receipts. Said policy was duly endorsed to
petitioner as mortgagee/trustor of the properties insured, with the knowledge and
consent of private respondent to the effect that "loss if any under this policy is payable
to the Pacific Banking Corporation"
Loss: On January 4, 1964, while the aforesaid policy was in full force and effect, a fire
broke out on the subject premises destroying the goods contained in its ground and
second floors.
On January 24, 1964, counsel for the petitioner sent a letter of demand to private
respondent for indemnity due to the loss of property by fire under the endorsement of
said policy
On January 28, 1964, private respondent informed counsel for the petitioner that it was
not yet ready to accede to the latter's demand as the former is awaiting the final report
of the insurance adjuster, H.H. Bayne Adjustment Company
On March 25, 1964, the said insurance adjuster notified counsel for the petitioner that
the insured under the policy had not filed any claim with it, nor submitted proof of loss
which is a clear violation of Policy Condition No.11, and for which reason, determination
of the liability of private respondent could not be had.
Issue: Whether the failure of the insured to file the required proof of loss prior to court
action is fatal to petitionersaction for a sum of money?
Held:
The evidence adduced shows that twenty-four (24) days after the fire, petitioner merely
wrote letters to private respondent to serve as a notice of loss, thereafter, the former did
not furnish the latter whatever pertinent documents were necessary to prove and
estimate its loss. Instead, petitioner shifted upon private respondent the burden of
fishing out the necessary information to ascertain the particular account of the articles
destroyed by fire as well as the amount of loss.
It is noteworthy that private respondent and its adjuster notified petitioner that insured
had not yet filed a written claim nor submitted the supporting documents in compliance
with the requirements set forth in the policy. Despite the notice, the latter remained
unheedful. Since the required claim by insured, together with the preliminary submittal
of relevant documents had not been complied with, it follows that private respondent
could not be deemed to have finally rejected petitioner's claim and therefore the latter's
cause of action had not yet arisen.
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 agreement has the force of law between the parties. The terms of
the policy constitute the measure of the insurer's liability, and in order to recover,
the insured must show himself within those terms. The compliance of the insured
with the terms of the policy is a condition precedent to the light of recovery

Submitted by: Eugene G. Limpin