Professional Documents
Culture Documents
SYLLABUS
DECISION
PARAS , C. J : p
On October 1, 1941, the respondent corporation, Christern, Huenefeld & Co., Inc.,
after payment of corresponding premium, obtained from the petitioner, Filipinas Cia. de
Seguros, re policy No. 29333 in the sum of P100,000, covering merchandise
contained in a building located at No. 711 Roman Street, Binondo, Manila. On February
27, 1942, or during the Japanese military occupation, the building and insured
merchandise were burned. In due time the respondent submitted to the petitioner its
claim under the policy. The salvaged goods were sold at public auction and, after
deducting their value, the total loss suffered by the respondent was xed at P92,650.
The petitioner refused to pay the claim on the ground that the policy in favor of the
respondent had ceased to be in force on the date the United States declared war
against Germany, the respondent corporation (though organized under and by virtue of
CD Technologies Asia, Inc. © 2017 cdasiaonline.com
the laws of the Philippines) being controlled by German subjects and the petitioner
being a company under American jurisdiction when said policy was issued on October
1, 1941. The petitioner, however, in pursuance of the order of the Director of the Bureau
of Financing, Philippine Executive Commission, dated April 9, 1943, paid to the
respondent the sum of P92,650 on April 19, 1943.
The present action was led on August 6, 1946, in the Court of First Instance of
Manila for the purpose of recovering from the respondent the sum of P92,650 above
mentioned. The theory of the petitioner is that the insured merchandise were burned
after the policy issued in 1941 in favor of the respondent corporation had ceased to be
effective because of the outbreak of the war between the United States and Germany
on December 10, 1941, and that the payment made by the petitioner to the respondent
corporation during the Japanese military occupation was under pressure. After trial, the
Court of First Instance of Manila dismissed the action without pronouncement as to
costs. Upon appeal to the Court of Appeals, the judgment of the Court of First Instance
of Manila was af rmed, with costs. The case is now before us on appeal by certiorari
from the decision of the Court of Appeals.
The Court of Appeals overruled the contention of the petitioner that the
respondent corporation became an enemy when the United States declared war
against Germany, relying on English and American cases which held that a corporation
is a citizen of the country or state by and under the laws of which it was created or
organized. It rejected the theory that the nationality of a private corporation is
determined by the character or citizenship of its controlling stockholders.
There is no question that majority of the stockholders of the respondent
corporation were German subjects. This being so, we have to rule that said respondent
became an enemy corporation upon the outbreak of the war between the United States
and Germany. The English and American cases relied upon by the Court of Appeals
have lost their force in view of the latest decision of the Supreme Court of the United
States in Clark vs. Uebersee Finanz Korporation, decided on December 8, 1947, 92 Law.
Ed. Advance Opinions, No. 4, pp. 148-153, in which the control test has been adopted.
In "Enemy Corporations" by Martin Domke, a paper presented to the Second
International Conference of the Legal Profession held at The Hague (Netherlands) in
August, 1948, the following enlightening passages appear:
"Since World War I, the determination of enemy nationality of corporations
has been discussed in many countries, belligerent and neutral. A corporation was
subject to enemy legislation when it was controlled by enemies, namely managed
under the in uence of individuals or corporations themselves considered as
enemies. It was the English courts which rst in the Daimler case applied this new
concept of "piercing the corporate veil', which was adopted by the Peace Treaties
of 1919 and the Mixed Arbitral Tribunals established after the First World War.
"The United States of America did not adopt the control test during the First
World War. Courts refused to recognize the concept whereby American-registered
corporations could be considered as enemies and thus subject to domestic
legislation and administrative measures regarding enemy property.
"World War II revived the problem again. It was known that German and
other enemy interests were cloaked by domestic corporation structure. It was not
only by legal ownership of shares that a material in uence could be exercised on
the management of the corporation but also by long-term loans and other factual
situations. For that reason, legislation on enemy property enacted in various
countries during World War II adopted by statutory provisions the control test and
determined, to various degrees, the incidents of control. Court decisions were
CD Technologies Asia, Inc. © 2017 cdasiaonline.com
rendered on the basis of such newly enacted statutory provisions in determining
enemy character of domestic corporation.
"The United States did not, in the amendments of the Trading with the
Enemy Act during the last war, include as did other legislations, the application of
the control test and again, as in World War I, courts refused to apply this concept
whereby the enemy character of an American or neutral-registered corporation is
determined by the enemy nationality of the controlling stockholders.
"Measures of blocking foreign funds, the so called freezing regulations,
and other administrative practice in the treatment of foreign-owned property in the
United States allowed to a large degree the determination of enemy interests in
domestic corporations and thus the application of the control test. Court
decisions sanctioned such administrative practice enacted under the First War
Powers Act of 1941, and more recently, on December 8, 1947, the Supreme Court
of the United States de nitely approved of the control theory. In Clark vs.
Uebersee Finanz Korporation, A. G., dealing with a Swiss corporation allegedly
controlled by German interests, the Court said: 'The property of all foreign interest
was placed within the reach of the vesting power (of the Alien Property
Custodian) not to appropriate friendly or neutral assets but to reach enemy
interests which masqueraded under those innocent fronts. . . . The power of
seizure and vesting was extended to all property of any foreign country or
national so that no innocent appearing device could become a Trojan horse.'"
It becomes unnecessary, therefore, to dwell at length on the authorities cited in
support of the appealed decision. However, we may add that, in Haw Pia vs. China
Banking Corporation, * 45 Off. Gaz., (Supp. 9) 229, we already held that the China
Banking Corporation came within the meaning of the word "enemy" as used in the
Trading with the Enemy Acts of civilized countries not only because it was incorporated
under the laws of an enemy country but because it was controlled by enemies.
The Philippine Insurance Law (Act No. 2427, as amended), in section 8, provides
that "anyone except a public enemy may be insured." It stands to reason that an
insurance policy ceases to be allowable as soon as an insured becomes a public
enemy.
"Effect of war, generally . — All intercourse between citizens of belligerent
powers which is inconsistent with a state of war is prohibited by the law of
nations. Such prohibition includes all negotiations, commerce, or trading with the
enemy; all acts which will increase, or tend to increase, its income or resources; all
acts of voluntary submission to it; or of receiving its protection; also, all acts
concerning the transmission of money or goods; and all contracts relating thereto
are thereby nulli ed. It further prohibits insurance upon trade with or by the
enemy, and upon the life or lives of aliens engaged in service with the enemy; this
for the reason that the subjects of one country cannot be permitted to lend their
assistance to protect by insurance the commerce or property of belligerent, alien
subjects, or to do anything detrimental to their country's interest. The purpose of
war is to cripple the power and exhaust the resources of the enemy, and it is
inconsistent that one country should destroy its enemy's property and repay in
insurances the value of what has been so destroyed, or that it should in such
manner increase the resources of the enemy, or render it aid, and the
commencement of war determines, for like reasons, all trading intercourse with
the enemy, which prior thereto may have been lawful. All individuals, therefore,
who compose the belligerent powers, exist, as to each other, in a state of utter
exclusion, and are public enemies." (6 Couch, Cyc. of Ins. Law, pp. 5352-5353.)
Footnotes
* 80 Phil., 604.
CD Technologies Asia, Inc. © 2017 cdasiaonline.com
CD Technologies Asia, Inc. © 2017 cdasiaonline.com
SECOND DIVISION
DECISION
PUNO , J : p
Before the Court is the petition for certiorari under Rule 45 of the Revised Rules of
Court by petitioner GULF RESORTS, INC., against respondent PHILIPPINE CHARTER
INSURANCE CORPORATION. Petitioner assails the appellate court decision 1 which
dismissed its two appeals and affirmed the judgment of the trial court.
For review are the warring interpretations of petitioner and respondent on the scope
of the insurance company's liability for earthquake damage to petitioner's properties.
Petitioner avers that, pursuant to its earthquake shock endorsement rider, Insurance Policy
No. 31944 covers all damages to the properties within its resort caused by earthquake.
Respondent contends that the rider limits its liability for loss to the two swimming pools
of petitioner.
The facts as established by the court a quo, and a rmed by the appellate court are
as follows:
[P]laintiff is the owner of the Plaza Resort situated at Agoo, La Union and
had its properties in said resort insured originally with the American Home
Assurance Company (AHAC-AIU). In the rst four insurance policies issued by
AHAC-AIU from 1984-85; 1985-86; 1986-1987; and 1987-88 (Exhs. "C", "D", "E" and
"F"; also Exhs. "1", "2", "3" and "4" respectively), the risk of loss from earthquake
shock was extended only to plaintiff's two swimming pools, thus, "earthquake
shock endt." (Item 5 only) (Exhs. "C-1"; "D-1," and "E" and two (2) swimming pools
only (Exhs. "C-1"; 'D-1", "E" and "F-1"). "Item 5" in those policies referred to the two
(2) swimming pools only (Exhs. "1-B", "2-B", "3-B" and "F-2"); that subsequently
AHAC(AIU) issued in plaintiff's favor Policy No. 206-4182383-0 covering the
period March 14, 1988 to March 14, 1989 (Exhs. "G" also "G-1") and in said policy
the earthquake endorsement clause as indicated in Exhibits "C-1", "D-1", Exhibits
"E" and "F-1" was deleted and the entry under Endorsements/Warranties at the
time of issue read that plaintiff renewed its policy with AHAC (AIU) for the period
of March 14, 1989 to March 14, 1990 under Policy No. 206-4568061-9 (Exh. "H")
which carried the entry under "Endorsement/Warranties at Time of Issue", which
read "Endorsement to Include Earthquake Shock (Exh. "6-B-1") in the amount of
P10,700.00 and paid P42,658.14 (Exhs. "6-A" and "6-B") as premium thereof,
computed as follows: EDCcaS
Rate-Various
F.S.T. 776.89
TOTAL 45,159.92;
that the above break-down of premiums shows that plaintiff paid only
P393.00 as premium against earthquake shock (ES); that in all the six insurance
policies (Exhs. "C", "D", "E", "F", "G" and "H"), the premium against the peril of
earthquake shock is the same, that is P393.00 (Exhs. "C" and "1-B"; "2-B" and "3-B-
1" and "3-B-2"; "F-02" and "4-A-1"; "G-2" and "5-C-1"; "6-C-1"; issued by AHAC (Exhs.
"C", "D", "E", "F", "G" and "H") and in Policy No. 31944 issued by defendant, the
shock endorsement provide(sic):
CD Technologies Asia, Inc. © 2018 cdasiaonline.com
In consideration of the payment by the insured to the company of
the sum included additional premium the Company agrees,
notwithstanding what is stated in the printed conditions of this policy due
to the contrary, that this insurance covers loss or damage to shock to any
of the property insured by this Policy occasioned by or through or in
consequence of earthquake (Exhs. "1-D", "2-D", "3-A", "4-B", "5-A", "6-D" and
"7-C"); cDCaTS
that in Exhibit "7-C" the word "included" above the underlined portion was
deleted; that on July 16, 1990 an earthquake struck Central Luzon and Northern
Luzon and plaintiff's properties covered by Policy No. 31944 issued by defendant,
including the two swimming pools in its Agoo Playa Resort were damaged. 2
After the earthquake, petitioner advised respondent that it would be making a claim
under its Insurance Policy No. 31944 for damages on its properties. Respondent
instructed petitioner to le a formal claim, then assigned the investigation of the claim to
an independent claims adjuster, Bayne Adjusters and Surveyors, Inc. 3 On July 30, 1990,
respondent, through its adjuster, requested petitioner to submit various documents in
support of its claim. On August 7, 1990, Bayne Adjusters and Surveyors, Inc., through its
Vice-President A.R. de Leon, 4 rendered a preliminary report 5 nding extensive damage
caused by the earthquake to the clubhouse and to the two swimming pools. Mr. de Leon
stated that "except for the swimming pools, all affected items have no coverage for
earthquake shocks." 6 On August 11, 1990, petitioner led its formal demand 7 for
settlement of the damage to all its properties in the Agoo Playa Resort. On August 23,
1990, respondent denied petitioner's claim on the ground that its insurance policy only
afforded earthquake shock coverage to the two swimming pools of the resort. 8 Petitioner
and respondent failed to arrive at a settlement. 9 Thus, on January 24, 1991, petitioner led
a complaint 1 0 with the regional trial court of Pasig praying for the payment of the
following:
1.) The sum of P5,427,779.00, representing losses sustained by the insured
properties, with interest thereon, as computed under par. 29 of the policy
(Annex "B") until fully paid;
2.) The sum of P428,842.00 per month, representing continuing losses sustained
by plaintiff on account of defendant's refusal to pay the claims;
5.) Costs. 1 1
Respondent led its Answer with Special and A rmative Defenses with Compulsory
Counterclaims. 1 2
On February 21, 1994, the lower court after trial ruled in favor of the respondent, viz:
The above schedule clearly shows that plaintiff paid only a premium of
P393.00 against the peril of earthquake shock, the same premium it paid against
earthquake shock only on the two swimming pools in all the policies issued by
AHAC(AIU) (Exhibits "C", "D", "E", "F" and "G"). From this fact the Court must
consequently agree with the position of defendant that the endorsement rider
(Exhibit "7-C") means that only the two swimming pools were insured against
earthquake shock. CSTHca
No pronouncement as to costs. 1 3
Petitioner's Motion for Reconsideration was denied. Thus, petitioner led an appeal
with the Court of Appeals based on the following assigned errors: 1 4
A. THE TRIAL COURT ERRED IN FINDING THAT PLAINTIFF-APPELLANT
CAN ONLY RECOVER FOR THE DAMAGE TO ITS TWO SWIMMING POOLS UNDER
ITS FIRE POLICY NO. 31944, CONSIDERING ITS PROVISIONS, THE
CIRCUMSTANCES SURROUNDING THE ISSUANCE OF SAID POLICY AND THE
ACTUATIONS OF THE PARTIES SUBSEQUENT TO THE EARTHQUAKE OF JULY
16, 1990.
On the other hand, respondent led a partial appeal, assailing the lower court's
CD Technologies Asia, Inc. © 2018 cdasiaonline.com
failure to award it attorney's fees and damages on its compulsory counterclaim.
After review, the appellate court a rmed the decision of the trial court and ruled,
thus:
However, after carefully perusing the documentary evidence of both
parties, We are not convinced that the last two (2) insurance contracts (Exhs. "G"
and "H"), which the plaintiff-appellant had with AHAC (AIU) and upon which the
subject insurance contract with Philippine Charter Insurance Corporation is said
to have been based and copied (Exh. "I"), covered an extended earthquake shock
insurance on all the insured properties.
Petitioner contends:
First, that the policy's earthquake shock endorsement clearly covers all of the
properties insured and not only the swimming pools. It used the words "any property
insured by this policy," and it should be interpreted as all inclusive.
Second, the unquali ed and unrestricted nature of the earthquake shock
endorsement is con rmed in the body of the insurance policy itself, which states that it is "
[s]ubject to: Other Insurance Clause, Typhoon Endorsement, Earthquake Shock Endt.,
CD Technologies Asia, Inc. © 2018 cdasiaonline.com
Extended Coverage Endt., FEA Warranty & Annual Payment Agreement On Long Term
Policies." 1 7
Third, that the quali cation referring to the two swimming pools had already been
deleted in the earthquake shock endorsement.
Fourth, it is unbelievable for respondent to claim that it only made an inadvertent
omission when it deleted the said qualification.
Fifth, that the earthquake shock endorsement rider should be given precedence over
the wording of the insurance policy, because the rider is the more deliberate expression of
the agreement of the contracting parties.
Sixth, that in their previous insurance policies, limits were placed on the
endorsements/warranties enumerated at the time of issue.
Seventh, any ambiguity in the earthquake shock endorsement should be resolved in
favor of petitioner and against respondent. It was respondent which caused the ambiguity
when it made the policy in issue.
Eighth, the quali cation of the endorsement limiting the earthquake shock
endorsement should be interpreted as a caveat on the standard re insurance policy, such
as to remove the two swimming pools from the coverage for the risk of re. It should not
be used to limit the respondent's liability for earthquake shock to the two swimming pools
only.
Ninth, there is no basis for the appellate court to hold that the additional premium
was not paid under the extended coverage. The premium for the earthquake shock
coverage was already included in the premium paid for the policy.
Tenth, the parties' contemporaneous and subsequent acts show that they intended
to extend earthquake shock coverage to all insured properties. When it secured an
insurance policy from respondent, petitioner told respondent that it wanted an exact
replica of its latest insurance policy from American Home Assurance Company (AHAC-
AIU), which covered all the resort's properties for earthquake shock damage and
respondent agreed. After the July 16, 1990 earthquake, respondent assured petitioner that
it was covered for earthquake shock. Respondent's insurance adjuster, Bayne Adjusters
and Surveyors, Inc., likewise requested petitioner to submit the necessary documents for
its building claims and other repair costs. Thus, under the doctrine of equitable estoppel, it
cannot deny that the insurance policy it issued to petitioner covered all of the properties
within the resort.
Eleventh, that it is proper for it to avail of a petition for review by certiorari under
Rule 45 of the Revised Rules of Court as its remedy, and there is no need for calibration of
the evidence in order to establish the facts upon which this petition is based. cDCSTA
Petitioner anchors its claims on AHAC-AIU's inadvertent deletion of the phrase "Item
5 Only" after the descriptive name or title of the Earthquake Shock Endorsement. However,
the words of the policy re ect the parties' clear intention to limit earthquake shock
CD Technologies Asia, Inc. © 2018 cdasiaonline.com
coverage to the two swimming pools.
Before petitioner accepted the policy, it had the opportunity to read its conditions. It
did not object to any de ciency nor did it institute any action to reform the policy. The
policy binds the petitioner.
Eighth, there is no basis for petitioner to claim damages, attorney's fees and
litigation expenses. Since respondent was willing and able to pay for the damage caused
on the two swimming pools, it cannot be considered to be in default, and therefore, it is not
liable for interest.
We hold that the petition is devoid of merit.
In Insurance Policy No. 31944, four key items are important in the resolution of the
case at bar.
First, in the designation of location of risk, only the two swimming pools were
specified as included, viz:
ITEM 3 — 393,000.00 — On the two (2) swimming pools only (against the
peril of earthquake shock only) 2 0
Second, under the breakdown for premium payments, 2 1 it was stated that:
PREMIUM RECAPITULATION
ITEM NOS. AMOUNT RATES PREMIUM
Fourth, the rider attached to the policy, titled "Extended Coverage Endorsement (To
Include the Perils of Explosion, Aircraft, Vehicle and Smoke)," stated, viz:
ANNUAL PAYMENT AGREEMENT ON
LONG TERM POLICIES
THE INSURED UNDER THIS POLICY HAVING ESTABLISHED AGGREGATE
SUMS INSURED IN EXCESS OF FIVE MILLION PESOS, IN CONSIDERATION OF A
DISCOUNT OF 5% OR 7 1/2% OF THE NET PREMIUM . . . POLICY HEREBY
UNDERTAKES TO CONTINUE THE INSURANCE UNDER THE ABOVE NAMED . . .
AND TO PAY THE PREMIUM. CIAacS
Earthquake Endorsement
In consideration of the payment by the Insured to the Company of the sum
of P. . . . . . . . . . . . . . . . . additional premium the Company agrees, notwithstanding
what is stated in the printed conditions of this Policy to the contrary, that this
insurance covers loss or damage (including loss or damage by re) to any of the
CD Technologies Asia, Inc. © 2018 cdasiaonline.com
property insured by this Policy occasioned by or through or in consequence of
Earthquake.
Provided always that all the conditions of this Policy shall apply (except in
so far as they may be hereby expressly varied) and that any reference therein to
loss or damage by re should be deemed to apply also to loss or damage
occasioned by or through or in consequence of Earthquake. 2 4
Petitioner contends that pursuant to this rider, no quali cations were placed on the
scope of the earthquake shock coverage. Thus, the policy extended earthquake shock
coverage to all of the insured properties.
It is basic that all the provisions of the insurance policy should be examined and
interpreted in consonance with each other. 2 5 All its parts are re ective of the true intent of
the parties. The policy cannot be construed 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 and riders, taken and interpreted
together, indubitably show the intention 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
intent of the parties to extend earthquake shock coverage only to the two swimming
pools. Section 2(1) of the Insurance Code de nes 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 .
2 6 (Emphasis ours)
pp. 12-13
Q. Now Mr. Mantohac, will it be correct to state also that insofar as your
insurance policy during the period from March 4, 1984 to March 4, 1985
CD Technologies Asia, Inc. © 2018 cdasiaonline.com
the coverage on earthquake shock was limited to the two swimming pools
only?
A. Yes, sir. It is limited to the two swimming pools, speci cally shown in the
warranty, there is a provision here that it was only for item 5.
A. Yes, sir.
CROSS EXAMINATION OF LEOPOLDO MANTOHAC TSN, November 25,
1991
pp. 23-26
Q. For the period from March 14, 1988 up to March 14, 1989, did you personally
arrange for the procurement of this policy?
A. Yes, sir.
Q. Did you also do this through your insurance agency?
A. If you are referring to Forte Insurance Agency, yes.
Q. And you wanted to protect all your properties against similar tremors in the
[future], is that correct?
A. Yes, sir.
Q. Now, after this policy was delivered to you did you bother to check the
CD Technologies Asia, Inc. © 2018 cdasiaonline.com
provisions with respect to your instructions that all properties must be
covered again by earthquake shock endorsement?
A. Are you referring to the insurance policy issued by American Home Assurance
Company marked Exhibit "G"?
Atty. Mejia:
Yes.
Witness:
A. I examined the policy and seeing that the warranty on the earthquake shock
endorsement has no more limitation referring to the two swimming pools
only, I was contented already that the previous limitation pertaining to the
two swimming pools was already removed.
Petitioner also cited and relies on the attachment of the phrase "Subject to: Other
Insurance Clause, Typhoon Endorsement, Earthquake Shock Endorsement, Extended
Coverage Endorsement, FEA Warranty & Annual Payment Agreement on Long Term
Policies" 2 9 to the insurance policy as proof of the intent of the parties to extend the
coverage for earthquake shock. However, this phrase is merely an enumeration of the
descriptive titles of the riders, clauses, warranties or endorsements to which the policy is
subject, as required under Section 50, paragraph 2 of the Insurance Code.
We also hold that no signi cance can be placed on the deletion of the quali cation
limiting the coverage to the two swimming pools. The earthquake shock endorsement
cannot stand alone. As explained by the testimony of Juan Baranda III, underwriter for
AHAC-AIU:
DIRECT EXAMINATION OF JUAN BARANDA III 3 0
pp. 9-12
Atty. Mejia:
WITNESS:
Yes[,] I remember having gone over these policies at one point of time, sir.
Q. Now, wach ( sic) of these six (6) policies marked in evidence as Exhibits C to H
respectively carries an earthquake shock endorsement[?] My question to
you is, on the basis on (sic) the wordings indicated in Exhibits C to H
respectively what was the extent of the coverage [against] the peril of
earthquake shock as provided for in each of the six (6) policies? ADaSET
WITNESS:
The extent of the coverage is only up to the two (2) swimming pools, sir.
CD Technologies Asia, Inc. © 2018 cdasiaonline.com
Q. Is that for each of the six (6) policies namely: Exhibits C, D, E, F, G and H?
A. Yes, sir.
ATTY. MEJIA:
What is your basis for stating that the coverage against earthquake shock as
provided for in each of the six (6) policies extend to the two (2) swimming
pools only?
WITNESS:
ATTY. MEJIA:
Witness referring to Exhibit C-1, your Honor.
WITNESS:
COURT:
As far as earthquake shock endorsement you do not have a speci c coverage for
other things other than swimming pool? You are covering building? They
are covered by a general insurance?
WITNESS:
Earthquake shock coverage could not stand alone. If we are covering building or
another we can issue earthquake shock solely but that the moment I see
this, the thing that comes to my mind is either insuring a swimming pool,
foundations, they are normally affected by earthquake but not by fire, sir.
Q. Plaintiff's witness, Mr. Mantohac testi ed and he alleged that only Exhibits C,
D, E and F inclusive [remained] its coverage against earthquake shock to
two (2) swimming pools only but that Exhibits G and H respectively entend
the coverage against earthquake shock to all the properties indicated in the
respective schedules attached to said policies, what can you say about
that testimony of plaintiff's witness? aSADIC
WITNESS:
As I have mentioned earlier, earthquake shock cannot stand alone without the
other half of it. I assure you that this one covers the two swimming pools
with respect to earthquake shock endorsement. Based on it, if we are going
to look at the premium there has been no change with respect to the rates.
CD Technologies Asia, Inc. © 2018 cdasiaonline.com
Everytime (sic) there is a renewal if the intention of the insurer was to
include the earthquake shock, I think there is a substantial increase in the
premium. We are not only going to consider the two (2) swimming pools of
the other as stated in the policy. As I see, there is no increase in the amount
of the premium. I must say that the coverage was not broaden (sic) to
include the other items.
COURT:
WITNESS:
They are the same in the sence (sic), in the amount of the coverage. If you are
going to do some computation based on the rates you will arrive at the
same premiums, your Honor.
ATTY. ANDRES:
Would you as a matter of practice [insure] swimming pools for fire insurance?
WITNESS:
A. Yes, sir.
ATTY. ANDRES:
Will you not also agree with me that these exhibits, Exhibits G and H which you
have pointed to during your direct-examination, the phrase "Item no. 5 only"
meaning to (sic) the two (2) swimming pools was deleted from the policies
issued by AIU, is it not?
ATTY. ANDRES:
As an insurance executive will you not attach any signi cance to the deletion of
the qualifying phrase for the policies? SaHcAC
WITNESS:
My answer to that would be, the deletion of that particular phrase is inadvertent.
Being a company underwriter, we do not cover. . it was inadvertent because
of the previous policies that we have issued with no speci c attachments,
premium rates and so on. It was inadvertent, sir.
pp. 4-5
Q. Just to be clear about this particular answer of yours Mr. Witness, what exactly
did you tell Atty. Omlas (sic) to copy from Exhibit "H" for purposes of
procuring the policy from Philippine Charter Insurance Corporation?
A. I told him that the insurance that they will have to get will have the same
provisions as this American Home Insurance Policy No. 206-4568061-9.
Q. You are referring to Exhibit "H" of course?
Q. So, all the provisions here will be the same except that of the premium rates?
A. Yes, sir. He assured me that with regards to the insurance premium rates that
they will be charging will be limited to this one. I (sic) can even be lesser.
Atty. Mejia:
Q. Will it be correct to state[,] Mr. Witness, that you made a comparison of the
provisions and scope of coverage of Exhibits "I" and "H" sometime in the
third week of March, 1990 or thereabout?
A. No, sir, I did not discover any difference inasmuch ( sic) as I was assured
already that the policy wordings and rates were copied from the insurance
policy I sent them but it was only when this case erupted that we
discovered some discrepancies.
Q. With respect to the items declared for insurance coverage did you notice any
discrepancy at any time between those indicated in Exhibit "I" and those
indicated in Exhibit "H" respectively?
A. With regard to the wordings I did not notice any difference because it was
exactly the same P393,000.00 on the two (2) swimming pools only against
the peril of earthquake shock which I understood before that this provision
will have to be placed here because this particular provision under the peril
of earthquake shock only is requested because this is an insurance policy
and therefore cannot be insured against fire, so this has to be placed.
pp. 22-26
Q. Do you recall the circumstances that led to your discussion regarding the
extent of coverage of the policy issued by Philippine Charter Insurance
Corporation?
Q. Now, may we know from you Engr. de Leon your basis, if any, for stating that
except for the swimming pools all affected items have no coverage for
earthquake shock?
In sum, there is no ambiguity in the terms of the contract and its riders. Petitioner
cannot rely on the general rule that insurance contracts are contracts of adhesion which
should be liberally construed in favor of the insured and strictly against the insurer
company which usually prepares it. 3 1 A contract of adhesion is one wherein a party,
usually a corporation, prepares the stipulations in the contract, while the other party merely
a xes his signature or his "adhesion" thereto. Through the years, the courts have held that
in these type of contracts, the parties do not bargain on equal footing, the weaker party's
participation being reduced to the alternative to take it or leave it. Thus, these contracts
are viewed as traps for the weaker party whom the courts of justice must protect. 3 2
Consequently, any ambiguity therein is resolved against the insurer, or construed liberally in
favor of the insured. 3 3
The case law will show that this Court will only rule out blind adherence to terms
where facts and circumstances will show that they are basically one-sided. 3 4 Thus, we
have called on lower courts to remain careful in scrutinizing the factual circumstances
behind each case to determine the e cacy of the claims of contending parties. In
CD Technologies Asia, Inc. © 2018 cdasiaonline.com
Development Bank of the Philippines v. National Merchandising Corporation, et al ., 3 5 the
parties, who were acute businessmen of experience, were presumed to have assented to
the assailed documents with full knowledge.
We cannot apply the general rule on contracts of adhesion to the case at bar.
Petitioner cannot claim it did not know the provisions of the policy. From the inception of
the policy, petitioner had required the respondent to copy verbatim the provisions and
terms of its latest insurance policy from AHAC-AIU. The testimony of Mr. Leopoldo
Mantohac, a direct participant in securing the insurance policy of petitioner, is re ective of
petitioner's knowledge, viz:
pp. 20-21
Q. Did you indicate to Atty. Omlas ( sic) what kind of policy you would want for
those facilities in Agoo Playa?
A. Yes, sir. I told him that I will agree to that renewal of this policy under Philippine
Charter Insurance Corporation as long as it will follow the same or exact
provisions of the previous insurance policy we had with American Home
Assurance Corporation.
Q. Did you take any step Mr. Witness to ensure that the provisions which you
wanted in the American Home Insurance policy are to be incorporated in
the PCIC policy?
A. Yes, sir.
Q. What steps did you take?
Respondent, in compliance with the condition set by the petitioner, copied AIU
Policy No. 206-4568061-9 in drafting its Insurance Policy No. 31944. It is true that there
was variance in some terms, speci cally in the replacement cost endorsement, but the
principal provisions of the policy remained essentially similar to AHAC-AIU's policy.
Consequently, we cannot apply the " ne print" or "contract of adhesion" rule in this case as
the parties' intent to limit the coverage of the policy to the two swimming pools only is not
ambiguous. 3 7
IN VIEW WHEREOF, the judgment of the Court of Appeals is a rmed. The petition
for certiorari is dismissed. No costs. cIEHAC
SO ORDERED.
Austria-Martinez, Callejo, Sr., Tinga and Chico-Nazario, JJ., concur.
Footnotes
7. Id., p. 49.
8. Id., p. 50.
25. Ruiz v. Sheriff of Manila , 34 SCRA 83 (1970); National Union Fire Insurance Company of
Pittsburg v. Stolt-Nielsen Philippines, Inc., 184 SCRA 682 (1990).
26. See Vance, pp. 1-2, cited in Agbayani, Commercial Laws of the Philippines, vol. 2, (1986), p.
6; Philamcare Health Systems, Inc. v. Court of Appeals, 379 SCRA 356 (2002).
34. Pan American World Airways, Inc. v. Rapadas , 209 SCRA 67 (1992); BPI Credit Corporation
v. Court of Appeals , 204 SCRA 601 (1991); Serra v. Court of Appeals , 229 SCRA 60
(1994).
36. Testimony of the vice president for corporate affairs and corporate secretary of petitioner,
TSN, September 23, 1991.
37. Sweet Lines, Inc. v. Teves , 83 SCRA 361 (1978); Tan v. Court of Appeals , 174 SCRA 403
(1989).
SYLLABUS
1. MERCANTILE LAW; INSURANCE; WHAT CONSTITUTES "DOING AN
INSURANCE BUSINESS" OR "TRANSACTING AN INSURANCE BUSINESS." — Section 2 (2) of
the Insurance Code enumerates what constitutes "doing an insurance business" or
"transacting an insurance business." These are: (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; (c) doing any kind of business, including a reinsurance business,
speci cally recognized as constituting the doing of an insurance business within the
meaning of this Code; (d) doing or proposing to do any business in substance equivalent
to any of the foregoing in a manner designed to evade the provisions of this Code. . . . The
same provision also provides, the fact that no pro t is derived from the making of
insurance contracts, agreements or transactions, or that no separate or direct
consideration is received therefor, shall not preclude the existence of an insurance
business.
2. ID.; ID.; TEST TO DETERMINE IF A CONTRACT IS AN INSURANCE CONTRACT
OR NOT. — The test to determine if a contract is an insurance contract or not, depends on
the nature of the promise, the act required to be performed, and the exact nature of the
agreement in the light of the occurrence, contingency, or circumstances under which the
performance becomes requisite. It is not by what it is called.
3. ID.; ID.; AN INSURANCE CONTRACT; A CONTRACT OF INDEMNITY. —
Basically, an insurance contract is a contract of indemnity. In it, one undertakes for a
consideration to indemnify another against loss, damage or liability arising from an
unknown or contingent event.
4. ID.; ID.; MUTUAL INSURANCE COMPANY; ELUCIDATED. — Relatedly, a mutual
insurance company is a cooperative enterprise where the members are both the insurer
and insured. In it, the members all contribute, by a system of premiums or assessments, to
the creation of a fund from which all losses and liabilities are paid, and where the pro ts
are divided among themselves, in proportion to their interest. Additionally, mutual
insurance associations, or clubs, provide three types of coverage, namely, protection and
indemnity, war risks, and defense costs.
5. ID.; ID.; INSURANCE CONTRACT; REGULATION BY THE STATE IS NECESSARY.
— Since a contract of insurance involves public interest, regulation by the State is
CD Technologies Asia, Inc. © 2018 cdasiaonline.com
necessary. Thus, no insurer or insurance company is allowed to engage in the insurance
business without a license or a certificate of authority from the Insurance Commission.
DECISION
QUISUMBING , J : p
This petition for review assails the Decision 1 dated July 30, 2002 of the Court of
Appeals in CA.-G.R. SP No. 60144, a rming the Decision 2 dated May 3, 2000 of the
Insurance Commission in I.C. Adm. Case No. RD-277. Both decisions held that there was
no violation of the Insurance Code and the respondents do not need license as insurer and
insurance agent/broker.
The facts are undisputed.
White Gold Marine Services, Inc. (White Gold) procured a protection and indemnity
coverage for its vessels from The Steamship Mutual Underwriting Association (Bermuda)
Limited (Steamship Mutual) through Pioneer Insurance and Surety Corporation (Pioneer).
Subsequently, White Gold was issued a Certi cate of Entry and Acceptance. 3 Pioneer also
issued receipts evidencing payments for the coverage. When White Gold failed to fully pay
its accounts, Steamship Mutual refused to renew the coverage.
Steamship Mutual thereafter led a case against White Gold for collection of sum of
money to recover the latter's unpaid balance. White Gold on the other hand, led a
complaint before the Insurance Commission claiming that Steamship Mutual violated
Sections 186 4 and 187 5 of the Insurance Code, while Pioneer violated Sections 299, 6
300 7 and 301 8 in relation to Sections 302 and 303, thereof. STaCIA
The Insurance Commission dismissed the complaint. It said that there was no need
for Steamship Mutual to secure a license because it was not engaged in the insurance
business. It explained that Steamship Mutual was a Protection and Indemnity Club (P & I
Club). Likewise, Pioneer need not obtain another license as insurance agent and/or a
broker for Steamship Mutual because Steamship Mutual was not engaged in the insurance
business. Moreover, Pioneer was already licensed, hence, a separate license solely as
agent/broker of Steamship Mutual was already superfluous.
The Court of Appeals a rmed the decision of the Insurance Commissioner. In its
decision, the appellate court distinguished between P & I Clubs vis-à-vis conventional
insurance. The appellate court also held that Pioneer merely acted as a collection agent of
Steamship Mutual.
In this petition, petitioner assigns the following errors allegedly committed by the
appellate court,
FIRST ASSIGNMENT OF ERROR
THE COURT A QUO ERRED WHEN IT RULED THAT THE RECORD IS BEREFT OF
ANY EVIDENCE THAT RESPONDENT STEAMSHIP IS ENGAGED IN INSURANCE
BUSINESS.
THE COURT A QUO ERRED WHEN IT RULED, THAT RESPONDENT PIONEER NEED
NOT SECURE A LICENSE WHEN CONDUCTING ITS AFFAIR AS AN
AGENT/BROKER OF RESPONDENT STEAMSHIP.
Simply, the basic issues before us are (1) Is Steamship Mutual, a P & I Club, engaged
in the insurance business in the Philippines? (2) Does Pioneer need a license as an
insurance agent/broker for Steamship Mutual?
The parties admit that Steamship Mutual is a P & I Club. Steamship Mutual admits it
does not have a license to do business in the Philippines although Pioneer is its resident
agent. This relationship is re ected in the certi cations issued by the Insurance
Commission. ECcTaS
Petitioner insists that Steamship Mutual as a P & I Club is engaged in the insurance
business. To buttress its assertion, it cites the de nition of a P & I Club in Hyopsung
Maritime Co., Ltd. v. Court of Appeals 1 0 as "an association composed of shipowners in
general who band together for the speci c purpose of providing insurance cover on a
mutual basis against liabilities incidental to shipowning that the members incur in favor of
third parties." It stresses that as a P & I Club, Steamship Mutual's primary purpose is to
solicit and provide protection and indemnity coverage and for this purpose, it has engaged
the services of Pioneer to act as its agent.
Respondents contend that although Steamship Mutual is a P & I Club, it is not
engaged in the insurance business in the Philippines. It is merely an association of vessel
owners who have come together to provide mutual protection against liabilities incidental
to shipowning. 1 1 Respondents aver Hyopsung is inapplicable in this case because the
issue in Hyopsung was the jurisdiction of the court over Hyopsung.
Is Steamship Mutual engaged in the insurance business?
Section 2(2) of the Insurance Code enumerates what constitutes "doing an
insurance business" or "transacting an insurance business". These are:
(a) making or proposing to make, as insurer, any insurance contract;
The same provision also provides, the fact that no pro t is derived from the making
of insurance contracts, agreements or transactions, or that no separate or direct
consideration is received therefor, shall not preclude the existence of an insurance
business. 1 2
The test to determine if a contract is an insurance contract or not, depends on the
nature of the promise, the act required to be performed, and the exact nature of the
agreement in the light of the occurrence, contingency, or circumstances under which the
performance becomes requisite. It is not by what it is called. 1 3
Basically, an insurance contract is a contract of indemnity. In it, one undertakes for a
consideration to indemnify another against loss, damage or liability arising from an
unknown or contingent event. 1 4
In particular, a marine insurance undertakes to indemnify the assured against marine
losses, such as the losses incident to a marine adventure. 1 5 Section 99 1 6 of the Insurance
Code enumerates the coverage of marine insurance. HEacDA
Finally, White Gold seeks revocation of Pioneer's certi cate of authority and removal
of its directors and officers. Regrettably, we are not the forum for these issues.
WHEREFORE, the petition is PARTIALLY GRANTED. The Decision dated July 30, 2002
of the Court of Appeals a rming the Decision dated May 3, 2000 of the Insurance
Commission is hereby REVERSED AND SET ASIDE. The Steamship Mutual Underwriting
Association (Bermuda) Ltd., and Pioneer Insurance and Surety Corporation are ORDERED
to obtain licenses and to secure proper authorizations to do business as insurer and
insurance agent, respectively. The petitioner's prayer for the revocation of Pioneer's
Certi cate of Authority and removal of its directors and o cers, is DENIED. Costs against
respondents.
SO ORDERED.
Davide, Jr., C.J., Ynares-Santiago, Carpio and Azcuna, JJ., concur.
Footnotes
1. Rollo, pp. 28-41. Penned by Associate Justice Delilah Vidallon-Magtolis, with Associate
Justices Candido V. Rivera, and Sergio L. Pestaño concurring.
2. CA Rollo, pp. 43-51.
3. Id. at 103.
4. SEC. 186. No person, partnership, or association of persons shall transact any insurance
business in the Philippines except as agent of a person or corporation authorized to do
the business of insurance in the Philippines, unless possessed of the capital and assets
required of an insurance corporation doing the same kind of business in the Philippines
and invested in the same manner; nor unless the Commissioner shall have granted to
him or them a certificate to the effect that he or they have complied with all the
provisions of law which an insurance corporation doing business in the Philippines is
required to observe.
SYNOPSIS
This is a petition for review under Rule 45 of the Rules of Court, assailing the
decision and resolution of the Court of Appeals dated May 17, 1994 and January 4, 1994,
respectively, in CA G.R. CV No. 18341. The appellate court a rmed in toto the judgment of
the Regional Trial Court of Misamis Oriental in an insurance claim led by private
respondent against Great Pacific Life Assurance Co.
The Supreme Court found the petition not meritorious. Contrary to petitioner's
allegations, there was no su cient proof that the insured had suffered from hypertension.
Aside from the statement of the insured's widow who was not even sure if the medicines
taken by Dr. Leuterio were for hypertension, the petitioner had not proven nor produced
any witness who could attest to Dr. Leuterio's medical history. Clearly, it had failed to
establish that there was concealment made by the insured, hence it cannot refuse payment
of the claim.
SYLLABUS
DECISION
QUISUMBING , J : p
This petition for review, under Rule 45 of the Rules of Court, assails the Decision 1
CD Technologies Asia, Inc. 2018 cdasiaonline.com
dated May 17, 1993, of the Court of Appeals and its Resolution 2 dated January 4, 1994 in
CA-G.R. CV No. 18341. The appellate court a rmed in toto the judgment of the Misamis
Oriental Regional Trial Court, Branch 18, in an insurance claim led by private respondent
against Great Paci c Life Assurance Co. The dispositive portion of the trial court's
decision reads: cdphil
A contract of group life insurance was executed between petitioner Great Paci c
Life Assurance Corporation (hereinafter Grepalife) and Development Bank of the
Philippines (hereinafter DBP). Grepalife agreed to insure the lives of eligible housing loan
mortgagors of DBP.
On November 11, 1983, Dr. Wilfredo Leuterio, a physician and a housing debtor of
DBP applied for membership in the group life insurance plan. In an application form, Dr.
Leuterio answered questions concerning his health condition as follows:
"7. Have you ever had, or consulted, a physician for a heart condition,
high blood pressure, cancer, diabetes, lung, kidney or stomach disorder or any
other physical impairment?
On November 15, 1983, Grepalife issued Certi cate No. B-18558, as insurance
coverage of Dr. Leuterio, to the extent of his DBP mortgage indebtedness amounting to
eighty-six thousand, two hundred (P86,200.00) pesos.
On August 6, 1984, Dr. Leuterio died due to "massive cerebral hemorrhage."
Consequently, DBP submitted a death claim to Grepalife. Grepalife denied the claim
alleging that Dr. Leuterio was not physically healthy when he applied for an insurance
coverage on November 15, 1983. Grepalife insisted that Dr. Leuterio did not disclose he
had been suffering from hypertension, which caused his death. Allegedly, such non-
disclosure constituted concealment that justified the denial of the claim.
On October 20, 1986, the widow of the late Dr. Leuterio, respondent Medarda V.
Leuterio, led a complaint with the Regional Trial Court of Misamis Oriental, Branch 18,
against Grepalife for "Speci c Performance with Damages." 5 During the trial, Dr. Hernando
Mejia, who issued the death certi cate, was called to testify. Dr. Mejia's ndings, based
partly from the information given by the respondent widow, stated that Dr. Leuterio
complained of headaches presumably due to high blood pressure. The inference was not
conclusive because Dr. Leuterio was not autopsied, hence, other causes were not ruled
CD Technologies Asia, Inc. 2018 cdasiaonline.com
out. cdtai
On February 22, 1988, the trial court rendered a decision in favor of respondent
widow and against Grepalife. On May 17, 1993, the Court of Appeals sustained the trial
court's decision. Hence, the present petition. Petitioners interposed the following assigned
errors:
"1. THE LOWER COURT ERRED IN HOLDING DEFENDANT-APPELLANT
LIABLE TO THE DEVELOPMENT BANK OF THE PHILIPPINES (DBP) WHICH IS
NOT A PARTY TO THE CASE FOR PAYMENT OF THE PROCEEDS OF A
MORTGAGE REDEMPTION INSURANCE ON THE LIFE OF PLAINTIFF'S HUSBAND
WILFREDO LEUTERIO ONE OF ITS LOAN BORROWERS, INSTEAD OF DISMISSING
THE CASE AGAINST DEFENDANT-APPELLANT [Petitioner Grepalife] FOR LACK
OF CAUSE OF ACTION.
Petitioner alleges that the complaint was instituted by the widow of Dr. Leuterio, not
the real party in interest, hence the trial court acquired no jurisdiction over the case. It
argues that when the Court of Appeals a rmed the trial court's judgment, Grepalife was
held liable to pay the proceeds of insurance contract in favor of DBP, the indispensable
party who was not joined in the suit. prcd
The insured private respondent did not cede to the mortgagee all his rights or
interests in the insurance, the policy stating that: "In the event of the debtor's death before
his indebtedness with the Creditor [DBP] shall have been fully paid, an amount to pay the
outstanding indebtedness shall rst be paid to the creditor and the balance of sum
assured, if there is any, shall then be paid to the bene ciary/ies designated by the debtor."
1 0 When DBP submitted the insurance claim against petitioner, the latter denied payment
thereof, interposing the defense of concealment committed by the insured. Thereafter,
DBP collected the debt from the mortgagor and took the necessary action of foreclosure
on the residential lot of private respondent. 1 1 I n Gonzales La O vs. Yek Tong Lin Fire &
Marine Ins. Co. 1 2 we held:
"Insured, being the person with whom the contract was made, is primarily
the proper person to bring suit thereon. . . . Subject to some exceptions, insured
may thus sue, although the policy is taken wholly or in part for the bene t of
another person named or unnamed, and although it is expressly made payable to
another as his interest may appear or otherwise. . . . Although a policy issued to a
mortgagor is taken out for the bene t of the mortgagee and is made payable to
him, yet the mortgagor may sue thereon in his own name, especially where the
mortgagee's interest is less than the full amount recoverable under the policy, . . .
.'
And in volume 33, page 82, of the same work, we read the following:
And since a policy of insurance upon life or health may pass by transfer, will or
succession to any person, whether he has an insurable interest or not, and such person
CD Technologies Asia, Inc. 2018 cdasiaonline.com
may recover it whatever the insured might have recovered, 14 the widow of the decedent
Dr. Leuterio may file the suit against the insurer, Grepalife.
The second assigned error refers to an alleged concealment that the petitioner
interposed as its defense to annul the insurance contract. Petitioner contends that Dr.
Leuterio failed to disclose that he had hypertension, which might have caused his death.
Concealment exists where the assured had knowledge of a fact material to the risk, and
honesty, good faith, and fair dealing requires that he should communicate it to the assured,
but he designedly and intentionally withholds the same. 15
Petitioner merely relied on the testimony of the attending physician, Dr. Hernando
Mejia, as supported by the information given by the widow of the decedent. Grepalife
asserts that Dr. Mejia's technical diagnosis of the cause of death of Dr. Leuterio was a duly
documented hospital record, and that the widow's declaration that her husband had
"possible hypertension several years ago" should not be considered as hearsay, but as part
of res gestae.
On the contrary the medical ndings were not conclusive because Dr. Mejia did not
conduct an autopsy on the body of the decedent. As the attending physician, Dr. Mejia
stated that he had no knowledge of Dr. Leuterio's any previous hospital con nement. 1 6 Dr.
Leuterio's death certi cate stated that hypertension was only "the possible cause of
death." The private respondent's statement, as to the medical history of her husband, was
due to her unreliable recollection of events. Hence, the statement of the physician was
properly considered by the trial court as hearsay. cdtai
The question of whether there was concealment was aptly answered by the
appellate court, thus:
"The insured, Dr. Leuterio, had answered in his insurance application that
he was in good health and that he had not consulted a doctor or any of the
enumerated ailments, including hypertension; when he died the attending
physician had certi ed in the death certi cate that the former died of cerebral
hemorrhage, probably secondary to hypertension. From this report, the appellant
insurance company refused to pay the insurance claim. Appellant alleged that the
insured had concealed the fact that he had hypertension.
Contrary to appellant's allegations, there was no su cient proof that the
insured had suffered from hypertension. Aside from the statement of the
insured's widow who was not even sure if the medicines taken by Dr. Leuterio
were for hypertension, the appellant had not proven nor produced any witness
who could attest to Dr. Leuterio's medical history. . .
xxx xxx xxx
Appellant insurance company had failed to establish that there was
concealment made by the insured, hence, it cannot refuse payment of the claim."
17 prcd
The fraudulent intent on the part of the insured must be established to entitle the
insurer to rescind the contract. 1 8 Misrepresentation as a defense of the insurer to avoid
liability is an a rmative defense and the duty to establish such defense by satisfactory
and convincing evidence rests upon the insurer. 1 9 In the case at bar, the petitioner failed to
clearly and satisfactorily establish its defense, and is therefore liable to pay the proceeds
of the insurance.
In the event of the debtor's death before his indebtedness with the creditor
shall have been fully paid, an amount to pay the outstanding indebtedness shall
rst be paid to the Creditor and the balance of the Sum Assured, if there is any
shall then be paid to the bene ciary/ies designated by the debtor." 2 2 (Emphasis
omitted)
However, we noted that the Court of Appeals' decision was promulgated on May 17,
1993. In private respondent's memorandum, she states that DBP foreclosed in 1995 their
residential lot, in satisfaction of mortgagor's outstanding loan. Considering this
supervening event, the insurance proceeds shall inure to the bene t of the heirs of the
deceased person or his bene ciaries. Equity dictates that DBP should not unjustly enrich
itself at the expense of another (Nemo cum alterius detrimenio protest). Hence, it cannot
collect the insurance proceeds, after it already foreclosed on the mortgage. The proceeds
now rightly belong to Dr. Leuterio's heirs represented by his widow, herein private
respondent Medarda Leuterio.
WHEREFORE, the petition is hereby DENIED. The Decision and Resolution of the
Court of Appeals in CA-G.R. CV 18341 is AFFIRMED with MODIFICATION that the petitioner
is ORDERED to pay the insurance proceeds amounting to Eighty-six thousand, two hundred
(P86,200.00) pesos to the heirs of the insured, Dr. Wilfredo Leuterio (deceased), upon
presentation of proof of prior settlement of mortgagor's indebtedness to Development
Bank of the Philippines. Costs against petitioner. LLjur
SO ORDERED.
Mendoza, Buena and De Leon Jr., JJ., concur.
Bellosillo, J., is on official leave.
Footnotes
1. Rollo, pp. 36-42.
2. Id. at 44.
3. Id. at 36.
4. Id. at 37.
5. Civil Case 10788.
CD Technologies Asia, Inc. 2018 cdasiaonline.com
6. Rollo, pp. 18-19.
7. Serrano vs. Court of Appeals, 130 SCRA 327, 335 (1984).
8. Ibid.
9. 43 Am Jur 2d, Insurance Section 766; citing Hill vs. International Indem. Co. 116 Kan 109,
225 P 1056, 38 ALR 362.
10. Rollo, p. 12.
11. Id. at 180.
12. 55 Phil. 386 (1930), citing Corpus Juris, volume 26 pages 483 et seq.
13. Id. at 391, citing Corpus Juris, volume 26 pages 483 at seq.
14. Section 181, Philippine Insurance Code.
15. Argente vs. West Coast Life Insurance Co., 51 Phil. 725, 731 (1928). Section 26,
Philippine Insurance Code. — A neglect to communicate that which a party knows and
ought to communicate is called a concealment.
16. Rollo, p. 40.
17. Id. at 39-40.
18. Ng Gan Zee vs. Asian Crusader Life Assurance Corp, 122 SCRA 461, 466 (1983)
19. Ibid.
20. Third Edition, Lohel A. Martirez, Philippine Insurance Code Annotated, p. 380, citing
Belvin vs. Connecticut Mutual Life Ins., 23 Comm. 244.
21. Section 183. Philippine Insurance Code.
22. Rollo, p. 12.
SYLLABUS
DECISION
DAVIDE, JR. , J : p
For our review under Rule 45 of the Rules of Court is the decision 1 of the Court of
Appeals in CA-G.R. SP No. 31916, entitled "Country Bankers Insurance Corporation
versus Armando Geagonia," reversing the decision of the Insurance Commission in I.C.
Case No. 3340 which awarded the claim of petitioner Armando Geagonia against
private respondent Country Bankers Insurance Corporation.
The petitioner is the owner of Norman's Mart located in the public market of San
Francisco, Agusan del Sur. On 22 December 1989, he obtained from the private
respondent re insurance policy No. F-14622 2 for P100,000.00. The period of the
policy was from 22 December 1989 to 22 December 1990 and covered the following:
"Stock-in-trade consisting principally of dry goods such as RTW's for men and women
wear and other usual to assured's business." cdasia
The petitioner declared in the policy under the subheading entitled CO-
CD Technologies Asia, Inc. © 2018 cdasiaonline.com
INSURANCE that Mercantile Insurance Co., Inc. was the co-insurer for P50,000.00. From
1989 to 1990, the petitioner had in his inventory stocks amounting to P392,130.50,
itemized as follows:
Zenco Sales, Inc. P55,698.00
F. Legaspi Gen. Merchandise 86,432.50
Cebu Tesing Textiles 250,000.00 (on credit)
========
P392,130.50
On 27 May 1990, re of accidental origin broke out at around 7:30 p.m. at the
public market of San Francisco, Agusan del Sur. The petitioner's insured stocks-in-trade
were completely destroyed prompting him to le with the private respondent a claim
under the policy. On 28 December 1990, the private respondent denied the claim
because it found that at the time of the loss the petitioner's stocks-in-trade were
likewise covered by re insurance policies No. GA-28146 and No. GA-28144, for
P100,000.00 each, issued by the Cebu Branch of the Philippines First Insurance Co., Inc.
(hereinafter PFIC). 3 These policies indicate that the insured was "Messrs. Discount
Mart (Mr. Armando Geagonia, Prop.)" with a mortgage clause reading:
"MORTGAGEE: Loss, if any, shall be payable to Messrs.
Cebu Tesing Textiles, Cebu City as their
interest may appear subject to the terms of
this policy. CO-INSURANCE DECLARED:
P100,000. — Phils. First CEB/F-24758" 4
The basis of the private respondent's denial was the petitioner's alleged violation
of Condition 3 of the policy.
The petitioner then led a complaint 5 against the private respondent with the
Insurance Commission (Case No. 3340) for the recovery of P100,000.00 under re
insurance policy No. F-14622 and for attorney's fees and costs of litigation. He
attached as Annex "M" 6 thereof his letter of 18 January 1991 which asked for the
reconsideration of the denial. He admitted in the said letter that at the time he obtained
the private respondent's re insurance policy he knew that the two policies issued by
the PFIC were already in existence; however, he had no knowledge of the provision in
the private respondent's policy requiring him to inform it of the prior policies; this
requirement was not mentioned to him by the private respondent's agent; and had it
been so mentioned, he would not have withheld such information. He further asserted
CD Technologies Asia, Inc. © 2018 cdasiaonline.com
that the total of the amounts claimed under the three policies was below the actual
value of his stocks at the time of loss, which was P1,000,000.00
In its answer, 7 the private respondent speci cally denied the allegations in the
complaint and set up as its principal defense the violation of Condition 3 of the policy.
In its decision of 21 June 1993, 8 the Insurance Commission found that the
petitioner did not violate Condition 3 as he had no knowledge of the existence of the
two re insurance policies obtained from the PFIC; that it was Cebu Tesing Textiles
which procured the PFIC policies without informing him or securing his consent; and
that Cebu Tesing Textile, as his creditor, had insurable interest on the stocks. These
ndings were based on the petitioner's testimony that he came to know of the PFIC
policies only when he led his claim with the private respondent and that Cebu Tesing
Textile obtained them and paid for their premiums without informing him thereof. The
Insurance Commission then decreed: cdasia
Its motion for the reconsideration of the decision 9 having been denied by the
Insurance Commission in its resolution of 20 August 1993, 1 0 the private respondent
appealed to the Court of Appeals by way of a petition for review. The petition was
docketed as CA-G.R. SP No. 31916.
In its decision of 29 December 1993, 1 1 the Court of Appeals reversed the
decision of the Insurance Commission because it found that the petitioner knew of the
existence of the two other policies issued by the PFIC. It said:
"It is apparent from the face of Fire Policy GA 28146/Fire Policy No. 28144
that the insurance was taken in the name of private respondent [petitioner herein].
The policy states that 'DISCOUNT MART (MR. ARMANDO GEAGONIA, PROP)' was
assured and that 'TESING TEXTILES' [was] only the mortgagee of the goods.
In addition, the premiums on both policies were paid for by private
respondent, not by the Tesing Textiles which is alleged to have taken out the other
insurances without the knowledge of private respondent. This is shown by
Premium Invoices nos. 46632 and 46630. (Annexes M and N). In both invoices,
Tesing Textiles is indicated to be only the mortgagee of the goods insured but the
party to which they were issued were the 'DISCOUNT MART (MR. ARMANDO
GEAGONIA).'
It is clear that it was the private respondent [petitioner herein] who took out
the policies on the same property subject of the insurance with petitioner. Hence,
in failing to disclose the existence of these insurances private respondent violated
Condition No. 3 of Fire Policy No. 14622. . . .
Indeed private respondent's allegation of lack of knowledge of the previous
insurances is belied by his letter to petitioner [of 18 January 1991. The body of
the letter reads as follows:] cdasia
His motion to reconsider the adverse decision having been denied, the petitioner
led the instant petition. He contends therein that the Court of Appeals acted with
grave abuse of discretion amounting to lack of excess of jurisdiction:
"A — . . . WHEN IT REVERSED THE FINDINGS OF FACTS OF THE INSURANCE
COMMISSION, A QUASI-JUDICIAL BODY CHARGED WITH THE DUTY OF
DETERMINING INSURANCE CLAIM AND WHOSE DECISION IS ACCORDED
RESPECT AND EVEN FINALITY BY THE COURTS;
B — . . . WHEN IT CONSIDERED AS EVIDENCE MATTERS WHICH WERE NOT
PRESENTED AS EVIDENCE DURING THE HEARING OR TRIAL; AND
C — . . . WHEN IT DISMISSED THE CLAIM OF THE PETITIONER HEREIN
AGAINST THE PRIVATE RESPONDENT."
The chief issues that crop up from the rst and third grounds are (a) whether the
petitioner had prior knowledge of the two insurance policies issued by the PFIC when
he obtained the re insurance policy from the private respondent, thereby, for not
disclosing such fact, violating Condition 3 of the policy, and (b) if he had, whether he is
precluded from recovering therefrom.
The second ground, which is based on the Court of Appeals' reliance on the
petitioner's letter of reconsideration of 18 January 1991, is without merit. The
petitioner claims that the said letter was not offered in evidence and thus should not
have been considered in deciding the case. However, as correctly pointed out by the
Court of Appeals, a copy of this letter was attached to the petitioner's complaint in I.C.
Case No. 3340 as Annex "M" thereof and made an integral part of the complaint. 1 2 It
has attained the status of a judicial admission and since its due execution and
authenticity was not denied by the other party, the petitioner is bound by it even if it
were not introduced as an independent evidence. 1 3
CD Technologies Asia, Inc. © 2018 cdasiaonline.com
As to the rst issue, the Insurance Commission found that the petitioner had no
knowledge of the previous two policies. The Court of Appeals disagreed and found
otherwise in view of the explicit admission by the petitioner in his letter to the private
respondent of 18 January 1991, which was quoted in the challenged decision of the
Court of Appeals. These divergent ndings of fact constitute an exception to the
general rule that in petitions for review under Rule 45, only questions of law are involved
and ndings of fact by the Court of Appeals are conclusive and binding upon this Court.
14
We agree with the Court of Appeals that the petitioner knew of the prior policies
issued by the PFIC. His letter of 18 January 1991 to the private respondent conclusively
proves this knowledge. His testimony to the contrary before the Insurance
Commissioner and which the latter relied upon cannot prevail over a written admission
made ante litem motam. It was, indeed, incredible that he did not know about the prior
policies since these policies were not new or original. Policy No. GA-28144 was a
renewal of Policy No. F-24758, while Policy No. GA-28146 had been renewed twice, the
previous policy being F-24792. cdasia
Furthermore, by stating within Condition 3 itself that such condition shall not
apply if the total insurance in force at the time of loss does not exceed P200,000.00,
the private respondent was amenable to assume a co-insurer's liability up to a loss not
exceeding P200,000.00. What it had in mind was to discourage over-insurance. Indeed,
the rationale behind the incorporation of "other insurance" clause in re policies is to
prevent over-insurance and thus avert the perpetration of fraud. When a property owner
obtains insurance policies from two or more insurers in a total amount that exceeds the
property's value, the insured may have an inducement to destroy the property for the
purpose of collecting the insurance. The public as well as the insurer is interested in
preventing a situation in which a fire would be profitable to the insured. 3 2
WHEREFORE, the instant petition is hereby GRANTED. The decision of the Court
of Appeals in CA-G.R. SP No. 31916 is SET ASIDE and the decision of the Insurance
Commission in Case No. 3340 is REINSTATED.
Costs against private respondent Country Bankers Insurance Corporation.
SO ORDERED.
Padilla, Bellosillo, Quiason and Kapunan, JJ ., concur.
Footnotes
1. Annex "A" of Petition; Rollo, 18-26. Per Associate Justice Vicente V. Mendoza, concurred
in by Associate Justices Jesus M. Elbinias and Lourdes K. Tayao-Jaguros.
2. Exhibit "1"; Original Records (OR) (CA-G.R. SP No. 31916), 34.
3. Exhibit "4"; Annex "C" of Petition; OR (CA-G.R. SP No. 31916), 27.
4. Exhibits "2" and "3"; Annexes "F" and "G", Id.; Id., 45-46.
SYLLABUS
DECISION
BAUTISTA ANGELO , J : p