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NG vs. ASIAN CRUSADER insurer to rescind the contract. And as correctly


observed by the lower court, “misrepresentation as
[G.R. No. L-30685] (May 30, 1983)
a defense of the insurer to avoid liability is an
FACTS: ‘affirmative’ defense. The duty to establish such a
defense by satisfactory and convincing evidence
In May 1962, Kwong Nam applied for a 20- rests upon the defendant. The evidence before the
year endowment policy with Asian Crusader Life Court does not clearly and satisfactorily establish
Assurance Corporation. Asian Crusader asked the that defense.”
following question:
Has any life insurance company ever refused your It bears emphasis that Kwong Nam had informed
application for insurance or for reinstatement of a the appellant’s medical examiner that the tumor for
lapsed policy or offered you a policy different from which he was operated on was “associated with
that applied for? If, so, name company and date. ulcer of the stomach.” In the absence of evidence
that the insured had sufficient medical knowledge
Kwong Nam answered “No” to the above question. as to enable him to distinguish between “peptic
Kwong Nam was also examined by Asian ulcer” and “a tumor”, his statement that said tumor
Crusader’s medical examiner to whom he disclosed was “associated with ulcer of the stomach,” should
that he was once operated and a tumor was be construed as an expression made in good faith
removed from his stomach and such was of his belief as to the nature of his ailment and
“associated with ulcer of the stomach.” operation. Indeed, such statement must be
Kwong Nam’s application was approved. In May presumed to have been made by him without
1963, he died. His widow, Ng Gan Zee, filed an knowledge of its incorrectness and without any
insurance claim but Asian Crusader refused her deliberate intent on his part to mislead the
claim as it insisted that Kwong Nam concealed appellant.
material facts from them when he was applying for
the insurance; that he misrepresented the fact that Where, “upon the face of the application, a question
he was actually denied application by Insular Life appears to be not answered at all or to be
when he was renewing his application with them; imperfectly answered, and the insurers issue a
that Kwong Nam was actually operated for peptic policy without any further inquiry, they waive the
ulcer. imperfection of the answer and render the omission
to answer more fully immaterial. As aptly noted by
CFI ordered Asian Crusader Life to pay the face
value of an insurance policy. Hence, this Appeal. the lower court, “if the ailment and operation of
Kwong Nam had such an important bearing on the
ISSUE: question of whether the defendant would undertake
Whether or not Ng Gan Zee can collect the the insurance or not, the court cannot understand
insurance claim. why the defendant or its medical examiner did not
make any further inquiries on such matters from the
RULING:
Chinese General Hospital or require copies of the
YES. Judgement affirmed. hospital records from the appellant before acting on
Thus, “concealment exists where the assured had the application for insurance. The fact of the matter
knowledge of a fact material to the risk, and is that the defendant was too eager to accept the
honesty, good faith, and fair dealing requires that application and receive the insured’s premium. It
he should communicate it to the assurer, but he would be inequitable now to allow the defendant to
designedly and intentionally withholds the same.” It avoid liability under the circumstances.
has also been held “that the concealment must, in
the absence of inquiries, be not only material, but CANILANG vs. CA
fraudulent, or the fact must have been intentionally
withheld.” [G.R. No. 92492] (June 17, 1993)

Sec. 27 of the Insurance Law, abovequoted, FACTS:


nevertheless requires that fraudulent intent on the
Canilang consulted Dr. Claudio and was diagnosed
part of the insured be established to entitle the
as suffering from "sinus tachycardia." Mr. Canilang
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consulted the same doctor again on 3 August 1982 coverage. The materiality of the information
and this time was found to have "acute bronchitis." withheld by Great Pacific did not depend upon the
state of mind of Jaime Canilang. A man’s state of
On the next day, 4 August 1982, Canilang applied
mind or subjective belief is not capable of proof in
for a "non-medical" insurance policy with Grepalife
our judicial process, except through proof of
naming his wife, as his beneficiary. Canilang was
external acts or failure to act from which inferences
issued ordinary life insurance with the face value of
as to his subjective belief may be reasonably
P19,700.
drawn. Neither does materiality depend upon the
On 5 August 1983, Canilang died of "congestive actual or physical events which ensue. Materiality
heart failure," "anemia," and "chronic anemia." The relates rather to the “probable and reasonable
wife as beneficiary, filed a claim with Grepalife influence of the facts” upon the party to whom the
which the insurer denied on the ground that the communication should have been made, in
insured had concealed material information from it. assessing the risk involved in making or omitting to
make further inquiries and in accepting the
Vda Canilang filed a complaint with the Insurance application for insurance; that “probable and
reasonable influence of the facts” concealed must,
Commissioner against Grepalife contending that as
of course, be determined objectively, by the judge
far as she knows her husband was not suffering ultimately.
from any disorder and that he died of kidney
YU vs. CA
disorder.
[G.R. No. L-12465] (May 29, 1959)
Grepalife was ordered to pay the widow by the
FACTS:
Insurance Commissioner holding that there was no
intentional concealment on the Part of Canilang Yu Pang Eng obtained a life insurance policy
and that Grepalife had waived its right to inquire naming his brother Yu Pang Cheng as beneficiary.
into the health condition of the applicant by the Eng subsequently died of medullary carcinoma,
issuance of the policy despite the lack of answers Grade 4, advanced and lesser curvature.
to "some of the pertinent questions" in the
Cheng claims the proceeds of the policy.
insurance application. CA reversed.

Issue: Insurance co. refused payment on the ground that


the policy was void due to the concealment.
Whether or not Grepalife is liable.
Issue:
RULING:
The petition is denied. Whether or not the policy is void.

We agree with the Court of Appeals that the RULING:


information which Jaime Canilang failed to disclose
was material to the ability of Great Pacific to YES. "CONCEALMENT."—"A neglect to
estimate the probable risk he presented as a communicate that which a party knows and ought
subject of life insurance. Had Canilang disclosed to communicate is called concealment." (Section
his visits to his doctor, the diagnosis made and the
medicines prescribed by such doctor, in the 25, Act No. 2427.)
insurance application, it may be reasonably
Whether intentional or unintentional the
assumed that Great Pacific would have made
further inquiries and would have probably refused concealment entitles the insurer to rescind the
to issue a non-medical insurance policy or, at the contract of insurance. (Section 26 of Act No. 2427.)
very least, required a higher premium for the same
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The insurance law requires the insured to undeclared co-insurances with the following:
P30,000 with Wellington Insurance; P25,000 with
communicate to the insurer all facts within his Empire Surety and P250,000 with Asian Surety
knowledge which are material to the contract and undertaken by insured Paramount on the same
property covered by its policy with Oriental whereas
which the other party has not the means of the only co-insurances declared in the subject
ascertaining (Section 27), and the materiality is to policy are those of P30,000.00 with Malayan
P50,000.00 with South Sea and P25.000.00 with
be determined not by the event but solely by the
Victory.
probable and reasonable influence of the facts The defense of fraud, in the form of non-declaration
upon the party to whom the communication is due of co-insurances which was not pleaded in the
answer, was also not pleaded in the Motion to
(Section 30 of Act 2427.) Dismiss.
The trial court denied the respondent’s motion.
Oriental filed another motion to include additional
GREAT PACIFIC LIFE vs. CA 1979 evidence of the co-insurance which could amount
to fraud.
The trial court still made Oriental liable for P
61,000. The CA reversed the trial court decision.
PACIFIC BANKING vs. CA Pacific Banking filed a motion for reconsideration of
[G.R. No. L-41014] (Nov 28, 1988) the said decision of the respondent Court of
Appeals, but this was denied for lack of merit.
Facts:
An open fire insurance policy, was issued to Issues:
Paramount Shirt Manufacturing by Oriental 1. WON unrevealed co-insurances Violated policy
Assurance Corporation to indemnify P61,000.00, conditions No. 3
caused by fire to the factory’s stocks, materials and 2. WON the insured failed to file the required proof
supplies. of loss prior to court action.
The insured was a debtor of Pacific Banking in the
amount of (P800,000.00) and the goods described Held: Yes. Petition dismissed.
in the policy were held in trust by the insured for
Pacific Banking under trust receipts. Ratio:
The policy was endorsed to Pacific Banking as 1. Policy Condition No. 3 explicitly provides:
mortgagee/ trustor of the properties insured, with 3. The Insured shall give notice to the Company of
the knowledge and consent of private respondent any insurance already effected, or which may
to the effect that "loss if any under this policy is subsequently be effected, covering any of the
payable to the Pacific Banking Corporation". property hereby insured, and unless such notice be
A fire broke out on the premises destroying the given and the particulars of such insurance or
goods contained in the building. insurances be stated in or endorsed on this Policy
The bank sent a letter of demand to Oriental for by or on behalf of the Company before the
indemnity. occurrence of any loss or damage, all benefit under
The company wasn’t ready to give since it was this policy shall be forfeited.
awaiting the adjuster’s report. The insured failed to reveal before the loss three
The company then made an excuse that the other insurances. Had the insurer known that there
insured had not filed any claim with it, nor were many co-insurances, it could have hesitated
submitted proof of loss which is a clear violation of or plainly desisted from entering into such contract.
Policy Condition No.11, as a result, determination Hence, the insured was guilty of clear fraud.
of the liability of private respondent could not be Concrete evidence of fraud or false declaration by
made. the insured was furnished by the petitioner itself
Pacific Banking filed in the trial court an action for a when the facts alleged in the policy under clauses
sum of money for P61,000.00 against Oriental "Co-Insurances Declared" and "Other Insurance
Assurance. Clause" are materially different from the actual
At the trial, petitioner presented communications of number of co-insurances taken over the subject
the insurance adjuster to Asian Surety revealing property.
4

As the insurance policy against fire expressly unless the claim is first presented extrajudicially in
required that notice should be given by the insured the manner provided in the policy, the cause of
of other insurance upon the same property, the action will accrue from the time the insurer finally
total absence of such notice nullifies the policy. rejects the claim for payment
Petitioner points out that Condition No. 3 in the In the case at bar, policy condition No. 11
policy in relation to the "other insurance clause" specifically provides that the insured shall on the
supposedly to have been violated, cannot certainly happening of any loss or damage give notice to the
defeat the right of the petitioner to recover the company and shall within fifteen (15) days after
insurance as mortgagee/assignee. Hence, they such loss or damage deliver to the private
claimed that the purpose for which the respondent (a) a claim in writing giving
endorsement or assignment was made was to particular account as to the articles or goods
protect the mortgagee/assignee against any destroyed and the amount of the loss or damage
untoward act or omission of the insured. It would be and (b) particulars of all other insurances, if any.
absurd to hold that petitioner is barred from Twenty-four days after the fire did petitioner merely
recovering the insurance on account of wrote letters to private respondent to serve as a
the alleged violation committed by the insured. notice of loss. It didn’t even furnish other
It is obvious that petitioner has missed all together documents. Instead, petitioner shifted upon private
the import of subject mortgage clause which respondent the burden of fishing out the necessary
specifically provides: information to ascertain the particular account of
“Loss, if any, under this policy, shall be payable to the articles destroyed by fire as well as the amount
the PACIFIC BANKING CORPORATION Manila of loss. Since the required claim by insured,
mortgagee/trustor as its interest may appear, it together with the preliminary submittal of relevant
being hereby understood and agreed that this documents had not been complied with, it follows
insurance as to the interest of the that private respondent could not be deemed to
mortgagee/trustor only herein, shall not be have finally rejected petitioner's claim and therefore
invalidated by any act or neglect—except fraud or there was no cause of action.
misrepresentation, or arson—of the mortgagor or It appearing that insured has violated or failed to
owner/trustee of the property insured; provided, perform the conditions under No. 3 and 11 of the
that in case the mortgagor or owner/ trustee contract, and such violation or want of performance
neglects or refuses to pay any premium, the has not been waived by the insurer, the insured
mortgagee/ trustor shall, on demand pay the cannot recover, much less the herein petitioner.
same.”
The paragraph clearly states the exceptions to the
general rule that insurance as to the interest of the ESCRA RULING:
mortgagee, cannot be invalidated; namely: fraud, or It is not disputed that the insured failed to reveal
misrepresentation or arson. Concealment of the
before the loss three other insurances. As found by
aforecited co-insurances can easily be fraud, or in
the very least, misrepresentation. the Court of Appeals, by reason of said unrevealed
Undoubtedly, it is but fair and just that where the insurances, the insured had been guilty of a false
insured who is primarily entitled to receive the declaration; a clear misrepresentation and a vital
proceeds of the policy has by its fraud and/or one because where the insured had been asked to
misrepresentation, forfeited said right. reveal but did not, that was deception. Otherwise
Petitioner further stressed that fraud which was not stated, had the insurer known that there were many
pleaded as a defense in private respondent's co-insurances, it could have hesitated or plainly
answer or motion to dismiss, should be deemed to desisted from entering into such contract. Hence,
have been waived. It will be noted that the fact of the insured was guilty of clear fraud (Rollo, p. 25).
fraud was tried by express or at least implied
consent of the parties. Petitioner did not only object Petitioner’s contention that the allegation of
to the introduction of evidence but on the contrary, fraud is but a mere inference or suspicion is
presented the very evidence that proved its untenable. In fact, concrete evidence of fraud or
existence. false declaration by the insured was furnished by
2. Generally, the cause of action on the the petitioner itself when the facts alleged in the
policy accrues when the loss occurs, But when the policy under clauses “Co-Insurances Declared” and
policy provides that no action shall be brought “Other Insurance Clause” are materially different
5

from the actual number of co-insurances taken over according to the sense and meaning of the terms
the subject property. Consequently, “the whole which the parties themselves have used. If such
foundation of the contract fails, the risk does not terms are clear and unambiguous, they must be
attach and the policy never becomes a contract taken and understood in their plain, ordinary and
between the parties. Representations of facts are popular sense.
the foundation of the contract and if the foundation
does not exist, the superstructure does not arise. Contracts of insurance are contracts of indemnity
Falsehood in such representations is not shown to upon the terms and conditions specified in the
vary or add to the contract, or to terminate a policy. The parties have a right to impose such
contract which has once been made, but to show reasonable conditions at the time of the making of
that no contract has ever existed (Tolentino, the contract as they may deem wise and
Commercial Laws of the Philippines, p. 991, Vol. II, necessary. The agreement has the force of law
8th Ed.). A void or inexistent contract is one which
between the parties. The terms of the policy
has no force and effect from the very beginning, as
if it had never been entered into, and which cannot constitute the measure of the insurer’s liability, and
be validated either by time or by ratification in order to recover, the insured must show himself
(Tongoy v. C.A., 123 SCRA 99 [1983]; Avila v. C.A. within those terms. The compliance of the insured
145 SCRA [1986]). with the terms of the policy is a condition precedent
to the right of recovery.
As the insurance policy against fire expressly
PETITION IS DISMISSED.
required that notice should be given by the insured
of other insurance upon the same property, the SUNLIFE vs. CA
total absence of such notice nullifies the policy.
[G.R. No. 105135] (June 22, 1995)
The paragraph clearly states the exceptions to the
general rule that insurance as to the interest of the On April 15, 1986, Bacani procured a life insurance
mortgagee, cannot be invalidated; namely: fraud, or
contract for himself from Sun Life. He was issued a
misrepresentation or arson. As correctly found by
the Court of Appeals, concealment of the aforecited life insurance policy with double indemnity in case
co-insurances can easily be fraud, or in the very of accidental death. The designated beneficiary
least, misrepresentation (Rollo, p. 27).
was his mother, Bernarda.
Undoubtedly, it is but fair and just that where the
insured who is primarily entitled to receive the On June 26, 1987, the insured died in a plane
proceeds of the policy has by its fraud and/or crash. Bernarda Bacani filed a claim with Sun Life,
misrepresentation, forfeited said right, with more seeking the benefits of the insurance. Sun Life
reason, petitioner which is merely claiming as
conducted an investigation and its findings
indorsee of said insured, cannot be entitled to such
proceeds. prompted it to reject the claim.

Generally, the cause of action on the policy accrues Sun Life discovered that 2 weeks prior to his
when the loss occurs. But when the policy provides
application, Bacani was examined and confined at
that no action shall be brought unless the claim is
first presented extrajudicially in the manner the Lung Center of the Philippines, where he was
provided in the policy, the cause of action will diagnosed for renal failure. During his confinement,
accrue from the time the insurer finally rejects the
the deceased was subjected to urinalysis, ultra-
claim for payment.
sonography and hematology tests. He did not
While it is a cardinal principle of insurance law that
reveal such fact in his application.
a policy or contract of insurance is to be construed
liberally in favor of the insured and strictly as In its letter, Sun Life informed Berarda, that the
against the insurer company yet, contracts of
insurance, like other contracts, are to be construed insured did not disclosed material facts relevant to
6

the issuance of the policy, thus rendering the have definitely affected petitioner’s action on his
application, either by approving it with the
contract of insurance voidable. A check corresponding adjustment for a higher premium or
representing the total premiums paid in the amount rejecting the same. Moreover, a disclosure may
of P10,172.00 was attached to said letter. have warranted a medical examination of the
insured by petitioner in order for it to reasonably
Bernarda and her husband, filed an action for assess the risk involved in accepting the
application.
specific performance against Sun Life. RTC ruled
for Bernarda holding that the facts concealed by the Thus, “good faith” is no defense in concealment.
The insured’s failure to disclose the fact that he
insured were made in good faith and under the
was hospitalized for two weeks prior to filing his
belief that they need not be disclosed. Moreover, it application for insurance, raises grave doubts about
held that the health history of the insured was his bona fides. It appears that such concealment
was deliberate on his part.
immaterial since the insurance policy was "non-
medical." CA affirmed. The argument, that petitioner’s waiver of the
medical examination of the insured debunks the
Issue: materiality of the facts concealed, is untenable. We
reiterate our ruling in Saturnino v. Philippine
Whether or not the beneficiary can claim despite American Life Insurance Company, 7 SCRA 316
the concealment. (1963), that “x x x the waiver of a medical
examination [in a non-medical insurance contract]
Held: renders even more material the information
required of the applicant concerning previous
NO. Petition is granted. condition of health and diseases suffered, for such
information necessarily constitutes an important
In weighing the evidence presented, the trial court factor which the insurer takes into consideration in
concluded that indeed there was concealment and deciding whether to issue the policy or not x x x.”
misrepresenta-tion, however, the same was made Anent the finding that the facts concealed had no
in “good faith” and the facts concealed or bearing to the cause of death of the insured, it is
well settled that the insured need not die of the
misrepresented were irrelevant since the policy was
disease he had failed to disclose to the insurer. It is
“non-medical.” We disagree. Section 26 of The sufficient that his non-disclosure misled the insurer
Insurance Code is explicit in requiring a party to a in forming his estimates of the risks of the proposed
insurance policy or in making inquiries (Henson v.
contract of insurance to communicate to the other,
The Philippine American Life Insurance Co., 56.
in good faith, all facts within his knowledge which O.G. No. 48 [1960]).
are material to the contract and as to which he
EGUARAS vs. GREAT EASTERN
makes no warranty, and which the other has no
[G.R. No. L-10436] (January 24, 1916)
means of ascertaining. Said Section provides: “A
neglect to communicate that which a party knows FACTS:

and ought to communicate, is called concealment.” Dominador Albay, petitioner’s son-in-law applied to
The terms of the contract are clear. The insured is the defendant insurance company for his life to be
specifically required to disclose to the insurer insured for
P5,000 and naming petitioner as the beneficiary.
matters relating to his health. The information which
The company accepted the application but while
the insured failed to disclose were material and
the policy was in
relevant to the approval and issuance of the
insurance policy. The matters concealed would
7

force, Dominador died. When Francisca tried to To further prove that fraud had been resorted to,
claim benefits as beneficiary, the company refused the SC compared the signatures of the real
to release the Dominador from previous documents and that of
funds so Francisca filed a complaint in court. The Castor Garcia on the medical form. Dominador had
TC ruled in favor of Francisca and sentenced the a firm and solid handwriting, culled from years of
company to pay education in American schools.
P5,000.

Upon appeal, the company argued that it refused to They further examined Dominador’s signature on
pay the claimant because they found out that the his electoral oath, which was signed before the
policy had been board of election inspectors and duly identified by
fraudulently applied for. It found that their agent, the chairman of said board. It found that it matched
Ponciano Remigio who sold the policy to the signature on the provisional receipt issued by
Dominador knew that the the company upon his application for the policy. In
latter had a serious medical condition before comparison, the signature on the medical forms
application. In the application, Dominador had and other subsequent documents were found to be
answered that he had a radically different so it can be concluded that it was
“good constitution” health wise. Remigio then done by a different person. Also, his age on the
engaged the services of one Dr. Jose Vidal application and insurance policy was 40 years old
supposedly to examine in 1912 while in his personal cedulas later on, he
Dominador but because of his knowledge of the was only 32 in 1911.
latter’s less than normal medical standing, he
presented a different Article 1269, CC: There is deceit when by words or
person for physical examination. This person, insidious machinations on the part of one of the
Castor Garcia was examined in his place and was contracting parties the other is induced to execute a
found to be in good contract which without them he would not have
health. On this basis, the doctor recommended that made.
the “Dominador Albay” that he had examined was
an insurable It is essential that deceit be made prior to or
risk and it was because of this that the company contemporaneous with the consent necessary to
had issued the policy. perfect a contract. The company in this case was
induced by the result of the medical examination
It must be noted that Ponciano had full knowledge and the recommendation of Remigio. The contract
of the fact that Dominador was not in good health therefore, is void and ineffective in accordance with
and had later the provisions of the civil code. Had Dominador not
died of intestinal occlusion after 3 days of illness been substituted, the physician would not have
and medical attendance. Despite a previous offer been able to identify Castor Garcia as the person
for P600 from he examined on trial.
Remigio to testify otherwise, Dr. Vidal confirmed
the identity of the person purporting to be Remigio had resorted to fraudulent means in order
Dominador during trial. to secure the payment for the policy and although it
Several witnesses also testified regarding the does not constitute a crime, the contract is still void.
seriousness of Dominador’s health prior to his As a result, the company is not obliged to pay
death such as Dr. Francisca the proceeds from the policy.
Gertrudo Reyes and one Jose Valencia.
NOTE: Although Remigio and Eguaras were
previously tried and acquitted for the crime of
ISSUE: estafa, the acquittal does
W/N the insurance company should pay Francisca not produce the effect of res judicata. The contract
the benefits she was entitled to was still void for the vitiation of the company’s
consent through
fraud.
RULING:
NO. JUDGMENT IS REVERSED. QUA vs. LAW UNION ROCK
8

[G.R. No. L-4611] (December 17, 1955) The rule is that to avoid a policy, the claim filed by
the insured must contain false and fraudulent
FACTS: statements with intent to defraud the insurer.

Qua Chee Gan owns four warehouses in Albay. He GREAT PACIFIC LIFE vs. CA 1999
was using these warehouses to house crops like
copra and hemp. All warehouses were insured by EDILLIO vs. MANILA BANKERS
Law Union and Rock Insurance for the amount of [G.R. No. 113899] (Sept 30, 1982)
P370,000.00. The insurance states that Qua Chee
Gan should install 11 hydrants in the warehouses’ FACTS:
premises. Qua Chee Gan installed only two, but
Law Union nevertheless went on with the insurance In April 1969, Carmen Lapuz filled out an
policy and collected premiums from Qua Chee application form for insurance under Manila Banker
Gan. The insurance contract also provides that “oil” Life Assurance Corporation. She stated that her
should not be stored within the premises of the date of birth was July 11, 1904. Upon payment of
warehouses. the Php 20.00 premium, she was issued the
insurance policy in April 1969. In May 1969,
In 1940, three of the warehouses were destroyed
Carmen Lapuz died in a vehicular accident. Regina
by fire. The damage caused amounted to P398k.
Edillon, who was named a beneficiary in the
Qua Chee Gan demanded insurance pay from Law
insurance policy sought to collect the insurance
Union but the latter refused as it alleged that after
proceeds but Manila Banker denied the claim.
investigation from their part, they found out that
Apparently, it is a rule of the insurance company
Qua Chee Gan caused the fire. Law Union in fact
that they were not to issue insurance policies to
sued Qua Chee Gan for Arson.
“persons who are under the age of sixteen (16)
Qua Chee Gan was acquitted in the arson case. He years of age or over the age of sixty (60) years …”
then demanded that Law Union pay up. This time, Note, that Lapuz was already 65 years old when
Law Union averred that the insurance contract is she was applying for the insurance policy.
void because Qua Chee Gan failed to install 11
hydrants; and that gasoline was found in one of the ISSUE: Whether or not Edillon is entitled to the
warehouses. insurance claim as a beneficiary.
ISSUE: Whether or not the insurance contract is
void. RULING:
YES. Judgment reversed.
RULING:
NO. Carmen Lapuz did not conceal her true age.
In the present case, gasoline is not specifically Despite this, the insurance company still received
mentioned among the prohibited articles listed in premium from Lapuz and issued the corresponding
the so-called “hemp warranty.” The clause relied insurance policy to her. When the accident
upon by the insurer speaks of “oils” and is happened, the insurance policy has been in force
decidedly ambiguous and uncertain; for in ordinary for 45 days already and such time was already
parlance, “oils” mean “lubricants” and not gasoline sufficient for Manila Banker to notice the fact that
or kerosene. Besides, the gasoline kept by the Lapuz is already over 60 years old and thereby
insured was only incidental to his business, being cancel the insurance policy. If Manila Banker failed
no more than a customary 2 days supply for the to act, it is either because it was willing to waive
five or six motor vehicles used for transporting of such disqualification; or, through the negligence or
the stored merchandise, and it is well settled rule incompetence of its employees for which it has only
that the keeping of inflammable oils on the itself to blame, it simply overlooked such fact.
premises, though prohibited by the policy, does not Under the circumstances, Manila Banker is already
void it if such keeping is incidental to the business. deemed in estoppel.
(Bachrach vs. British American Ass. Co., 17 Phil.
555, 660.) ESCRA RULING:
The age of the insured Carmen O. Lapuz was not
concealed to the insurance company. Her
application for insurance coverage which was on a
9

printed form furnished by private respondent and ISSUE:


which contained very few items of information
clearly indicated her age at the time of filing the Whether or not the insurance company has the
same to be almost 65 years of age. Despite such right to rescind the contract of insurance despite
information which could hardly be overlooked in the the presence of an incontestability clause
application form, considering its prominence
thereon and its materiality to the coverage applied RULING:
for, the respondent insurance corporation received
her payment of premium and issued the YES.
corresponding certificate of insurance without
question. The accident which resulted in the death The so-called “incontestability clause” precludes
of the insured, a risk covered by the policy, the insurer from raising the defenses of false
occurred on May 31, 1969 or FORTY-FIVE (45) representations or concealment of material facts
DAYS after the insurance coverage was applied insofar as health and previous diseases are
for. There was sufficient time for the private concerned if the insurance has been in force for at
respondent to process the application and to notice least two years during the insured’s lifetime. The
that the application was over 60 years of age and phrase “during the lifetime” found in Section 48 of
thereby cancel the policy on that ground if it was the Insurance Law simply means that the policy is
minded to do so. If the private respondent failed to no longer considered in force after the insured has
act, it is either because it was willing to waive such died. The key phrase in the second paragraph of
disqualification; or, through the negligence or Section 48 is “for a period of two years”. The policy
incompetence of its employees for which it has only was issued on November 6, 1973 and the insured
itself to blame, it simply overlooked such fact. died on April 26, 1975. The policy was thus in force
Under the circumstances, the insurance corporation for a period of only one year and five months.
is already deemed in estoppel. Its inaction to Considering that the insured died before the two-
revoke the policy despite a departure from the year period has lapsed, respondent company is
exclusionary condition contained in the said policy not, therefore, barred from proving that the policy is
constituted a waiver of such condition. void ab initio by reason of the insured’s fraudulent
concealment or misrepresentation. Moreover,
TAN vs. CA respondent company rescinded the contract of
[G.R. No. 48049] (Jun 29, 1989) insurance and refunded the premiums paid on
November 11, 1975, previous to the
FACTS: commencement of this action on November 27,
Tan Lee Siong, father of herein petitioners, applied 1975.
for life insurance in the amount of P80,000.00 with
respondent company Philippine American Life WHEREFORE, the petition is hereby DENIED for
Insurance Company. Said application was lack of merit. The questioned decision of the Court
approved and a corresponding policy was issued of Appeals is AFFIRMED.
effective November 5, 1973, with petitioners as the
beneficiaries. On April 26, 1975, Tan Lee Siong ESCRA RULING:
died of hepatoma. Hence, petitioners filed with The so-called “incontestability clause” precludes
respondent company their claim for the proceeds of the insurer from raising the defenses of false
the life insurance policy. However, the insurance representations or concealment of material facts
company denied the said claim and rescinded the insofar as health and previous diseases are
policy by reason of the alleged misrepresentation concerned if the insurance has been in force for
and concealment of material facts made by the at least two years during the insured’s lifetime.
deceased Tan Lee Siong in his application for The phrase “during the lifetime” found in Section
insurance. The premiums paid on the policy were 48 simply means that the policy is no longer
thereupon refunded. The petitioners contend that considered in force after the insured has died.
the respondent company no longer had the right to
The key phrase in the second paragraph of
rescind the contract of insurance as rescission
Section 48 is “for a period of two years.”
must allegedly be done during the lifetime of the
insured within two years and prior to the
commencement of action. As noted by the Court of Appeals, to wit: “The
policy was issued on November 6, 1973 and the
10

insured died on April 26, 1975. The policy was fraudulent insurance schemes; that by reason of
thus in force for a period of only one year and five these fraud and machinations, the insurance policy
months. Considering that the insured died before West Coast issued is void; that West Coast seeks
the two-year period had lapsed, respondent to avoid the insurance policy. Tan Chay Heng filed
company is not, therefore, barred from proving a demurrer as it claimed that West Coast’s
that the policy is void ab initio by reason of the ANSWER is a cross-complaint and the facts
insured’s fraudulent concealment or contained therein was not sufficient as a defense.
misrepresentation. Moreover, respondent The lower court directed West Coast to amend its
company rescinded the contract of insurance and ANSWER which West Coast duly excepted from
and so the lower court ruled in favor of Tan Chay
refunded the premiums paid on September 11,
Heng. The lower court further ruled that under
1975, previous to the commencement of this
Section 47 of [the old] Insurance Law, if an insurer
action on November 27, 1975.”
(West Coast) has the right to rescind a contract of
insurance, it must do so before a suit is brought
The insurer has two years from the date of against the insurer on the said contract.
issuance of the insurance contract or of its last
reinstatement within which to contest the policy, ISSUE:
whether or not, the insured still lives within such
period. After two years, the defenses of Whether or not Section 47 is applicable in the case
concealment or misrepresentation, no matter at bar.
how patent or well founded, no longer lie.
Congress felt this was a sufficient answer to the RULING:
various tactics employed by insurance companies
to avoid liability. The petitioners’ interpretation No. West Coast was not seeking for the rescission
would give rise to the incongruous situation of the insurance contract. In fact, West Coast avers
where the beneficiaries of an insured who dies that there was no insurance contract at all because
right after taking out and paying for a life the temporary insurance issued in favor of Tan
insurance policy, would be allowed to collect on Ceang was null and void. For West Coast, it was
the policy even if the insured fraudulently void ab initio because of the fraudulent
concealed material facts. circumstances attending to it. Therefore, it cannot
be subject to rescission. The Supreme Court
TAN CHAY vs. WEST COAST LIFE however remanded the case to the lower court to
[G.R. No. L-27541] (Nov 21, 1927) determine the material allegations made by West
Coast against Tan Chay Heng.
FACTS:
Precisely, the defense of West Cast was that
In April 1925, West Coast Life Insurance Company through fraud in its execution, the policy is void ab
(West Coast) accepted and issued a temporary life initio, and therefore, no valid contract was ever
insurance policy (pending further review) to Tan made. Its action then cannot be fore rescission
Ceang. The life insurance was for P10,000.00 and because an action to rescind is founded upon and
the premium paid therefor was P936.00. The presupposes the existence of the contract. Hence,
beneficiary listed in the policy was Tan Chay Heng. West Coast’s defense is not barred by Sec. 47.
In May 1925, Tan Ceang died. Tan Chay Heng filed
an insurance claim which was denied by West
Coast. Tan Chay Heng sued West Coast. West
Coast averred, in its ANSWER that Tan Chay In the instant case, it will be noted that even in its
Heng, in connivance with others made Tan Ceang prayer, the defendant does not seek to have the
to enter into an insurance policy and name Tan alleged insurance contract rescinded. It denies that
Chay Heng as the beneficiary; that Tan Ceang was it ever made any contract of insurance on the life of
induced to lie on the application form about his Tan Caeng, or that any such a contract ever
health and life conditions (he was made to account existed, and that is the question which it seeks to
that he was not addicted to opium, morphine, and have litigated by its special defense. In the very
cocaine when in fact he was); that Tan Chay Heng nature of things, if the defendant never made or
was a gang leader involved in the racket of entered into the contract in question, there is no
11

contract to rescind, and, hence, section 47 upon A fire broke out in the building, and the store was
which the lower court based its decision in burned. Yap filed an insurance claim, but the same
sustaining the demurrer does not apply. was denied for a breach.
Oliva Yap filed a case for payment of the face value
As stated, an action to rescind a contract is of her fire insurance policy. The insurance company
founded upon and presupposes the existence of refused to pay because she never informed
the contract which is sought to be rescinded. If all Pioneer of another insurer. The trial court decided
of the material matters set forth and alleged in the in favor of Yap. The CA affirmed.
defendant's special plea are true, there was no
valid contract of insurance, for the simple reason Issue:
that the minds of the parties never met and never Whether or not petitioner should be absolved from
agreed upon the terms and conditions of the liability on the Pioneeer policy on account of any
contract. We are clearly of the opinion that, if such violation of the co-insurance clause
matters are known to exist by a preponderance of
the evidence, they would constitute a valid defense Held: No. Petition dismissed.
to plaintiff's cause of action. Upon the question as
to whether or not they are or are not true, we do not Ratio:
at this time have or express any opinion, but we are There was a violation. The insurance policy for
clear that section 47 does not apply to the P20,000.00 issued by the Great American, ceased
allegations made in the answer, and that the trial to be recognized by them as a co-insurance policy.
court erred in sustaining the demurrer. The endorsement shows the clear intention of the
parties to recognize on the date the endorsement
PIONEER vs. YAP was made, the existence of only one co-insurance,
[G.R. No. L-36232] (Dec 19, 1974) the Northwest one. The finding of the Court of
Appeals that the Great American Insurance policy
Facts: was substituted by the Federal Insurance policy is
indeed contrary to said stipulation.
Respondent Oliva Yap was the owner of a store in Other insurance without the consent of Pioneer
a two-storey building where she sold shopping would avoid the contract. It required no affirmative
bags and footwear. Chua Soon Poon, her son-in- act of election on the part of the company to make
law, was in charge of the store. operative the clause avoiding the contract,
Yap took out a Fire Insurance Policy No. 4216 from wherever the specified conditions should occur. Its
Pioneer Insurance with a value of P25,000.00 obligations ceased, unless, being informed of the
covering her stocks, office furniture, fixtures and fact, it consented to the additional insurance.
fittings. The validity of a clause in a fire insurance policy to
Among the conditions in the policy executed by the the effect that the procurement of additional
parties are the following: insurance without the consent of the insurer
unless such notice be given and the particulars of renders the policy void is in American
such insurance or insurances be stated in, or jurisprudence.
endorsed on this Policy by or on behalf of the Milwaukee Mechanids' Lumber Co., vs. Gibson-
Company before the occurrence of any loss or "The rule in this state and practically all of the
damage, all benefits under this Policy shall be states is to the effect that a clause in a policy to the
forfeited… Any false declaration or breach or this effect that the procurement of additional insurance
condition will render this policy null and void. without the consent of the insurer renders the policy
Another insurance policy for P20,000.00 issued by void is a valid provision.”
Great American covering the same properties. The In this jurisdiction, General Insurance & Surety
endorsement recognized co-insurance by Corporation vs. Ng Hua- “The annotation then,
Northwest for the same value. must be deemed to be a warranty that the property
Oliva Yap took out another fire insurance policy for was not insured by any other policy. Violation
P20,000.00 covering the same properties from the thereof entitled the insurer to rescind. Furthermore,
Federal Insurance Company, Inc., which was even if the annotations were overlooked the
procured without notice to and the written consent defendant insurer would still be free from liability
of Pioneer. because there is no question that the policy issued
by General Indemnity has not been stated in nor
12

endorsed on Policy No. 471 of defendant. The Julian Sy went to Reliance to claim but he was
obvious purpose of the aforesaid requirement in the refused. Same thing happened with the others who
policy is to prevent over-insurance and thus avert were sister companies.
the perpetration of fraud where a fire would be Sy violated the "Other Insurance Clause"
profitable to the insured.“ RTC: favored New Life and against the three
insurance companies
ESCRA RULING: CA: reversed -failure to state or endorse the other
insurance coverage
By the plain terms of the policy, other
insurance without the consent of petitioner ISSUE:
would ipso facto avoid the contract. It required
no affirmative act of election on the part of the W/N Sy can claim against the three insurance
company to make operative the clause avoiding companies for violating the "Other Insurance
the contract, wherever the specified conditions Clause"
should occur. Its obligations ceased, unless, being
informed of the fact, it consented to the HELD:
additional insurance.
NO.
The obvious purpose of the aforesaid The terms of the contract are clear and
requirement in the policy is to prevent over- unambiguous.
insurance and thus avert the perpetration of The insured is specifically required to disclose to
fraud. The public, as well as the insurer, is the insurer any other insurance and its particulars
interested in preventing the situation in which a which he may have effected on the same subject
fire would be profitable to the insured. A waiver matter.
must be express. If it is to be implied from The knowledge of such insurance by the insurer's
conduct mainly, said conduct must be clearly agents, even assuming the acquisition thereof by
indicative of a clear intent to waive such right. the former, is not the "notice" that would estop the
Especially in these cases where a person is insurers from denying the claim.
assumed to have waived a valuable right, conclusion of the trial court that Reliance and
nothing less than a clear, positive waiver, made Equitable are "sister companies" is an unfounded
with full knowledge of the circumstances, must conjecture drawn from the mere fact that Yap Kam
be required. Chuan was an agent for both companies which also
had the same insurance claims adjuster
NEW LIFE ENTERPRISES vs. CA Availmentof the services of the same agents and
[G.R. No. 94071] (1992) adjusters by different companies is a common
practice in the insurancebusiness and such facts do
FACTS: not warrant the speculative conclusion of the trial
court.
May 15, 1981: Western Guaranty Corporation The conformity of the insured to the terms of the
issued Fire Insurance Policy to New Life policy isimplied from his failure to express any
Enterprises foar P350,000 disagreement with what is provided for.
renewed on May, 13, 1982 a clear misrepresentation and a vital one because
July 30,1981: Reliance Surety and Insurance Co., where the insured had been asked to reveal but did
Inc. issued Fire Insurance Policy to New Life not, that was deception - guilty of clear fraud
Enterprises for P300,000 total absence of such notice nullifies the policy
November 12, 1981; Additional P700,000 assuming arguendo that petitioners felt the
February 8, 1982: Equitable Insurance Corporation legitimate need to be clarified as to the policy
issued Fire Insurance Policy to New Life condition violated, there was a considerable lapse
Enterprises for P200,000 of time from their receipt of the insurer's
October 19, 1982 2 am: fire electrical in nature clarificatory letter dated March 30, 1983, up to the
destroyed the stock in trade worth P1,550,000 time the complaint was filed in court on January 31,
1984. The one-year prescriptive period was yet
toexpire on November 29, 1983, or about eight (8)
13

months from the receipt of the clarificatory letter, Facts:


but petitioners let the period lapse without bringing
their action in court Prudential Guarantee cancelled Areola’s personal
accident insurance on the grounds that the latter
ESCRA RULING: failed to pay his premiums 7 months after issuing
The terms of the contract are clear and the policy. Areola was supposed to pay the total
unambiguous. The insured is specifically amount of P1,609.65 which included the premium
required to disclose to the insurer any other of P1,470.00, documentary stamp of P110.25 and
insurance and its particulars which he may have 2% premium tax of P29.40. The statement of
effected on the same subject matter. The account had a stipulation not considering it a
knowledge of such insurance by the insurer’s receipt. It also reminded the customer to ask for a
agents, even assuming the acquisition thereof by receipt after payment. There was also a stipulation
the former, is not the “notice” that would estop calling for a demand for a provisional receipt after
the insurers from denying the claim. Besides, the payment to an agent. A provisional receipt was sent
to petitioner telling him that the provisional receipt
so-called theory of imputed knowledge, that is,
would be confirmed by an official one. The
knowledge of the agent is knowledge of the
company then cancelled the policy for non-payment
principal, aside from being of dubious
of premiums. After being surprised, Areola
applicability here has likewise been roundly confronted a company agent and demanded an
refuted by respondent court whose factual official receipt. The latter told him that it was a
findings we find acceptable. mistake, but never gave him an official receipt.
Areola sent a letter demanding that he be
While it is a cardinal principle of insurance law reinstated or he would file for damages if his
that a policy or contract of insurance is to be demand was not met. The company then told him
construed liberally in favor of the insured and that his payments weren’t in full yet. The company
strictly against the insurer company, yet replied to Areola by telling him that there was
contracts of insurance, like other contracts, are reason to believe that no payment has been made
to be construed according to the sense and since no official receipt was issued. The company
meaning of the terms which the parties then told him that they would still hold him under
themselves have used. If such terms are clear the policy. The company then confirmed that he
and unambiguous, they must be taken and paid the premium and that they would extend the
understood in their plain, ordinary and popular policy by one year.
sense. Moreover, obligations arising from
contracts have the force of law between the Thereby, the company offered to reinstate same
contracting parties and should be complied with policy it had previously cancelled and even
in good faith. proposed to extend its lifetime on finding that the
cancellation was erroneous and that the premiums
were paid in full by petitioner-insured but were not
Petitioners should be aware of the fact that a
remitted by the company's branch manager, Mr.
party is not relieved of the duty to exercise the
Malapit.
ordinary care and prudence that would be
exacted in relation to other contracts. The However, they were too late for Areola already filed
conformity of the insured to the terms of the an action for breach of contract in the trial court.
policy is implied from his failure to express any The company’s defense lay in rectifying its
disagreement with what is provided for. omission; hence, there was no breach of contract.
The court ruled in favor of Areola and asked
PACIFIC BANKING vs. CA (1988) Prudential to pay 250,000 pesos in moral and
exemplary damages. The court held that the
QUA CHEE GAN vs. LAW UNION (1955) company was in bad faith in cancelling the policy.
Had the insured met an accident at that time, he
TAN vs. CA wouldn’t be covered by the policy.

AREOLA vs. CA This ruling was challenged on appeal by


[G.R. No. 95641] (Sept 22, 1994) respondent insurance company, denying bad faith
14

in unilaterally cancelling the policy. The AC As for any obligation wherein the agent has
absolved Prudential on the grounds that it was not exceeded his power, the principal is not bound
motivated by negligence, malice or bad faith in except when he ratifies it expressly or tacitly.
cancelling subject policy. Rather, the cancellation of Malapit's failure to remit the premiums he received
the insurance policy was based on what the cannot constitute a defense for private respondent
existing records showed. The court even added insurance company; no exoneration from liability
that the errant manager who didn’t remit the profits could result therefrom. The fact that private
was forced to resign. Areola then filed for a petition respondent insurance company was itself
in the Supreme Court. defrauded due to the anomalies that took place
does not free the same from its obligation to
Issue: petitioner Areola. As held in Prudential Bank v.
1. Did the erroneous act of cancelling subject Court of Appeals
insurance policy entitle petitioner-insured to “A bank is liable for wrongful acts of its officers
payment of damages? done in the interests of the bank or in the course of
2. Did the subsequent act of reinstating the dealings of the officers in their representative
wrongfully cancelled insurance policy by capacity but not for acts outside the scope of their
respondent insurance company, in an effort to authority. Accordingly, a banking corporation is
rectify such error, obliterate whatever liability for liable to innocent third persons where the
damages it may have to bear, thus absolving it? representation is made in the course of its business
by an agent acting within the general scope of his
Held: Yes. No. Petition granted. authority even though the agent is secretly abusing
his authority and attempting to perpetrate a fraud
Ratio: upon his principal or some other person.”
1. Petitioner alleged that the manager’s Prudential is liable for damages for the fraudulent
misappropriation of his premium payments is the acts committed by Malapit. Reinstating the
proximate cause of the cancellation of the insurance policy can not obliterate the injury
insurance policy. Subsequent reinstatement could inflicted. A contract of insurance creates reciprocal
not possibly absolve respondent insurance obligations for both insurer and insured. Reciprocal
company from liability, due to the breach of obligations are those which arise from the same
contract. He contended that damage had already cause and in which each party is both a debtor and
been done. a creditor of the other, such that the obligation of
Prudential averred that the equitable relief sought one is dependent upon the obligation of the other.
by petitioner-insured was granted to the filing of the 2. Due to the agreement to enter into a contract of
complaint, petitioner-insured is left without a cause insurance where Prudential promised to extend
of action. Reinstatement effectively restored protection to petitioner-insured against the risk
petitioner-insured to all his rights under the policy. insured, there was a debtor creditor relation ship
The court held that Malapit's fraudulent act of between the two parties. Under Article 1191, the
misappropriating the premiums paid by petitioner- injured party is given a choice between fulfillment or
insured is directly imputable to respondent rescission of the obligation in case one of the
insurance company. A corporation, such as obligors fails to comply with what is incumbent
respondent insurance company, acts solely thru its upon him. However, said article entitles the injured
employees. The latters' acts are considered as its party to payment of damages, regardless of
own. Malapit represented its interest and acted in whether he demands fulfillment or rescission of the
its behalf. His act of receiving the premiums obligation.
collected is well within the province of his authority. The damages would be nominal because the
Thus, his receipt of said premiums is receipt by insurance company took steps to rectify the
private respondent insurance company who, by contract . There was also no actual or substantial
provision of law is bound by the acts of its agent. damage inflicted. Nominal damages are
Article 1910 thus reads: "recoverable where a legal right is technically
Art. 1910. The principal must comply with all the violated and must be vindicated against an invasion
obligations which the agent may have contracted that has produced no actual present loss of any
within the scope of his authority. kind, or where there has been a breach of contract
and no substantial injury or actual damages
whatsoever have been or can be shown.”
15

ESCRA RULING: upon his principal or some other person, for his
We uphold petitioner-insured’s submission. own ultimate benefit.”
Malapit’s fraudulent act of misappropriating the
premiums paid by petitioner-insured is beyond Consequently, respondent insurance company is
doubt directly imputable to respondent insurance liable by way of damages for the fraudulent acts
company. A corporation, such as respondent committed by Malapit that gave occasion to the
insurance company, acts solely thru its erroneous cancellation of subject insurance
employees. The latters’ acts are considered as its policy. Its earlier act of reinstating the insurance
own for which it can be held to account. The facts policy can not obliterate the injury inflicted on
are clear as to the relationship between private petitioner-insured. Respondent company should
respondent insurance company and Malapit. As be reminded that a contract of insurance creates
admitted by private respondent insurance reciprocal obligations for both insurer and
company in its answer, Malapit was the manager insured. Reciprocal obligations are those which
of its Baguio branch. It is beyond doubt that he arise from the same cause and in which each
represented its interests and acted in its behalf. party is both a debtor and a creditor of the other,
such that the obligation of one is dependent upon
His act of receiving the premiums collected is the obligation of the other.
well within the province of his authority. Thus,
his receipt of said premiums is receipt by private TAN CHAY vs. WEST COAST LIFE (1927)
respondent insurance company who, by provision
of law, particularly under Article 1910 of the
Civil Code, is bound by the acts of its agent. x x x
Malapit’s failure to remit the premiums he
received cannot constitute a defense for private
respondent insurance company; no exoneration
from liability could result therefrom. The fact
that private respondent insurance company was
itself defrauded due to the anomalies that took
place in its Baguio branch office, such as the non-
accrual of said premiums to its account, does not
free the same from its obligation to petitioner
Areola. As held in Prudential Bank v. Court of
Appeals citing the ruling in McIntosh v. Dakota
Trust Co.: “A bank is liable for wrongful acts of
its officers done in the interests of the bank or in
the course of dealings of the officers in their
representative capacity but not for acts outside
the scope of their authority. A bank holding out
its officers and agent as worthy of confidence will
not be permitted to profit by the frauds they may
thus be enabled to perpetrate in the apparent
scope of their employment; nor will it be
permitted to shirk its responsibility for such
frauds, even though no benefit may accrue to the
bank therefrom. Accordingly, a banking
corporation is liable to innocent third persons
where the representation is made in the course of
its business by an agent acting within the
general scope of his authority even though, in the
particular case, the agent is secretly abusing his
authority and attempting to perpetrate a fraud

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