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Sunlife V. Ca: (57) Title 4, Sec. 26 of The Insurance Code - Insurance - DB
Sunlife V. Ca: (57) Title 4, Sec. 26 of The Insurance Code - Insurance - DB
SUNLIFE v. CA
G.R. No. 105135| Jun. 22, 1995 | QUIASON, J.: RTC ruled for respondents. The RTC concluded that
Concealment the facts concealed by the insured were made in good
2 weeks before nag apply ng insurance may faith and under the belief that they need not be
examination pala sa Lung Center! disclosed. Moreover, it held that the health history of
the insured was immaterial since the insurance policy
FACTS - ROBERT PROCURES LIFE INSURANCE
was "non-medical."
FROM SUN LIFE AND NAMES HIS MOTHER AS
BENEFICIARY
Sun Life appeals to CA, which affirmed the RTC. The
On Apr. 15, 1986, Robert John Bacani procured a life
CA ruled that Sun Life cannot avoid its obligation by
insurance contract for himself from petitioner, Sun Life.
claiming concealment because the cause of death was
He was issued a Policy valued at P100K, with double
unrelated to the facts concealed by the insured. It also
indemnity in case of accidental death. The designated
sustained the finding of the RTC that the matters
beneficiary was his mother, respondent Bernarda
relating to the health history of the insured were
Bacani.
irrelevant since Sun Life waived the medical
examination prior to the approval and issuance of the
ROBERT DIES IN A PLANE CRASH, BERNARDA FILES
insurance policy. It also agreed with the RTC that the
CLAIM WITH SUN LIFE; SUN LIFE REJECTS CLAIM
policy was "non-medical."
On Jun. 26, 1987, the insured died in a plane crash.
Bernarda filed a claim with Sun Life, seeking the
Sun Life’s MR got denied. Hence, this petition.
benefits of the insurance policy taken by her son. Sun
Life conducted an investigation and its findings
ISSUE: W/N CA erred in affirming RTC [YES]
prompted it to reject the claim.
HELD
SUN LIFE SAID INSURED DIDN’T DISCLOSE
MATERIAL FACTS THEREFORE INSURANCE IS The trial court concluded that indeed there was
VOIDABLE - In its letter, Sun Life informed Bernarda, concealment and misrepresentation, however, the same
that the insured did not disclosed material facts was made in "good faith" and the facts concealed or
relevant to the issuance of the policy, thus rendering misrepresented were irrelevant since the policy was
the contract of insurance voidable. A check "non-medical." We disagree.
representing the total premiums paid of P10K was
attached to said letter. Sec. 26 of the Insurance Code is explicit in requiring
a party to a contract of insurance to communicate
Sun Life claimed that the insured gave false to the other, in good faith, all facts within his
statements in his application when he answered the knowledge which are material to the contract and
following questions: as to which he makes no warranty, and which the
"5. Within the past 5 years have you: other has no means of ascertaining. Said Section
a) consulted any doctor or other health practitioner? provides:
b) submitted to: "A neglect to communicate that which a party knows
ECG? and ought to communicate, is called concealment."
X-rays?
blood tests?
other tests? Materiality is to be determined not by the event, but
c) attended or been admitted to any hospital or other medical facility? solely by the probable and reasonable influence of the
"6. Have you ever had or sought advice for: xxx xxx xxx facts upon the party to whom communication is due, in
b) urine, kidney or bladder disorder?"
forming his estimate of the disadvantages of the
The deceased answered question No. 5(a) in the proposed contract or in making his inquiries (The
affirmative but limited his answer to a consultation Insurance Code, Sec 31).
with a certain Dr. Raymundo of the Chinese General
Hospital on Feb. 1986, for cough and flu complications. THE CONTRACT SPECIFICALLY REQUIRED INSURED
The other questions were answered in the negative. TO DISCLOSE MATTERS RELATING TO HIS HEALTH
The terms of the contract are clear. The insured is
Sun Life discovered that two weeks prior to his specifically required to disclose to the insurer matters
application for insurance, the insured was relating to his health.
examined and confined at the Lung Center of the
Philippines, where he was diagnosed for renal failure. THE INFORMATION WHICH THE INSURED FAILED
During his confinement, the deceased was subjected to TO DISCLOSE WERE MATERIAL AND RELEVANT TO
urinalysis, ultra-sonography and hematology tests. THE APPROVAL AND THE ISSUANCE OF THE
INSURANCE POLICY - The information which the
On Nov. 17, 1988, Bernarda and her husband insured failed to disclose were material and relevant to
Rolando filed an action for specific performance the approval and the issuance of the insurance policy.
against Sun Life in RTC of Valenzuela. The matters concealed would have definitely affected