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FAR EASTERN UNIVERSITY INSTITUTE OF LAW

INSURANCE OUTLINE1
DY 2ND TRIMESTER, SY 2009-2010 2009

ATTY. ALEXANDER C. THURSDAY, 17 SEPTEMBER

I. GENERAL CONCEPTS
A. INSURANCE
1. Definition Sec. 2(1), I.C.2 2. Elements Philamcare Health Systems, Inc. v. Court of Appeals , 379 SCRA 356 (2002); xGulf Resorts Inc. v. Philippine Charter Insurance Corporation, 458 SCRA 550 (2005) a. The insured has an insurable interest xSecs. 12-14, I.C.; b. The insured is subject to a risk of loss by the happening of the designated peril Sec. 3, par. 1, I.C.; c. The insurer assumes the risk xSec. 2, I.C.; d. 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 e. In consideration of the insurers promise, the insured pays a premium xSec. 77, I.C. 3. Characteristics a. Aleatory (but not wagering) Art. 2010, Civil Code3; Sec. 25, I.C. b. Indemnity (except life and accident insurance where the result is death, and valued policies) Sec. 17, I.C. c. Personal

The Outline presents the manner by which Insurance will be taken up in class. The cases preceded by s and the codal provisions in bold typeface shall be extensively discussed. The items preceded by x's and those footnoted in the Outline represent cases or topics which need no extended discussions, either because the essence of the rulings are already summarized in the Outline or they contain similar rulings or doctrines as other cases to be discussed. 2 Presidential Decree No. 1460, as amended, otherwise known as the Insurance Code of the Philippines (I.C.). 3 The New Civil Code of the Philippines.

2 d. Unilateral (executed as to insured and executory as to insurer upon payment of premiums) e. Conditional (distinguish between property insurance, where loss may or may not occur and may be total or partial, and life insurance, where death will occur so that time of happening is the contingent element) 4. Perfection Arts. 1318-1319, Civil Code; Secs. 77 and 226, I.C.; Enriquez v. Sun Life Assurance Co. of Canada , 41 Phil. 269 (1920); But See Eternal Gardens Memorial Park Corporation v. Philippine American Life Insurance Corporation, 551 SCRA 1 (2008) 5. xKinds of Insurance

B. INSURANCE DISTINGUISHED FROM OTHER CONTRACTS


1. Suretyship Art. 2047, Civil Code; Sec. 2(1), par. 2, I.C. 2. Pre-Need Plans Sec. 3.9, SRC4 3. Variable Contracts Sec. 232, I.C.

C. INSURANCE BUSINESS
1. Doing an Insurance Business Sec. 2(2), I.C.; Phil. American Life Insurance Company v. Ansaldo, 234 SCRA 509 (1994) 2. Mutual Insurance Companies White Gold Marine Services, Inc. v. Pioneer Insurance Surety Corporation, 464 SCRA 448 (2005)

D. LAWS GOVERNING INSURANCE


1. I.C. See Sec. 5, I.C. 2. Civil Code Art. 2011, Civil Code; The Insular Life Assurance Company, Ltd. V. Ebrado, 80 SCRA 181 (1977) a. Revocation of irrevocable beneficiaries in terminated marriages xArts. 43(4), 50, and 64, Family Code5 b. Void donations xArts. 739, 2012, Civil Code c. Life annuity contracts xArts. 2021-2027, Civil Code d. Compulsory motor vehicle liability insurance xArt. 2186, Civil Code e. Insurers right of subrogation xArt. 2207, Civil Code 3. General Principles on Insurance Constantino v. Asia Life Insurance Co., 87 Phil. 248 (1950)
Republic Act No. 8799, otherwise known as the Securities Regulations Code. Executive Order No. 209, as amended, otherwise known as the Family Code of the Philippines.
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3 4. xSpecial Laws a. Revised Government Service Insurance Act of 1977 6 covers insurance of government employees b. Social Security Act of 1954 7 covers insurance of employees in private employment; c. Property Insurance Law8 covers insurance of government property; d. R.A. No. 48989 provides life, disability and accident insurance coverage to barangay officials; e. E.O. No. 25010 provides increased insurance benefits for barangay officials under R.A. No. 4898, as well as members of Sangguniang Panalalawigan, Panglungsod, and Bayan; and f. PDIC Charter11 insures deposits of all banks entitled to benefits of insurance thereunder. 5. Corporation Code12 for insurance corporations; Sec. 185, par. 2, I.C.

E. INTERPRETATION OF INSURANCE CONTRACTS


1. Clear Provision Given Ordinary Meaning Union Manufacturing Co., Inc. v. Phil. Guaranty Co., 47 SCRA 271 (1972); Ty v. First National Surety & Assurance Co., Inc., 1 SCRA 1324 (1961)13; 2. Ambiguous Provision Interpreted Against Insurer Qua Chee Gan v. Law Union and Rock Insurance Co., Ltd. , 98 Phil. 85 (1955); Del Rosario v. Equitable Ins. And Casualty Co., Inc. , 8 SCRA 343 (1963); But See Verendia v. Court of Appeals, 217 SCRA 417 (1993) 3. Stipulations Cannot Be Segregated Gulf Resorts Inc. v. Philippine Charter Insurance Corporation , 458 SCRA 550 (2005) 4. Judicial Construction Cannot Alter Terms Misamis Lumber Corp. v. Capital Ins. & Surety Co., Inc. , 17 SCRA 228 (1966); Fortune Insurance and Surety Co., Inc. v. Court of Appeals , 244 SCRA 308 (1995)

Presidential Decree No. 1146, as amended. Republic Act No. 1161, as amended. 8 Republic Act No. 656, as amended by Presidential Decree No. 245. 9 Republic Act No. 4898, as amended by Republic Act No. 5756. 10 Executive Order No. 250. 11 Republic Act No. 3591, as amended. 12 Batas Pambansa Blg. 68, otherwise known as the Corporation Code of the Philippines. 13 See also Ty v. Filipinas Compania de Seguros, et al., 17 SCRA 364 (1966); But See Panaton v. Malayan Insurance Co., Inc. 2 Court of Appeals Report 78.
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II. PARTIES
A. INSURED
1. Definition the person to be indemnified; the person who applied for and to whom an insurance policy is issued. 2. Capacity Art. 1390, Civil Code a. Married women Sec. 3, pars. 2 and 4, I.C.; Art. 73, Family Code b. Minors Sec. 3, pars. 3-5, I.C.; Art. 38, Civil Code; xR.A. No. 680914 3. Disqualification: Public Enemy Sec. 7, I.C.; Filipinas Compania de Seguros v. Christern Henefeld & Co. , 89 Phil. 4\54 (1951); xConstantino v. Asia Life Insurance Co. , 87 Phil. 248 (1950) 4. Trustee or Agent Sec. 54, I.C. 5. Partner Sec. 55, I.C.

B. INSURER
1. Definition the person who undertakes to indemnify another by a contract of insurance; Sec. 184, I.C. a. Insurance Corporations xSec. 185, par. 1, I.C. b. Mutual Insurance Companies xSec. 262, I.C. c. Professional Reinsurers xSec. 280, I.C. d. Mutual Benefit Associations (excluded from definition, but still subject to I.C. regulation) xSec. 390, I.C. 2. Capitalization/Certificate of Authority Secs. 6, 186-187, I.C. 3. Prohibited Acts Secs. 361-362, I.C.

C. BENEFICIARY
1. Definition the person who receives a benefit or advantage, or who is entitled to the benefit of the contract, i.e., the one to whom the insurance is payable or who is entitled to the proceeds of the policy on the occurrence of the event designated. 2. To Whom Insurance Proceeds Payable Secs. 53 and 56, I.C.; a. Stipulation Pour Autrui Art. 1311, Civil Code; Bonifacio Bros., Inc. v. Mora, 20 SCRA 261 (1967); Coquia v. Fieldmens Insurance

Republic Act No. 6809 amended Article 234 of the Family Code by reducing the age of majority from 21 years to 18 years.

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5 Co., Inc., 26 SCRA 178 (1968); Guingon v. Del Monte, 20 SCRA 1043 (1967) b. Estate Del Val v. Del Val, 29 Phil. 534 (1915) c. Assignee Rizal Commercial Banking Corporation v. Court of Appeals, 289 SCRA 292 (1998) 3. Designation of Beneficiary a. No Designation In Re: Mario V. Chanliongco , 79 SCRA 364 (1977); Vda. de Consuegra v. Governments Service Insurance System, 37 SCRA 315 (1971); b. Invalid Designation Art. 2012 in relation to Art. 739, Civil The Insular Life Assurance Company, Ltd. V. Ebrado , 80 181 (1977); Southern Luzon Employees Ass. V. Golpeo, et Phil. 83 (1954); Social Security System v. Davac, et al. , 17 863 (1966); Code ; SCRA al. , 96 SCRA

c. Revocable Designation Sec. 11, I.C.; Gercio v. Sun Life Assurance Co. of Canada, 48 Phil. 53 (1925) d. Irrevocable Designation Nario v. Philippine American Life Ins. Co., 20 SCRA 434 (1967); Philippine American Life Insurance Company v. Pineda, 175 SCRA 416 (1989) e. Exceptions to Irrevocable Designation Arts. 43(4), 50, 64, Family Code; 5. Forfeiture Sec. 12, I.C. 6. Insured Outlives Policy Sec. 180, I.C.; Villanueva v. Oro, 81 Phil. 464 (1948)

D. INSURANCE AGENT AND INSURANCE BROKER


1. Insurance Agent Sec. 300, I.C.; Aisporna v. Court of Appeals , 113 SCRA 459 (1982) 2. Insurance Broker Sec. 301, I.C.; Philippine Health-Care Providers, Inc. v. Estrada, 542 SCRA 616 (2008) 3. Authority to Receive Payment/Effect of Payment Sec. 306, I.C. ; Malayan Insurance Co., Inc. v. Arnaldo , 154 SCRA 672 (1987); South Sea Surety and Insurance Co., Inc. v. Court of Appeals , 244 SCRA 744 (1995)

III.INSURABLE INTEREST
A. CONCEPT
1. Definition In general, a person has an insurable interest in the subject matter insured where he has such a relation or connection with, or concern in, such subject matter that he derive pecuniary benefit or advantage from its preservation or will suffer pecuniary loss or damage from its destruction, termination or injury by the happening of the event insured against. 2. Necessity of Insurable Interest; Consequence of Lack of Secs. 3, 4, 18, and 25, I.C.

B. IN LIFE AND HEALTH INSURANCE


1. Who Has Insurable Interest Sec. 10, I.C. a. Blood relationship Sec. 10(a), I.C.; Philamcare Health Systems, Inc. v. Court of Appeals, 379 SCRA 356 (2002); Gercio v. Sun Life Assurance Co. of Canada, 48 Phil. 53 (1925) b. Education or support Sec. 10(b), I.C.; Art. 195, Family Code c. Creditor Sec. 10(c), I.C.; Great Pacific Life Assurance Corp. v. Court of Appeals, 316 SCRA 677 (1999) d. Pecuniary Interest Sec. 10(d), I.C.; El Oriente, Fabrica de Tabacos, Inc., v. Posadas, 56 Phil. 147 (1931); 2. When Insurable Interest Must Exist Sec. 19, I.C. 3. Transfer by Will or Succession Upon Death of Insured Sec. 181, I.C.

C. IN PROPERTY INSURANCE
1. Who Has Insurable Interest15 Secs. 13 and 14, I.C. a. Existing Interest Sec. 14(a), I.C.; Traders Insurance & Surety Co. v. Golangco, et al., 95 Phil. 824 (1954); Filipino Merchants Insurance Co., Inc. v. Court of Appeals , 179 SCRA 638 (1989); Gaisano Cagayan, Inc. v. Insurance Company of North America , 490 SCRA 286 (2006); Ong Ling Sing v. FEB Leasing & Finance Corporation, 425 SCRA 333 (2007); Lampano v. Jose, 30 Phil. 537 (1915)
The test of insurable interest in property is whether the insured has such a right, title, or interest therein, or relation thereto that he will be benefited by its preservation and continued existence, or suffer a direct pecuniary loss from its destruction or injury by the peril insured against (Suter v. Union Surety & Ins. Co., Inc., 51 O.G. 1905 [1954]).
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7 b. Inchoate Interest Sec. 14(b), I.C. c. Expectancy Secs. 14(c) and 16, I.C. d. Mortgagor Secs. 8 and 9, I.C.; Art. 2127, Civil Code; San Miguel Brewery v. Law Union and Rock Insurance Co. , 40 Phil. 674 (1920); Saura Import & Export Co., Inc. v. Philippine International Surety Co., Inc., 8 SCRA 143 (1963); Palileo v. Cosio, 97 Phil. 919 (1955); Great Pacific Life Assurance Corp. v. Court of Appeals , 316 SCRA 677 (1999) e. Carrier or Depositary Sec. 15, I.C.; Sec. 6, General Bonded Warehouse Act16; Lopez v. Del Rosario and Quiogue , 44 Phil. 98 (1922) 2. Measure of Insurable Interest Secs. 17 and 14(a), I.C.; San Miguel Brewery v. Law Union and Rock Insurance Co. , 40 Phil. 674 (1920); Ong Ling Sing v. FEB Leasing & Finance Corporation , 425 SCRA 333 (2007); 3. Effect of Lack of Insurable Interest Sec. 18, I.C.; Sharuff & Co. v. Baloise Fire Insurance Co., 64 Phil. 258 (1937); Garcia v. Hongkong Fire & Marine Insurance Co. , 45 Phil. 122 (1923); Cha v. Court of Appeals, 277 SCRA 690 (1997) 4. When Insurable Interest Must Exist Sec. 19, I.C.; Tai Tong Chuache & Co. v. Insurance Commission , 158 SCRA 366 (1988) 5. Effect of Change of Interest in Thing Insured a. General rule: suspended Sec. 20, I.C.; San Miguel Brewery v. Law Union and Rock Insurance Co., 40 Phil. 674 (1920); Bachrach v. British American Assurance Co., 17 Phil. 555 (1910) b. Exceptions i. Life, accident, and health insurance Sec. 20, I.C. ii. Change of interest after occurrence of loss Sec. 21, I.C. iii. Change of interest in things separately insured Sec. 22, I.C. iv. Transfer of interest by will or succession upon death of insured Sec. 23, I.C. v. Transfer of interest by one of partners, joint owners, or common owners jointly insured, to the others Sec. 24, I.C. vi. Insurance policy framed to insure to benefit of whomsoever becomes owner of thing insured Sec. 57, I.C. 6. Effect of Transfer of Thing Insured Sec. 58, I.C.; San Miguel Brewery v. Law Union and Rock Insurance Co., 40 Phil. 674 (1920)
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Act No. 3893.

IV. PREMIUM
A. PAYMENT REQUIRED
1. Binding Effect of Payment Secs. 77 and 306, par. 2, I.C.; South Sea Surety and Insurance Co., Inc. v. Court of Appeals , 244 SCRA 744 (1995); Areola v. Court of Appeals, 236 SCRA 643 (1994) 3. Effect of Non-Payment Sec. 64(a), I.C.; National Leather Co. Inc. v. U.S. Life Insurance Co., 87 Phil. 410 (1950); Sales de Gonzaga v. Crown Life Insurance Co., 91 Phil. 10 (1952); Valenzuela v. Court of Appeals, 191 SCRA 1 (1990); 2. Statutory Exceptions a. Grace period Sec. 77, I.C. i. For individual life or endowment insurance Sec. 227(a), I.C. ii. For group life insurance Sec. 228(a), I.C. iii. For industrial life insurance Sec. 230(a), I.C. b. Acknowledgment receipt Sec. 78, I.C.; American Assurance Company v. Chua, 309 SCRA 250 (1999) Home

c. Acceptance by obligee of surety bond Sec. 177, I.C.; Philippine Pryce Assurance Corp. v. Court of Appeals , 230 SCRA 164 (1994) d. Rules on cover notes (if premium cannot yet be computed) Sec. 52, I.C.; Pacific Timber v. Court of Appeals, 112 SCRA 199 (1982) e. Non-lapse of individual life or endowment insurance i. Automatic policy loan Sec. 227(g), I.C. ii. Application of dividend Sec. 227(e), I.C. iii. Reinstatement clause Sec. 227(j), I.C. 3. Jurisprudential Exceptions a. Estoppel and credit extension Philippine Phoenix Surety & Insurance Company v. Woodworks, Inc. , 92 SCRA 419 (1979); Capital Insurance & Surety Co., Inc. v. Plastic Era Co., Inc. , 65 SCRA 134 (1975); Arce v. Capital Insurance & Surety Co., Inc. , 117 SCRA 63 (1982); Malayan Insurance Co., Inc. v. Arnaldo , 154 SCRA 672 (1987); UCPB General Insurance Co., Inc. v. Masagana Telemart, Inc., 356 SCRA 307 (2001); UCPB General Insurance Co., Inc. v. Masagana Telemart, Inc., 356 SCRA 307 (2001) b. Installments and partial payment Philippine Phoenix Surety & Insurance, Inc. v. Woodworks, Inc., 20 SCRA 1270 (1967); Tibay

9 v. Court of Appeals, 257 SCRA 126 (1996); Makati Tuscany v. Court of Appeals, 215 SCRA 462 (1992)

B. RETURN OF PREMIUM
1. Grounds a. No exposed to peril insured against Secs. 79(a) and 80, I.C. ; Makati Tuscany v. Court of Appeals, 215 SCRA 462 (1992) b. Time policy surrendered before expiration Sec. 79(b), I.C. c. Voidable policy Sec. 81, I.C. d. When by default of insured (other than actual fraud), insurer never incurred liability under the policy Sec. 81, I.C.; Great Pacific Life Insurance Corporation v. Court of Appeals, 184 SCRA 501 (1990) e. Over-insurance by several insurers Sec. 82, I.C. 2. Rebate of Premium Sec. 361, I.C.

V. THE POLICY
A. POLICY OF INSURANCE
1. Definition; Contract of Insurance Sec. 49, I.C.; Enriquez v. Sun Life Assurance Co. of Canada, 41 Phil. 269 (1920); Perez v. Court of Appeals, 323 SCRA 613 (2000); Lucero Vda. de Singayen v. Insular Life Assurance Co., 62 Phil. 9 (1935); Tang v. Court of Appeals, 90 SCRA 236 (1979) 2. Form Sec. 50, I.C. 3. Necessity of Approval of Form Sec. 226, I.C. 4. Basic Provisions Sec. 51, I.C. a. Parties to the contract; b. Amount of insurance (except in open or running policies); c. Premium; d. Property or life insured; e. Interest of insured in property insured if he is not the owner; f. Risks insured against; and g. Period of insurance. 5. Additional Matters Secs. 227, 228, 230, I.C.

10 6. Designation of Beneficiaries Secs. 54-57, I.C. 7. Rider, Clause, Warranty or Endorsement Sec. 50, I.C.; Commissioner of Internal Revenue v. Lincoln Philippine Life Insurance Company, Inc., 379 SCRA 423 (2002) 8. Interpretation and Proof Art. 1377, Civil Code 9. Application of Rules to Modification of Policy Sec. 47, I.C.

B. COVER NOTES
1. Binding Effect Sec. 52, I.C.; De Lim v. Sun Life Assurance Co. of Canada, 41 Phil. 263 (1920); Great Pacific Life Assurance Company v. Court of Appeals, 89 SCRA 543 (1979) 2. Separate Premium Not Required Pacific Timber v. Court of Appeals, 112 SCRA 199 (1982)

C. KINDS OF PROPERTY INSURANCE POLICY


1. Classification Sec. 59, I.C. 2. Open Policy Secs. 60, 161, and 171, I.C. ; Development Insurance Corporation v. Intermediate Appellate Court, 143 SCRA 62 (1986) 3. Valued Policy Secs. 61, 156, and 171, I.C. 4. Running Policy Sec. 62, I.C.

D. CANCELLATION, RENEWAL, REFORMATION


1. Cancellation a. By Insurer Sec. 64, I.C.; Philamcare Health Systems, Inc. v. Court of Appeals, 379 SCRA 356 (2002) i. non-payment of premiums ii. conviction of crime increasing hazard insured against iii. discovery of fraud or material misrepresentation iv. discovery of acts or omissions increasing hazard insured against v. physical changes in property insured making it uninsurable vi. Insurance Commissioner determines policy or insured may violate I.C. b. By insured Sec. 79(b), I.C. c. For compulsory motor vehicle liability insurance Secs. 380-381, I.C.

11 d. Notice Sec. 65, I.C.; Paulino v. Capital Insurance, 105 Phil. 1315 (1959); Saura Import & Export Co., Inc. v. Philippine International Surety Co., Inc., 8 SCRA 143 (1963); Malayan Insurance Co., Inc. v. Arnaldo, 154 SCRA 672 (1987) 2. Renewal Sec. 66, I.C. 3. Reformation San Miguel Brewery v. Law Union and Rock Insurance Co., 40 Phil. 674 (1920)

VI. ASCERTAINING AND CONTROLLING RISKS


A. CONCEALMENT
1. Definition Sec. 26, I.C. 2. What Must Be Communicated; Requisites Sec. 28, I.C.; a. Facts within his knowledge b. Facts material to the contract Secs. 31 and 107, I.C. ; Saturnino v. Philippine American Life Ins. Co., 7 SCRA 316 (1963); Sunlife Assurance Company of Canada v. Court of Appeals , 245 SCRA 268 (1995) c. Other party has no means of ascertaining such facts; and d. He makes no warranty as to such facts; exception Sec. 29, I.C. 3. What Need Not Be Communicated a. Facts other party knows Sec. 30(a), I.C.; Insular Life Assurance v. Feliciano, 73 Phil. 201 (1941); Insular Life Assurance Co. v. Feliciano, 74 Phil. 468 (1943); b. Facts other party ought to know Secs. 30(b) and 32, I.C. c. Facts of which other party waives communication Secs. 30(c) and 33, I.C.; Ng Gan Zee v. Asian Crusader Life Assurance Corp. , 122 SCRA 461 (1983) d. Facts which prove or tend to prove existence of risk excluded by a warranty, and which are not otherwise material Sec. 30(d), I.C. e. Facts relating to a risk excepted from the policy and which are not otherwise material Sec. 30(e), I.C. f. Nature and amount of interest Secs. 34 and 51(e), I.C. g. Opinion or judgment Secs. 35 and 108, I.C. 4. Effect Secs. 27 and 29, I.C.; Argente v. West Coast Life Insurance Co., 51 Phil. 725 (1928); Yu Pang Cheng v. Court of Appeals , 105 Phil.

12 930 (1959); Saturnino v. Philippine American Life Ins. Co. , 7 SCRA 316 (1963); Great Pacific Life Assurance Company v. Court of Appeals, 89 SCRA 543 (1979); Gen. Insurance & Surety Corp. v. Ng Hua, 106 Phil. 1117 (1960); Vda de Canilang v. Court of Appeals , 233 SCRA 443 (1993); Sunlife Assurance Company of Canada v. Court of Appeals, 245 SCRA 268 (1995)

B. REPRESENTATION
1. Definition and Characteristics a. Form Sec. 36, I.C. b. When Made Sec. 37, I.C. i. at time of issuance of policy ii. before issuance of policy Secs. 41 and 42, I.C. c. Interpretation Sec. 38, I.C. d. Promissory representation; statement of belief or expectation Sec. 39, I.C. e. Modification of warranty Sec. 40, I.C. 2. Falsity Secs. 43 and 44, I.C.; Harding v. Commercial Union Assurance Company, 38 Phil. 464 (1918); 3. Materiality Sec. 46 in rel. to Sec. 31, I.C. 4. Effect of False and Material Representation Sec. 45, I.C. ; Saturnino v. Philippine American Life Ins. Co., 7 SCRA 316 (1963); Musgi v. West Coast Life Insurance Co., 61 Phil. 864 (1935); Edillon v. Manila Bankers Life Insurance Corp., 117 SCRA 187 (1982); Gonzalez LaO v. Yek Tong Lin Fire & Marine Insurance Co., Ltd. , 55 Phil. 386 (1930); Tan Chay Heng v. West Coast Life Insurance Co. , 51 Phil. 80 (1927); Qua Chee Gan v. Law Union and Rock Insurance Co., Ltd. , 98 Phil. 85 (1955)

C. WARRANTIES
1. Definition and Characteristics a. Kinds i. Express or implied Sec. 67, I.C. ii. Affirmative or Promissory b. To what warranties relate Sec. 68, I.C. c. Form Sec. 69, I.C.

13 2. Express Warranties Sec. 70, I.C.; Ang Giok Chip v. Springfield Fire & Marine Insurance Co., 56 Phil. 375 (1931) 3. Affirmative Warranties Sec. 71, I.C. 4. Promissory Warranties Secs. 72 and 73, I.C. 5. Effect of Breach a. Breach of material warranty or provision Sec. 74, I.C.; Young v. Midland Textile Insurance Co., 30 Phil. 617 (1915); Qua Chee Gan v. Law Union and Rock Insurance Co., Ltd. , 98 Phil. 85 (1955) b. Breach of immaterial provision Sec. 75, I.C.; Gen. Insurance & Surety Corp. v. Ng Hua, 106 Phil. 1117 (1960) c. Breach of warranty without fraud Sec. 76, I.C.

D. OTHER DEVICES
1. Conditions 2. Exceptions, Exclusions, or Exemptions

E. INCONTESTABLE CLAUSE
1. Rescission of Insurance Contract (for Life and Non-Life Insurance) Sec. 48, par. 1, I.C. a. Time to rescind Tan Chay Heng v. West Coast Life Insurance Co., 51 Phil. 80 (1927) b. Effect of failure to rescind before commencement of action c. Waiver of right to rescind 2. Incontestible Clause (for Life Insurance Only) Sec. 48, par. 3, and Secs. 227(b), 228(b), and 230(b), I.C. a. Requisites of incontestability Tan v. Court of Appeals, 174 SCRA 403 (1989); Philamcare Health Systems, Inc. v. Court of Appeals , 379 SCRA 356 (2002) b. Effects and purpose of incontestability c. Defenses not barred by incontestability

F. STIPULATIONS LIMITING COMMENCEMENT OF ACTION TO LESS THAN ONE YEAR IS VOID Sec. 63, I.C.; Agric. Credit & Cooperative
Financing Administration v. Alpha Ins. & Surety Co. , Inc., 24 SCRA 151 (1968); Ang v. Fulton Fire Ins. Co. , 2 SCRA 945 (1961); Sun Insurance Office, Ltd. v. Court of Appeals, 195 SCRA 193 (1991); New Life Enterprises v. Court of Appeals, 207 SCRA 669 (1992)

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VII. LOSS AND NOTICE OF LOSS


A. LOSS
1. Concepts and Definitions a. Loss b. Proximate Cause c. Remote Cause d. Immediate Cause e. Peril Insured Against 2. Losses for which Insurer Liable a. Loss of which a peril insured against was the proximate cause Sec. 84, I.C. b. Loss caused by a peril not insured against to which the thing insured was exposed in the course of rescuing the same from the peril insured against Sec. 85, I.C. c. Loss caused by efforts to rescue the thing insured from a peril insured against Sec. 85, I.C. d. Loss, the immediate cause of which was the peril insured against, if the proximate cause thereof was not excepted in the contract Sec. 86, I.C.; Paris-Manila Perfume Co. v. Phoenix Assurance Co. , 49 Phil. 758 (1926) e. Loss caused by negligence of the insured Sec. 87, I.C.; FGU Insurance Corporation v. Court of Appeals, 454 SCRA 337 (2005) 3. Losses for which Insurer Not Liable a. Loss of which a peril insured against was only a remote cause Sec. 84, I.C. b. Loss, the immediate cause of which was the peril insured against, if the proximate cause thereof was excepted in the contract Sec. 86, I.C. c. Loss caused by willful act or through connivance of insured Sec. 87, I.C., But See Sec. 180-A, I.C.; East Furniture Inc. v. Globe & Rutgers Fire Ins. Co., 57 Phil. 576 (1932); Prats & Co. v. Phoenix Insurance Co., 52 Phil. 807 (1929) 4. Void Agreement Sec. 83, I.C.

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B. NOTICE AND PROOF


1. Requisites for Recovery After Loss a. Give notice of loss without unnecessary delay b. When required by policy, submit a preliminary proof of loss 2. Notice of Loss Sec. 88, I.C.; Bachrach v. British American Assurance Co., 17 Phil. 555 (1910) 3. Proof of Loss Secs. 89 and 92, I.C. ; Fernandez v. National Life Insurance Co., 105 Phil. 59 (1959); Insular Life Assurance Co. Ltd. v. Fernandez, 109 Phil 530 (1960); Malayan Insurance Co., Inc. v. Arnaldo, 154 SCRA 672 (1987); Pacific Banking Corp. v. Court of Appeals, 168 SCRA 1 (1988) 4. Defects Sec. 90, I.C. 5. Delay Sec. 91, I.C.; Pacific Timber v. Court of Appeals , 112 SCRA 199 (1982); Philippine Charter Insurance Corporation v. Chemoil Lighterage Corporation, 462 SCRA 77 (2005)

VIII.DOUBLE INSURANCE AND REINSURANCE


A. DOUBLE INSURANCE
1. Definition Sec. 93, I.C. 2. Requisites Sec. 93, I.C.; Pacific Banking Corp. v. Court of Appeals , 168 SCRA 1 (1988); Pioneer Insurance and Surety Corporation v. Yap, 61 SCRA 426 (1974); New Life Enterprises v. Court of Appeals , 207 SCRA 669 (1992); Geagonia v. Court of Appeals, 241 SCRA 152 (1995) a. Same person is insured b. Two or more insurers that insured the person separately c. Insurance is over the same subject d. Same interest is involved e. Same peril is insured against 3. Other Insurance Clause a. Alternative forms b. Rationale c. Validity d. Additional insurance

16 4. Over-Insurance By Double Insurance Sec. 94, I.C.

B. REINSURANCE
1. Definition Sec. 95, I.C.; Equitable Insurance and Casualty Co., Inc. v. Rural Insurance and Surety Co., Inc. , 4 SCRA 343 (1962); Phil. American Life Ins. Co. v. Auditor General , 22 SCRA 135 (1968); Fieldmens Insurance Co., Inc. v. Asian Surety & Insruance Co., Inc. , 34 SCRA 36 (1970) 2. Distinguish from Double Insurance 3. When Required Secs. 215-222 and 275, I.C. 4. Matters to be Communicated by Reinsured Sec. 96, I.C. 5. Reinsurers Extent of Liability Sec. 87, I.C. 6. Original Insured No Interest in Reinsurance Sec. 98, I.C.; Artex Development Co., Inc. v. Wellington Insurance Co., Inc. , 51 SCRA 352 (1973); Coquia v. Fieldmens Insurance Co., Inc. , 26 SCRA 178 (1968); Guingon v. Del Monte, 20 SCRA 1043 (1967); Gibson v. Revilla, 92 SCRA 219 (1979)

IX. MARINE INSURANCE


A. DEFINITION AND COVERAGE
1. Insurance Against Loss Or Damage Sec. 99(1), I.C.; Go Tiaoco y Hermanos v. Union Ins. Society of Canton , 40 Phil. 40 (1919); Filipino Merchants Insurance Co., Inc. v. Court of Appeals , 179 SCRA 638 (1989) 2. Marine Protection and Indemnity Insurance Sec. 99(2), I.C.: Insurance against legal liability; White Gold Marine Services, Inc. v. Pioneer Insurance Surety Corporation, 464 SCRA 448 (2005)

B. INSURABLE INTEREST
1. Owner of Ship Sec. 100, I.C.: Has insurable interest in ship a. If charterer covenants to pay ships value in case of loss Sec. 100, I.C. b. If ship hypothecated by bottomry Sec. 101, I.C.; See Art. 719, Code of Commerce 2. Owner of Ship Sec. 103, I.C.: Has insurable interest in freightage (Sec. 102, I.C.

17 a. If charter party Sec. 104, I.C. b. If no charter party and freightage is to be paid Sec. 104, I.C. 3. One Who Has Insurable Interest in Thing Insured Sec. 105, I.C.: Has insurable interest in profits 4. Charterer of Ship Sec. 106, I.C.: To extent that he is liable to be damnified by its loss

C. ASCERTAINING AND CONTROLLING RISKS


1. Concealment a. What must be communicated (in addition to Sec. 28) i. Sec. 104, I.C.: All information material to the risk ii. Sec. 104, I.C.: State exact and whole truth with respect to representations and answers to inquiries iii. Sec. 105, I.C.: Information or belief or expectation of third party in relation to material fact deemed material iv. Sec. 106, I.C.: Knowledge of prior loss presumed if info might have reached insured in usual mode and rate of transmission b. Concealment as to following Sec. 110, I.C.: Does not vitiate entire contract, but exonerates insurer from loss resulting from risk concealed i. National character of insured ii. Liability of things insured to capture and detention iii. Liability to seizure from breach of foreign laws of trade iv. Want of necessary documents v. Use of false and simulated papers 2. Representation a. Sec. 111, I.C.: Insurer entitled to rescind contract if representation is Intentionally false in any material respect (Compare with Sec. 45, where intent not essential) b. Sec. 112, I.C.: Falsity of representation as to expectation in absence of fraud does not avoid contract 3. Implied Warranties a. Seaworthiness of ship Sec. 113, I.C.; Madrigal, Tiangco & Co. v. Hanson, Orth & Stevenson, Inc., 103 Phil. 345 (1958) i. Definition Sec. 114, I.C.; See Sec. 119, I.C.; Philippine American General Insurance Co., Inc. v. Court of Appeals , 273 SCRA 262 (1997)

18 ii. When seaworthiness required Secs. 115 and 117, I.C. iii. Extent of seaworthiness Sec. 116, I.C. iv. Unseaworthiness during voyage Sec. 118, I.C.; Roque v. Intermediate Appellate Court, 139 SCRA 596 (1985) b. Ship will carry requisite documentary proof if nationality or neutrality is expressly warranted, and will not carry documents which cast reasonable suspicion Sec. 120, I.C. c. No improper deviation Sec. 125, I.C. i. Definition Sec. 123, I.C.: ii. When no deviation Secs. 121 and 122, I.C. iii. When deviation proper Sec. 124, I.C. iv. Effect of improper deviation Sec. 126, I.C. d. Not an illegal venture

D. LOSS
1. Kinds of Loss a. Total or, if not total, then partial Secs. 127 and 128, I.C. b. Total loss may be actual (absolute total loss) or constructive (technical total loss) Secs. 129 and 137, I.C. 2. Actual Total Loss a. Definition Sec. 130, I.C.; Philippine Mfg. Co. v. Union Insurance Society of Canton, 42 Phil. 378 (1921); Malayan Insurance Corporation v. Court of Appeals, 270 SCRA 242 (1997) b. Presumption Sec. 132, I.C. c. Right to payment of insured Sec. 135, I.C.; Pan Malayan Insurance Corp. v. Court of Appeals, 201 SCRA 382 (1991) 3. Constructive Total Loss a. Definition Sec. 139; Oriental Assurance Corporation v. Court of Appeals, 200 SCRA 459 (1991); Pan Malayan Insurance Corp. v. Court of Appeals, 201 SCRA 382 (1991) b. Right to abandon of insured Secs. 131 and 139, I.C. i. Definition Sec. 138, I.C. ii. Requisites of abandonment Secs. 140 to 142, I.C. iii. Notice of abandonment Secs. 143 to 145, I.C. iv. Acceptance of abandonment Secs. 150 and 151

19 v. Refusal to accept abandonment Secs. 149 and 154, I.C. vi. Effect of insuers payment even if no formal abandonment Sec. 147, I.C. vi. Effects of abandonment Secs. 146, 148, 152 and 153, I.C. c. Right to recover actual loss if insured omits to abandon Sec. 155, I.C. 4. Liabilities of Insurer Secs. 133 and 134, I.C. 5. Free from Particular Average Sec. 137, I.C. ; Secs. 164 and 165, I.C. ; Arts. 802-812, Code of Commerce ; Jarque v. Smith, Bell & Co. , 56 Phil. 758 (1930)

E. MEASURE OF INDEMNITY Secs. 156 to 163, and 166, I.C.

X. FIRE INSURANCE
A. DEFINITION AND COVERAGE
1. Definition and Coverage Sec. 167, I.C. 2. Prohibition Sec. 173, I.C.; See Sec. 83, I.C.

B. MATTERS AFFECTING POLICY


1. Change in Use or Condition of Thing Insured a. When change entitles insurer to rescind Sec. 168 b. When change does not affect contract Sec. 169, I.C. 2. Acts of Insured Sec. 170, I.C.; Bachrach v. British American Assurance Co., 17 Phil. 555 (1910)

C. MEASURE OF INDEMNITY
1. Open Policy Sec. 171, I.C.; Galian v. State Assurance Co., 29 Phil. 413 (1915) 2. Valued Policy Secs. 171 and 172, I.C.; Ong Guan Can and Bank of the P.I v. Century Ins. Co., 46 Phil. 592 (1924)

20

XI. LIFE INSURANCE


A. DEFINITION AND COVERAGE
1. Definition and Coverage Sec. 179, I.C.; Gallardo v. Morales, 107 Phil. 903 (1960) a. Payable upon death of insured or his surviving a specified period Sec. 180, par. 1, I.C. b. Payment of endowments or annuities Sec. 180, par. 2, and Sec. 2, par. 1, I.C.; Secs. 2021-2027, Civil Code 2. Who Exercises Rights of Minor Insured or Beneficiaries Sec. 180, par. 3, I.C., as amended by Art. 225, Family Code; Nario v. Philippine American Life Ins. Co., 20 SCRA 434 (1967); Pineda v. Court of Appeals, 226 SCRA 754 (1993); Bank of the Philippine Islands v. Posadas, 56 Phil. 215 (1931); Del Val v. Del Val, 29 Phil. 534 (1915) 3. Liability of Insurer for Suicide and Accidental Death Sec. 180-A, I.C.; See Sec. 87, I.C.; Calanoc v. Court of Appeals, 98 Phil. 79 (1955); Kanapi v. Insular Life Assurance Co., Ltd. , 94 Phil. 397 (1954); Biagtan v. The Insular Life Assurance Company, Ltd. , 44 SCRA 58 (1972); De la Cruz v. Capital Ins. & Surety Co., Inc. , 17 SCRA 559 (1966)

B. TRANSFER OF POLICY
1. By Transfer, Will or Succession Sec. 181, I.C. 2. Notice to Insurer Sec. 182, I.C.

C. MEASURE

OF INDEMNITY Sec. 183, I.C.; Commissioner of Internal Revenue v. Lincoln Philippine Life Insurance Company, Inc. , 379 SCRA 423 (2002)

XII. CASUALTY AND COMPULSORY MOTOR VEHICLE LIABILITY INSURANCE


A. CASUALTY INSURANCE
1. Definition and Coverage a. Sec. 174, I.C. Loss or liability arising from accident or mishap, excluding those which by law or custom are considered as falling exclusively within the scope of other types of insurance, i.e., fire and marine. It includes:

21 i. Employers liability insurance ii. Motor vehicle liability insurance Authorized Driver Clause: Tanco, Jr. v. Philippine Guaranty Co., 15 SCRA 313 (1965); CCC Insurance Corporation v. Court of Appeals , 31 SCRA 264 (1970); Villacorta v. Insurance Commission, 100 SCRA 467 (1980); Association of Baptists for World Evangelism, Inc. v. Fieldmens insurance Co., Inc., 124 SCRA 618 (1983); Stokes v. Malayan Insurance Co., Inc., 127 SCRA 766 (1984); Gutierrez v. Captial Insurance & Surety Co., Inc. , 130 SCRA 100 (1984); Malayan Insurance Co., Inc. v. Court of Appeals , 146 SCRA 45 (1986); Palermo v. Pyramid Insurance Co., Inc. , 161 SCRA 677 (1988); Perla Compania de Seguros, Inc. v. Court of Appeals, 208 SCRA 487 (1992) iii. Plate glass insurance iv. Burglary and theft insurance v. Personal accident and health insurance as written by non-life insurance companies Accident: Pan Malayan Insurance Corporation v. Court of Appeals , 184 SCRA 54 (1990); Sun Insurance Office, Ltd. v. Court of Appeals , 211 SCRA 554 (1992); Finman General Assurance Corp. v. Court of Appeals , 213 SCRA 493 (1992); Vda. de Maglana v. Consolacion , 212 SCRA 268 (1992); FGU insurance Corporation v. Court of Appeals, 287 SCRA 718 (1998) b. Others pollution liability insurance, pharmacist liability insurance, medical malpractice insurance, garage insurance, directors and officers liability insurance

B. COMPULSORY MOTOR VEHICLE LIABILITY INSURANCE (CMVLI)


1. Definitions Secs. 373, I.C. 2. Coverage and Requirements Secs. 374, 376-378, and 383 I.C. ; Shafer v. Judge, RTC of Olongapo City, Br. 75 , 167 SCRA 386 (1988); Government Service Insurance System v. Court of Appeals , 308 SCRA 559 (1999); Tiu v. Arriesgado, 437 SCRA 426 (2004); Perla Compania de Seguros, Inc. v. Ancheta, 164 SCRA 144 (1988) 3. Rules on Insurer Secs. 375 and 379, I.C. 3. Rules on Cancellation Secs. 380 and 381, I.C. 4. Effect of change of ownership Sec. 382, I.C. 5. Claims Procedure Secs. 384 and 385, I.C.; Shafer v. Judge, RTC of Olongapo City, Br. 75, 167 SCRA 386 (1988); Government Service

22 Insurance System v. Court of Appeals , 308 SCRA 559 (1999); Summit Guaranty & Insurance Co., Inc. v. Arnaldo , 158 SCRA 331 (1988); First Integrated Bonding & Insurance Co., Inc. v. Hernando , 199 SCRA 796 (1991); Travellers Insurance & Surety Corp. v. Court of Appeals, 272 SCRA 536 (1997); Vda. de Gabriel v. Court of Appeals , 264 SCRA 137 (1996) 6. Prohibited Acts and Sanctions Secs. 386 to 389, I.C.

XIII.SURETYSHIP
A. DEFINITION AND COVERAGE
1. Definition and Coverage Sec. 175, I.C.; Sec. 2, pars. 1 and 2, I.C. ; Security Pacific Assurance Corporation v. Tria-Infante , 468 SCRA 526 (2005) 2. Nature of Liability Sec. 176, I.C.; National Shipyards & Steel Corp. v. Torrento, 20 SCRA 427 (1967); Leyson v. Rizal Surety and Insurance Co., 16 SCRA 551 (1966); National Power Corporation v. Court of Appeals, 145 SCRA 533 (1986) 3. Suppletory Application of Civil Code Sec. 178, I.C.; Art. 2047 and Arts. 1207-1222, Civil Code

B. PREMIUM Sec. 177, I.C.; Philippine Pryce Assurance Corp. v. Court of


Appeals, 230 SCRA 164 (1994)

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