Category Archives: Insurance Doctrines

August 2, 2012

I. Construction of Insurance Contracts

By LLBe:LawLifeBuzzEtcetera 1) Calanoc vs. Court of Appeals, 98 Phil. 79 In construing ambiguous terms in an insurance policy covering accidental death, the Supreme Court held that such terms are to be construed strictly against the insurer, and liberally in favor of the insured so as to effect the dominant purpose of indemnity or payment to the insured. The killing of the victim was a pure accident on his part since it is possible that the malefactor had fired the shot merely to scare away the people around for his own protection and not necessarily to kill or hit the victim. 2) Biagtan vs. The Insular ife Assurance Co!pan", t#. $$ %C&A '8 Unlike the ruling in the case of Calanoc vs. Court of Appeals, where the killing of the victim was held as accidental and thus covered by the insurance policy, the Supreme Court held that in the instant case, the insured was killed intentionally. The term intentional! implies the e"ercise of the reasoning faculties, consciousness and volition. () )in!an *eneral Assurance Corp. vs. Court of Appeals, 21( %C&A $9( The terms accident! and accidental! are construed by the courts in their ordinary and common acceptation. The terms have been taken to mean that which happen by chance, without intention and design, and which is une"pected, unusual and unforeseen. #here the death or in$ury is not the natural or probable result of the insured%s voluntary act, the resulting death is within the protection of the policies insuring against death or in$ury from accident. $) +enith Insurance Corporation vs. Court of Appeals, 18' %C&A (98 Under the Insurance Code, in case of unreasonable delay in the payment of the proceeds of an insurance policy, the damages that may be awarded are& a' attorney%s fees( b' other e"penses incurred by the insured person by reason of such unreasonable denial or withholding of payment( c' interest at twice the ceiling prescribed by the )onetary *oard of the amount of the claim due the in$ured( and d' the amount of the claim.

') %un Insurance ,ffice, t#. vs. Court of Appeals, 211 %C&A ''$ An accident is an event which happens without any human agency or, if happening through human agency, an event which, under the circumstances is unusual to and not e"pected by the person to whom it happens. There is no accident when a deliberate act is performed unless some additional, une"pected, independent and unforeseen happening occurs which produces or brings about their in$ury or death. There is nothing in the policy that relieves the insurer of the responsibility to pay the indemnity agreed upon if the insured is shown to have contributed to his own accident.