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Ng v Asian Crusader G.R. No.

L-30685 May 30, 1983


J. Escolin: Issue: WON Asian Crusader was deceived into
entering the contract or in accepting the risk at the
rate of premium agreed upon because of insured's
Facts: representation?
Kwong Nam applied for a 20-year endowment
insurance on his life for the sum of P20,000.00, with
Held: No. Petition dismissed.
his wife, appellee Ng Gan Zee as beneficiary. On the
same date, Asian Crusader, upon receipt of the
required premium from the insured, approved the Ratio:
application and issued the corresponding policy.
Kwong Nam died of cancer of the liver with Section 27 of the Insurance Law:
metastasis. All premiums had been paid at the time of Sec. 27. Such party a contract of insurance must
his death. communicate to the other, in good faith, all facts
Ng Gan Zee presented a claim for payment of the face within his knowledge which are material to the
value of the policy. On the same date, she submitted contract, and which the other has not the means of
the required proof of death of the insured. Appellant ascertaining, and as to which he makes no warranty.
denied the claim on the ground that the answers "Concealment exists where the assured had
given by the insured to the questions in his knowledge of a fact material to the risk, and honesty,
application for life insurance were untrue. good faith, and fair dealing requires that he should
Appellee brought the matter to the attention of the communicate it to the assurer, but he designedly and
Insurance Commissioner. The latter, after conducting intentionally withholds the same."
an investigation, wrote the appellant that he had It has also been held "that the concealment must, in
found no material concealment on the part of the the absence of inquiries, be not only material, but
insured and that, therefore, appellee should be paid fraudulent, or the fact must have been intentionally
the full face value of the policy. The company refused withheld."
to settle its obligation.
Fraudulent intent on the part of the insured must be
Appellant alleged that the insured was guilty of established to entitle the insurer to rescind the
misrepresentation when he answered "No" to the contract. And as correctly observed by the lower
following question appearing in the application for court, "misrepresentation as a defense of the insurer
life insurance- to avoid liability is an 'affirmative' defense. The duty
Has any life insurance company ever refused your to establish such a defense by satisfactory and
application for insurance or for reinstatement of a convincing evidence rests upon the defendant. The
lapsed policy or offered you a policy different from evidence before the Court does not clearly and
that applied for? If, so, name company and date. satisfactorily establish that defense."
The lower court ruled against the company on lack of It bears emphasis that Kwong Nam had informed the
evidence. appellant's medical examiner of the tumor. His
statement that said tumor was "associated with ulcer
Appellant further maintains that when the insured of the stomach" should be construed as an expression
was examined in connection with his application for made in good faith of his belief as to the nature of his
life insurance, he gave the appellant's medical ailment and operation.
examiner false and misleading information as to his
ailment and previous operation. The company While the information communicated was imperfect,
contended that he was operated on for peptic ulcer 2 the same was sufficient to have induced appellant to
years before the policy was applied for and that he make further inquiries about the ailment and
never disclosed such an operation. operation of the insured.
Section 32 of Insurance Law: > Grepalife was ordered to pay the widow by the
Insurance Commissioner holding that there was no
Section 32. The right to information of material facts
intentional concealment on the Part of Canilang and
maybe waived either by the terms of insurance or by
that Grepalife had waived its right to inquire into the
neglect to make inquiries as to such facts where they
health condition of the applicant by the issuance of
are distinctly implied in other facts of which
the policy despite the lack of answers to "some of the
information is communicated.
pertinent questions" in the insurance application. CA
Where a question appears to be not answered at all reversed.
or to be imperfectly answered, and the insurers issue
a policy without any further inquiry, they waive the
imperfection of the answer and render the omission Issue:
to answer more fully immaterial. Whether or not Grepalife is liable.
The company or its medical examiner did not make Held:
any further inquiries on such matters from the
hospital before acting on the application for SC took note of the fact that Canilang failed to
insurance. The fact of the matter is that the disclose that hat he had twice consulted Dr. Wilfredo
defendant was too eager to accept the application B. Claudio who had found him to be suffering from
and receive the insured's premium. It would be "sinus tachycardia" and "acute bronchitis. Under the
inequitable now to allow the defendant to avoid relevant provisions of the Insurance Code, the
liability under the circumstances." information concealed must be information which
the concealing party knew and "ought to [have]
communicate[d]," that is to say, information which
Vda. De Canilang v. CA - Concealment was "material to the contract.
223 SCRA 443 (1993)
The information which Canilang failed to disclose was
material to the ability of Grepalife to estimate the
Facts:
probable risk he presented as a subject of life
> Canilang consulted Dr. Claudio and was diagnosed insurance. Had Canilang disclosed his visits to his
as suffering from "sinus tachycardia." Mr. Canilang doctor, the diagnosis made and the medicines
consulted the same doctor again on 3 August 1982 prescribed by such doctor, in the insurance
and this time was found to have "acute bronchitis." application, it may be reasonably assumed that
> On the next day, 4 August 1982, Canilang applied Grepalife would have made further inquiries and
for a "non-medical" insurance policy with Grepalife would have probably refused to issue a non-medical
naming his wife, as his beneficiary. Canilang was insurance policy or, at the very least, required a
issued ordinary life insurance with the face value of higher premium for the same coverage.
P19,700.
> On 5 August 1983, Canilang died of "congestive The materiality of the information withheld by
heart failure," "anemia," and "chronic anemia." The Canilang from Grepalife did not depend upon the
wife as beneficiary, filed a claim with Grepalife which state of mind of Jaime Canilang. A man's state of mind
the insurer denied on the ground that the insured had or subjective belief is not capable of proof in our
concealed material information from it. judicial process, except through proof of external acts
> Vda Canilang filed a complaint with the Insurance or failure to act from which inferences as to his
Commissioner against Grepalife contending that as subjective belief may be reasonably drawn. Neither
far as she knows her husband was not suffering from does materiality depend upon the actual or physical
any disorder and that he died of kidney disorder. events which ensue. Materiality relates rather to the
"probable and reasonable influence of the facts"
upon the party to whom the communication should
have been made, in assessing the risk involved in The non-acceptance of the insurance plan by Pacific
making or omitting to make further inquiries and in Life was allegedly not communicated by petitioner
accepting the application for insurance; that Mondragon to private respondent Ngo Hing. Instead,
"probable and reasonable influence of the facts" on May 6, 1957, Mondragon wrote back Pacific Life
concealed must, of course, be determined again strongly recommending the approval of the 20-
objectively, by the judge ultimately. year endowment insurance plan to children, pointing
out that since the customers were asking for such
coverage.
SC found it difficult to take seriously the argument
Helen Go died of influenza. Ngo Hing sought the
that Grepalife had waived inquiry into the
payment of the proceeds of the insurance, but having
concealment by issuing the insurance policy
failed in his effort, he filed the action for the recovery
notwithstanding Canilang's failure to set out answers
before the Court of First Instance of Cebu, which ruled
to some of the questions in the insurance application.
against him.
Such failure precisely constituted concealment on the
part of Canilang. Petitioner's argument, if accepted,
would obviously erase Section 27 from the Insurance Issues:
Code of 1978.
1. Whether the binding deposit receipt constituted a
temporary contract of the life insurance in question
Great Pacific v CA G.R. No. L-31845 April 30, 1979 2. Whether Ngo Hing concealed the state of health
J. De Castro and physical condition of Helen Go, which rendered
void the policy

Facts:
Held: No. Yes. Petition dismissed.
Ngo Hing filed an application with the Great Pacific for
a twenty-year endowment policy in the amount of
P50,000.00 on the life of his one-year old daughter Ratio:
Helen. He supplied the essential data which
petitioner Mondragon, the Branch Manager, wrote The receipt was intended to be merely a provisional
on the form. The latter paid the annual premium the insurance contract. Its perfection was subject to
sum of P1,077.75 going over to the Company, but he compliance of the following conditions: (1) that the
retained the amount of P1,317.00 as his commission company shall be satisfied that the applicant was
for being a duly authorized agent of Pacific Life. insurable on standard rates; (2) that if the company
does not accept the application and offers to issue a
Upon the payment of the insurance premium, the policy for a different plan, the insurance contract shall
binding deposit receipt was issued Ngo Hing. not be binding until the applicant accepts the policy
Likewise, petitioner Mondragon handwrote at the offered; otherwise, the deposit shall be refunded; and
bottom of the back page of the application form his (3) that if the company disapproves the application,
strong recommendation for the approval of the the insurance applied for shall not be in force at any
insurance application. Then Mondragon received a time, and the premium paid shall be returned to the
letter from Pacific Life disapproving the insurance applicant.
application. The letter stated that the said life
insurance application for 20-year endowment plan is The receipt is merely an acknowledgment that the
not available for minors below seven years old, but latter's branch office had received from the applicant
Pacific Life can consider the same under the Juvenile the insurance premium and had accepted the
Triple Action Plan, and advised that if the offer is application subject for processing by the insurance
acceptable, the Juvenile Non-Medical Declaration be company. There was still approval or rejection the
sent to the company. same on the basis of whether or not the applicant is
"insurable on standard rates." Since Pacific Life
disapproved the insurance application of respondent The company then made an excuse that the insured
Ngo Hing, the binding deposit receipt in question had had not filed any claim with it, nor submitted proof of
never become in force at any time. The binding loss which is a clear violation of Policy Condition
deposit receipt is conditional and does not insure No.11, as a result, determination of the liability of
outright. This was held in Lim v Sun. private respondent could not be made.
The deposit paid by private respondent shall have to Pacific Banking filed in the trial court an action for a
be refunded by Pacific Life. sum of money for P61,000.00 against Oriental
Assurance.
2. Ngo Hing had deliberately concealed the state of
health of his daughter Helen Go. When he supplied At the trial, petitioner presented communications of
data, he was fully aware that his one-year old the insurance adjuster to Asian Surety revealing
daughter is typically a mongoloid child. He withheld undeclared co-insurances with the following: P30,000
the fact material to the risk insured. with Wellington Insurance; P25,000 with Empire
Surety and P250,000 with Asian Surety undertaken by
“The contract of insurance is one of perfect good faith
insured Paramount on the same property covered by
uberrima fides meaning good faith, absolute and
its policy with Oriental whereas the only co-
perfect candor or openness and honesty; the absence
of any concealment or demotion, however slight.” insurances declared in the subject policy are those of
P30,000.00 with Malayan P50,000.00 with South Sea
The concealment entitles the insurer to rescind the and P25.000.00 with Victory.
contract of insurance.
The defense of fraud, in the form of non-declaration
Pacific v CA G.R. No. L-41014 November 28, 1988 of co-insurances which was not pleaded in the
J. Paras answer, was also not pleaded in the Motion to
Dismiss.
The trial court denied the respondent’s motion.
Facts: Oriental filed another motion to include additional
An open fire insurance policy, was issued to evidence of the co-insurance which could amount to
Paramount Shirt Manufacturing by Oriental fraud.
Assurance Corporation to indemnify P61,000.00, The trial court still made Oriental liable for P 61,000.
caused by fire to the factory’s stocks, materials and The CA reversed the trial court decision. Pacific
supplies. Banking filed a motion for reconsideration of the said
The insured was a debtor of Pacific Banking in the decision of the respondent Court of Appeals, but this
amount of (P800,000.00) and the goods described in was denied for lack of merit.
the policy were held in trust by the insured for Pacific
Banking under trust receipts.
Issues:
The policy was endorsed to Pacific Banking as
mortgagee/ trustor of the properties insured, with 1. WON unrevealed co-insurances Violated policy
the knowledge and consent of private respondent to conditions No. 3
the effect that "loss if any under this policy is payable 2. WON the insured failed to file the required proof of
to the Pacific Banking Corporation". loss prior to court action.
A fire broke out on the premises destroying the goods
contained in the building.
Held: Yes. Petition dismissed.
The bank sent a letter of demand to Oriental for
indemnity.
Ratio:
The company wasn’t ready to give since it was
awaiting the adjuster’s report. 1. Policy Condition No. 3 explicitly provides:
3. The Insured shall give notice to the Company of any provided, that in case the mortgagor or owner/
insurance already effected, or which may trustee neglects or refuses to pay any premium, the
subsequently be effected, covering any of the mortgagee/ trustor shall, on demand pay the same.”
property hereby insured, and unless such notice be The paragraph clearly states the exceptions to the
given and the particulars of such insurance or general rule that insurance as to the interest of the
insurances be stated in or endorsed on this Policy by mortgagee, cannot be invalidated; namely: fraud, or
or on behalf of the Company before the occurrence misrepresentation or arson. Concealment of the
of any loss or damage, all benefit under this policy aforecited co-insurances can easily be fraud, or in the
shall be forfeited. very least, misrepresentation.
The insured failed to reveal before the loss three Undoubtedly, it is but fair and just that where the
other insurances. Had the insurer known that there insured who is primarily entitled to receive the
were many co-insurances, it could have hesitated or proceeds of the policy has by its fraud and/or
plainly desisted from entering into such contract. misrepresentation, forfeited said right.
Hence, the insured was guilty of clear fraud.
Petitioner further stressed that fraud which was not
Concrete evidence of fraud or false declaration by the pleaded as a defense in private respondent's answer
insured was furnished by the petitioner itself when or motion to dismiss, should be deemed to have been
the facts alleged in the policy under clauses "Co- waived. It will be noted that the fact of fraud was tried
Insurances Declared" and "Other Insurance Clause" by express or at least implied consent of the parties.
are materially different from the actual number of co- Petitioner did not only object to the introduction of
insurances taken over the subject property. evidence but on the contrary, presented the very
As the insurance policy against fire expressly required evidence that proved its existence.
that notice should be given by the insured of other 2. Generally, the cause of action on the policy accrues
insurance upon the same property, the total absence when the loss occurs, But when the policy provides
of such notice nullifies the policy. that no action shall be brought unless the claim is first
Petitioner points out that Condition No. 3 in the policy presented extrajudicially in the manner provided in
in relation to the "other insurance clause" supposedly the policy, the cause of action will accrue from the
to have been violated, cannot certainly defeat the time the insurer finally rejects the claim for payment
right of the petitioner to recover the insurance as In the case at bar, policy condition No. 11 specifically
mortgagee/assignee. Hence, they claimed that the provides that the insured shall on the happening of
purpose for which the endorsement or assignment any loss or damage give notice to the company and
was made was to protect the mortgagee/assignee
shall within fifteen (15) days after such loss or damage
against any untoward act or omission of the insured. deliver to the private respondent (a) a claim in writing
It would be absurd to hold that petitioner is barred giving particular account as to the articles or goods
from recovering the insurance on account of the destroyed and the amount of the loss or damage and
alleged violation committed by the insured. (b) particulars of all other insurances, if any.
It is obvious that petitioner has missed all together Twenty-four days after the fire did petitioner merely
the import of subject mortgage clause which wrote letters to private respondent to serve as a
specifically provides: notice of loss. It didn’t even furnish other documents.
“Loss, if any, under this policy, shall be payable to the Instead, petitioner shifted upon private respondent
PACIFIC BANKING CORPORATION Manila the burden of fishing out the necessary information
mortgagee/trustor as its interest may appear, it being to ascertain the particular account of the articles
hereby understood and agreed that this insurance as destroyed by fire as well as the amount of loss. Since
to the interest of the mortgagee/trustor only herein, the required claim by insured, together with the
shall not be invalidated by any act or neglect—except preliminary submittal of relevant documents had not
fraud or misrepresentation, or arson—of the been complied with, it follows that private
mortgagor or owner/trustee of the property insured; respondent could not be deemed to have finally
rejected petitioner's claim and therefore there was Surety and P250,000 with Asian Surety undertaken by
no cause of action. insured Paramount on the same property covered by
its policy with Oriental whereas the only co-
It appearing that insured has violated or failed to
insurances declared in the subject policy are those of
perform the conditions under No. 3 and 11 of the
P30,000.00 with Malayan P50,000.00 with South Sea
contract, and such violation or want of performance
and P25.000.00 with Victory.
has not been waived by the insurer, the insured
cannot recover, much less the herein petitioner. The defense of fraud, in the form of non-declaration
of co-insurances which was not pleaded in the
Pacific v CA G.R. No. L-41014 November 28, 1988
answer, was also not pleaded in the Motion to
J. Paras Dismiss.
The trial court denied the respondent’s motion.
Facts: Oriental filed another motion to include additional
evidence of the co-insurance which could amount to
An open fire insurance policy, was issued to fraud.
Paramount Shirt Manufacturing by Oriental
Assurance Corporation to indemnify P61,000.00, The trial court still made Oriental liable for P 61,000.
caused by fire to the factory’s stocks, materials and The CA reversed the trial court decision. Pacific
supplies. Banking filed a motion for reconsideration of the said
decision of the respondent Court of Appeals, but this
The insured was a debtor of Pacific Banking in the was denied for lack of merit.
amount of (P800,000.00) and the goods described in
the policy were held in trust by the insured for Pacific
Banking under trust receipts. Issues:
The policy was endorsed to Pacific Banking as 1. WON unrevealed co-insurances Violated policy
mortgagee/ trustor of the properties insured, with conditions No. 3
the knowledge and consent of private respondent to
2. WON the insured failed to file the required proof of
the effect that "loss if any under this policy is payable
loss prior to court action.
to the Pacific Banking Corporation".
A fire broke out on the premises destroying the goods
contained in the building. Held: Yes. Petition dismissed.
The bank sent a letter of demand to Oriental for
indemnity. Ratio:
The company wasn’t ready to give since it was 1. Policy Condition No. 3 explicitly provides:
awaiting the adjuster’s report.
3. The Insured shall give notice to the Company of any
The company then made an excuse that the insured insurance already effected, or which may
had not filed any claim with it, nor submitted proof of subsequently be effected, covering any of the
loss which is a clear violation of Policy Condition property hereby insured, and unless such notice be
No.11, as a result, determination of the liability of given and the particulars of such insurance or
private respondent could not be made. insurances be stated in or endorsed on this Policy by
Pacific Banking filed in the trial court an action for a or on behalf of the Company before the occurrence
sum of money for P61,000.00 against Oriental of any loss or damage, all benefit under this policy
Assurance. shall be forfeited.
At the trial, petitioner presented communications of The insured failed to reveal before the loss three
the insurance adjuster to Asian Surety revealing other insurances. Had the insurer known that there
undeclared co-insurances with the following: P30,000 were many co-insurances, it could have hesitated or
with Wellington Insurance; P25,000 with Empire
plainly desisted from entering into such contract. proceeds of the policy has by its fraud and/or
Hence, the insured was guilty of clear fraud. misrepresentation, forfeited said right.
Concrete evidence of fraud or false declaration by the Petitioner further stressed that fraud which was not
insured was furnished by the petitioner itself when pleaded as a defense in private respondent's answer
the facts alleged in the policy under clauses "Co- or motion to dismiss, should be deemed to have been
Insurances Declared" and "Other Insurance Clause" waived. It will be noted that the fact of fraud was tried
are materially different from the actual number of co- by express or at least implied consent of the parties.
insurances taken over the subject property. Petitioner did not only object to the introduction of
evidence but on the contrary, presented the very
As the insurance policy against fire expressly required
evidence that proved its existence.
that notice should be given by the insured of other
insurance upon the same property, the total absence 2. Generally, the cause of action on the policy accrues
of such notice nullifies the policy. when the loss occurs, But when the policy provides
that no action shall be brought unless the claim is first
Petitioner points out that Condition No. 3 in the policy
presented extrajudicially in the manner provided in
in relation to the "other insurance clause" supposedly
the policy, the cause of action will accrue from the
to have been violated, cannot certainly defeat the
right of the petitioner to recover the insurance as time the insurer finally rejects the claim for payment
mortgagee/assignee. Hence, they claimed that the In the case at bar, policy condition No. 11 specifically
purpose for which the endorsement or assignment provides that the insured shall on the happening of
was made was to protect the mortgagee/assignee any loss or damage give notice to the company and
against any untoward act or omission of the insured. shall within fifteen (15) days after such loss or damage
It would be absurd to hold that petitioner is barred deliver to the private respondent (a) a claim in writing
from recovering the insurance on account of the giving particular account as to the articles or goods
alleged violation committed by the insured. destroyed and the amount of the loss or damage and
(b) particulars of all other insurances, if any.
It is obvious that petitioner has missed all together
the import of subject mortgage clause which Twenty-four days after the fire did petitioner merely
specifically provides: wrote letters to private respondent to serve as a
notice of loss. It didn’t even furnish other documents.
“Loss, if any, under this policy, shall be payable to the
Instead, petitioner shifted upon private respondent
PACIFIC BANKING CORPORATION Manila
the burden of fishing out the necessary information
mortgagee/trustor as its interest may appear, it being
to ascertain the particular account of the articles
hereby understood and agreed that this insurance as
destroyed by fire as well as the amount of loss. Since
to the interest of the mortgagee/trustor only herein,
the required claim by insured, together with the
shall not be invalidated by any act or neglect—except
preliminary submittal of relevant documents had not
fraud or misrepresentation, or arson—of the
been complied with, it follows that private
mortgagor or owner/trustee of the property insured;
respondent could not be deemed to have finally
provided, that in case the mortgagor or owner/
rejected petitioner's claim and therefore there was
trustee neglects or refuses to pay any premium, the
no cause of action.
mortgagee/ trustor shall, on demand pay the same.”
It appearing that insured has violated or failed to
The paragraph clearly states the exceptions to the
perform the conditions under No. 3 and 11 of the
general rule that insurance as to the interest of the
contract, and such violation or want of performance
mortgagee, cannot be invalidated; namely: fraud, or
has not been waived by the insurer, the insured
misrepresentation or arson. Concealment of the
cannot recover, much less the herein petitioner.
aforecited co-insurances can easily be fraud, or in the
very least, misrepresentation. Digested by: Roxanne A. Huyo
Undoubtedly, it is but fair and just that where the Subject: Insurance
insured who is primarily entitled to receive the Title: Eguaras v. Great Eastern Life Ass. Co.
Topic: Misrepresentation, effect (Section 45) from the complaint, with the costs against the
plaintiff.

Facts:
Issue: WON the life insurance obtained is legal and
On April 14, 1913, counsel for Francisca
valid or whether on the contrary it was issued through
Eguaras filed a written complaint in the said Laguna
fraud and deceit, and in such case, whether the
court, alleging as a cause of action that about October
defendant, The Great Eastern Life Assurance
14, 1912, her son-in-law Dominador Albay had
Company, Ltd., is still under obligation to pay the
applied in writing to the defendant insurance
value thereof to the plaintiff.
company to insure his life for the sum of P5,000,
naming as the beneficiary in case of his death the
plaintiff Francisca Eguaras; that after compliance with Ruling:
the requisites and the investigation carried on by the
defendant company, and it had been satisfied It appears from the record that the insured had
concerning the physical condition of the applicant, it knowledge of the false replied contained in the two
accepted the application for insurance and on applications for insurance and knowing permitted
November 6, 1912, issued policy No. 5592, Exhibit A, fraud to be practised upon the insurance company,
which has been made a part of the complaint, for in his acknowledgment and consent his mother-
whereby the said insurance company insured the life in-law was designated as the beneficiary of the
of the said Dominador Albay in the sum of P5,000, insurance, despite the fact that he had children and
payable in the event of his death to Francisca Eguaras; his mother was still living. In the present case the
that on December 6, 1912, said policy No. 5592 being fraud consisted in the fact that a healthy and robust
in force, the insured Dominador Albay, died in the person was substituted in place of insured invalid
municipality of Santa Cruz, Laguna, and despite the when Dr. Vidal made the physical examination of the
fact that the beneficiary submitted satisfactory proofs one who seeking to be insured, for the real person
of his death and that the defendant company who desired to be insured and who ought to have
investigated the event, still it refused and continues been examined was in bad health on and before the
to refuse to pay to the plaintiff the value of the policy, date of executing the insurance contract of which
Exhibit A, thereby causing damages estimated at facts the insured Dominador Albay and the insurance
P1,000. The court was therefore asked to render agent Ponciano Remigio had full knowledge.
judgment against the Great Eastern Life Assurance It is therefore proven that the signatures on
Company, Ltd., and its general agent, West G. Smith, the insurance applications reading "Dominador
by sentencing them to pay to the plaintiff the sum of Albay" are false and forged; that the person who
P5,000, the value of policy No. 5592, plus the sum of presented himself to Dr. Vidal to be examined was
P1,000 for damages inflicted upon them, in addition not the real Dominador Albay, but another different
to the costs of the suit. person; that at the time of the application for
The demurrer filed to the foregoing complaint having insurance and the issuance of the policy which is the
been overruled, counsel for the insurance company subject matter of this suit the real Dominador Albay
and for West G. Smith replied thereto, admitting the was informed of all those machinations, wherefore it
allegations of the complaint with respect to the legal is plain that the insurance contract between the
status of the parties by denying all the rest, and defendant and Dominador Albay is null and void
setting forth in special defense that the insurance because it is false, fraudulent and illegal.
policy issued in the name of Dominador [Albay] had Article 1269 of the Civil Code states:
been obtained through fraud and deceit known and
consented to by the interested parties and is There is deceit when by words or insidious
therefore completely illegal, void, and ineffective; machinations on the part of one of the contracting
wherefore he prayed that the defendants be absolved parties the other is induced to execute a contract
which without them he would not have made.
It is essential to the nature of the deceit, to which the > Qua Chee Gan, a merchant, owned 4 warehouses
foregoing article refers, that said deceit be prior to or in Albay which were used for the storage or copra and
contemporaneous with the consent that is a hemp in which the appelle deals with exclusively.
necessary requisite for perfecting the contract, but > The warehouses together with the contents were
not that it may have occurred or happened insured with Law Union since 1937 and the loss made
thereafter. A contract is therefore deceitful, for the payable to PNB as mortgagee of the hemp and copra.
execution whereof the consent of one of the parties
has been secured by means of fraud, because he was > A fire of undetermined cause broke out in July 21,
persuaded by words or insidious machinations, 1940 and lasted for almost 1 whole week.
statements or false promises, and a defective consent > Bodegas 1, 3, and 4 including the merchandise
wrung from him, even though such do not constitute stored were destroyed completely.
estafa or any other criminal subject to the penal law.
> Insured then informed insurer of the unfortunate
With this array of circumstantial evidence event and submitted the corresponding fire claims,
derived from facts duly proven as a result of the which were later reduced to P370T.
present suit, we get, if not a moral certainly, at least
a full conviction that when Castor Garcia presented > Insurer refused to pay claiming violations of the
himself to be examined by the physician Vidal in place warranties and conditions, filing of fraudulent claims
of Dominador Albay, serious deceit occurred in and that the fire had been deliberately caused by the
perfecting the insurance contract, for had the agent insured.
of the company not been deceived it would not have > Insured filed an action before CFI which rendered a
granted the insurance applied for by Albay, nor would decision in favor of the insured.
it have executed the contract by virtue of whereof
payment is claimed of the value of policy obtained
through fraud; and consequently on such Issues and Resolutions:
assumptions it is improper, nor is it permitted by the (1) Whether or not the policies should be avoided for
law, to order collection of the amount claimed. the reason that there was a breach of warranty.
In a contract executed with the requisites fixed in
article 1261, one of the contracting parties may have
given his consent through error, violence, Under the Memorandum of Warranty, there should
intimidation, or deceit, and in any of such cases the be no less than 1 hydrant for each 150 feet of external
contract is void, even though, despite this nullity, no wall measurements of the compound, and since
crime was committed. (Article 1265, Civil Code.) bodegas insured had an external wall per meter of
There may not have been estafa in the case at bar, but 1640 feet, the insured should have 11 hydrants in the
it was conclusively demonstrated by the trial that compound. But he only had 2.
deceit entered into the insurance contract, fulfillment
whereof is claimed, and therefore the conclusions
Even so, the insurer is barred by estoppel to claim
reached by the court in the judgment it rendered in
violation of the fire hydrants warranty, because
the criminal proceedings for estafa do not affect this
knowing that the number of hydrants it demanded
suit, nor do they influence the decision proper herein,
never existed from the very beginning, appellant
nor can they produce in the present suit, over the
nevertheless issued the policies subject to such
exception of the defendant, the force of res
warranty and received the corresponding
adjudicata.
premiums. The insurance company was aware, even
Qua Chee Gan v. Law Union Rock - Breach of Warranty before the policies were issued, that in the premises
98 PHIL 85 there were only 2 hydrants and 2 others were owned
by the Municipality, contrary to the requirements of
the warranties in question.
Facts:
It should be close to conniving at fraud upon the It is well to note that gasoline is not specifically
insured to allow the insurer to claim now as void the mentioned among the prohibited articles listed in the
policies it issued to the insured, without warning him so-called hemp warranty. The clause relied upon by
of the fatal defect, of which the insurer was informed, the insurer speaks of “oils”. Ordinarily, oils mean
and after it had misled the insured into believing that lubricants and not gasoline or kerosene. Here again,
the policies were effective. by reason of the exclusive control of the insurance
company over the terms of the contract, the
ambiguity must be held strictly against the insurer
Accdg to American Jurisprudence: It is a well-settled and liberally in favor of the insured, specially to avoid
rule that the insurer at the time of the issuance of a forfeiture.
a policy has the knowledge of existing facts, which if
insisted on, would invalidate the contract from its
very inception, such knowledge constitutes a waiver Furthermore, the gasoline kept was only incidental to
of conditions in the contract inconsistent with known the insured’s business. It is a well settled rule that
facts, and the insurer is stopped thereafter from keeping of inflammable oils in the premises though
asserting the breach of such conditions. The reason prohibited by the policy does NOT void it if such
for the rule is: To allow a company to accept one’s keeping is incidental to the business. Also, the hemp
money for a policy of insurance which it knows to be warranty forbade the storage only in the building to
void and of no effect, though it knows as it must that which the insurance applies, and/or in any building
the insured believes it to be valid and binding is so communicating therewith; and it is undisputed that
contrary to the dictates of honesty and fair dealing, as no gasoline was stored in the burnt bodegas and that
so closely related to positive fraud, as to be abhorrent Bodega No. 2 which was where the gasoline was
to fair-minded men. It would be to allow the found stood isolated from the other bodegas.
company to treat the policy as valid long enough to Qua v Law Union. G.R. No. L-4611 December 17, 1955
get the premium on it, and leave it at liberty to
repudiate it the next moment. J. Reyes

Moreover, taking into account the well-known rule Facts:


that ambiguities or obscurities must strictly be Qua owned 4 warehouses used for the storage of
interpreted against the party that cause them, the copra and hemp. They were insured with the Law
memorandum of warranty invoked by the insurer Union.
bars the latter from questioning the existence of the
appliances called for, since its initial expression “the Fire broke out and completely destroyed 3 bodegas.
undernoted appliances for the extinction of fire being The plaintiff submitted claims totalling P398,562.81.
kept on the premises insured hereby..” admits of the The Insurance Company resisted payment on the
interpretation as an admission of the existence of grounds that the fire had been deliberately caused by
such appliances which insurer cannot now contradict, the insured or by other persons in connivance with
should the parole evidence apply. him.
Que Chee Gan and his brother were tried for arson,
but were acquitted by the trial court. As regards the
(2) Whether or not the insured violated the hemp insurance claim, the trial court ruled in favor of Qua
warranty provision against the storage of gasoline and entitled him to recover more than Php 300,000
since insured admitted there were 36 cans of gasoline for indemnities from the insurance company. Hence,
in Bodega 2 which was a separate structure and not the company appealed to the SC.
affected by the fire.
In its first assignment of error, the insurance company
alleged that the trial Court should have held that the
policies were avoided for breach of warranty. The
contract noted that fire hydrants were required in a
particular measurement of space (every 150 The appellant company so worded the policies that
feet). Hence, they argued that since the bodegas while exacting the greater number of fire hydrants
insured had an external wall perimeter of 500 meters, and appliances, it kept the premium discount at the
the appellee should have 11 fire hydrants in the minimum of 2 1/2%, thereby giving the insurance
compound, and that he actually had only 2, with a company a double benefit. Such abnormal treatment
further pair. of the insured strongly points at an abuse of the
insurance company's selection of the words and
terms of the contract, over which it had absolute
Issues: control.
1. WON the insurance company can void the policies Receipt of Premiums or Assessments after Cause for
it had issued Forfeiture Other than Nonpayment. — It is a well
2. WON the insured violated the "Hemp Warranty" settled rule of law that an insurer which with
provisions of the policy against the storage of gasoline knowledge of facts entitling it to treat a policy as no
longer in force, receives and accepts a premium on
3. WON the insured planned the destruction of the the policy, estopped to take advantage of the
bodega forfeiture. It cannot treat the policy as void for the
purpose of defense to an action to recover for a loss
thereafter occurring and at the same time treat it as
Held: No. No. No.
valid for the purpose of earning and collecting further
premiums.
Ratio: Moreover, taking into account the well known rule
1. The insurer, who at the time of issuance, has that ambiguities or obscurities must be strictly
knowledge of existing facts which would invalidate interpreted against the party that caused them, the
the contract from the beginning, such constitutes a "memo of warranty" invoked by appellant bars the
waiver of conditions in the contract inconsistent with latter from questioning the existence of the
the facts, and the insurer is stopped thereafter from appliances called for in the insured premises
asserting the breach of such conditions. Also, an 2. The ambiguity must be held strictly against the
insurance company intends to executed a valid insurer and liberally in favor of the insured, specially
contract in return for the premium received; and to avoid a forfeiture. So long as insurance companies
when the policy contains a condition which renders it insist upon the use of ambiguous, intricate and
voidable at its inception, and this result is known to technical provisions, which conceal rather than
the insurer, it will be presumed to have intended to frankly disclose, their own intentions, the courts
waive the conditions and to execute a binding must, in fairness to those who purchase insurance,
contract, rather than to have deceived the insured construe every ambiguity in favor of the insured.
into thinking he is insured when in fact he is not.
Appellee admitted that there were 36 cans of
The appellant is barred estoppel to claim violation of gasoline in the building designed. It However,
the so-called fire hydrants warranty, because it gasoline is not specifically mentioned among the
knew the number of hydrants demanded therein prohibited articles listed in the so-called "hemp
never existed from the very beginning and issued the warranty." The cause relied upon by the insurer
policies. speaks of "oils", and is uncertain because, "Oils"
To allow a company to accept one's money for a usually mean "lubricants" and not gasoline or
policy of insurance which it then knows to be void and kerosene.
of no effect, though it knows as it must, that the If the company intended to rely upon a condition of
assured believes it to be valid and binding, is so that character, it ought to have been plainly
contrary to the dictates of honesty and fair dealing, expressed in the policy.
and so closely related to positive fraud, as to the
abhorrent to fair-minded men.
The contract of insurance is one of perfect good faith > On Nov. 18, 1925, during the effectivity of the
not for the insured alone, but equally so for the policy, Vicenta died of cerebral apoplexy. Thereafter,
insurer; in fact, it is mere so for the latter, since its Bernardo claimed payment but was refused.
dominant bargaining position carries with it stricter > It is admitted that in the Medical Examiner’s report,
responsibility. Vicenta, in response to the question asked by the
Also, the gasoline kept in Bodega No. 2 was only medical examiner, her replies were as follows:
incidental to his business, being no more than a o “How frequently do you use beer, wine, spirits and
customary 2 day's supply for the five or six motor other intoxicants?” she answered “beer only in small
vehicles used for transporting of the stored quantities”.
merchandise. "It is well settled that the keeping of
inflammable oils on the premises though prohibited o “What physician have you consulted or been
by the policy does not void it if such keeping is treated by within the last 5 years and for what illness
incidental to the business." or ailment?” she answered “none”
3. It was unlikely that Qua burned the warehouse to > It is however, not disputed that in 1924, Vicenta
defraud the company because he had the resources was taken to a hospital for what was first diagnosed
to pay off the National Bank in a short time. Also, no as alcoholism and later changed to manic-depressive
motive appears for attempt to defraud the insurer. psychosis and then again changed to pscyhonuerosis.
While the acquittal of the insured in the arson case is
not res judicata on the present civil action, the
insurer's evidence, to judge from the decision in the Issue:
criminal case, is practically identical in both cases and Whether or not on the basis of the
must lead to the same result, since the proof to misrepresentations of Vicenta, Bernardo is barred
establish the defense of connivance at the fire in from recovery.
order to defraud the insurer "cannot be materially
less convincing than that required in order to convict
the insured of the crime of arson." Held:
As to the defense that the burned bodegas could not YES.
possibly have contained the quantities of copra and The court found that the representations made by
hemp stated in the fire claims, the insurer relied on Vicenta in his application for life insurance were false
its adjuster investigator who examined the premises with respect to her state of health and that she knew
during and after the fire. His testimony, however, was and was aware that the representations so made by
based on inferences from the photographs and traces her were false. In an action on a life insurance policy
found after the fire, and must yield to the where the evidence conclusively shows that the
contradictory testimony of those who actually saw answers to questions concerning diseases were
the contents of the bodegas shortly before the fire, untrue, the truth or falsity of the answer becomes the
while inspecting them for the mortgagee Bank. determining factor.
Argente v. West Coast Life Insurance Co.-
Misrepresentation
If the policy was procured by fraudulent
51 PHIL 725 misrepresentations, the contract of insurance
apparently set forth therein was never legally
existent. It can be fairly assumed that had the true
Facts:
facts been disclosed by the insured, the insurance
> A joint life insurance policy was issued to Bernardo would never have been granted.
Argente and his wife Vicenta upon payment of
premium, by West Coast.
Great Pacific v CA G.R. No. 113899. October 13, 1999
J. Quisimbing 3. Whether the Court of Appeals erred in holding
Grepalife liable in the amount of eighty six thousand,
two hundred (P86,200.00) pesos without proof of the
Facts: actual outstanding mortgage payable by the
A contract of group life insurance was executed mortgagor to DBP.
between petitioner Great Pacific and Development
Bank Grepalife agreed to insure the lives of eligible
Held: No to all three. Petition dismissed.
housing loan mortgagors of DBP.
Wilfredo Leuterio, a physician and a housing debtor
of DBP, applied for membership in the group life Ratio:
insurance plan. In an application form, Dr. Leuterio 1. Petitioner alleges that the complaint was instituted
answered questions concerning his health condition by the widow of Dr. Leuterio, not the real party in
as follows: interest, hence the trial court acquired no jurisdiction
“7. Have you ever had, or consulted, a physician for a over the case. It argues that when the Court of
heart condition, high blood pressure, cancer, Appeals affirmed the trial court’s judgment, Grepalife
diabetes, lung, kidney or stomach disorder or any was held liable to pay the proceeds of insurance
other physical impairment? contract in favor of DBP, the indispensable party who
was not joined in the suit.
8. Are you now, to the best of your knowledge, in
good health?” The insured private respondent did not cede to the
mortgagee all his rights or interests in the insurance,
Grepalife issued a coverage to the value of
the policy stating that: “In the event of the debtor’s
P86,200.00 pesos.
death before his indebtedness with the Creditor
Dr. Leuterio died due to “massive cerebral [DBP] shall have been fully paid, an amount to pay the
hemorrhage.” DBP submitted a death claim to outstanding indebtedness shall first be paid to the
Grepalife. Grepalife denied the claim alleging that Dr. creditor and the balance of sum assured, if there is
Leuterio was not physically healthy when he applied any, shall then be paid to the beneficiary/ies
for an insurance coverage. Grepalife insisted that Dr. designated by the debtor.” When DBP’s claim was
Leuterio did not disclose he had been suffering from denied, it collected the debt from the mortgagor and
hypertension, which caused his death. Allegedly, took the necessary action of foreclosure on the
such non-disclosure constituted concealment that residential lot of private respondent.
justified the denial of the claim.
Gonzales vs. Yek Tong Lin- Insured, being the person
The widow, respondent Medarda V. Leuterio, filed with whom the contract was made, is primarily the
against Grepalife. proper person to bring suit thereon. Insured may
The trial court rendered a decision in favor of thus sue, although the policy is taken wholly or in part
respondent widow and against Grepalife. The Court for the benefit of another person named or unnamed,
of Appeals sustained the trial court’s decision. and although it is expressly made payable to another
as his interest may appear or otherwise. Although a
policy issued to a mortgagor is taken out for the
Issues: benefit of the mortgagee and is made payable to him,
yet the mortgagor may sue thereon in his own name,
1. Whether the Court of Appeals erred in holding
especially where the mortgagee’s interest is less than
petitioner liable to DBP as beneficiary in a group life
the full amount recoverable under the policy. Insured
insurance contract from a complaint filed by the
may be regarded as the real party in interest,
widow of the decedent/mortgagor?
although he has assigned the policy for the purpose
2. Whether the Court of Appeals erred in not finding of collection, or has assigned as collateral security any
that Dr. Leuterio concealed that he had hypertension, judgment he may obtain.
which would vitiate the insurance contract?
And since a policy of insurance upon life or health may Edillon v Manila Bankers Life G.R. No. L-34200
pass by transfer, will or succession to any person, September 30, 1982
whether he has an insurable interest or not, and such
J. Vasquez
person may recover it whatever the insured might
have recovered,[14] the widow of the decedent Dr.
Leuterio may file the suit against the insurer, Facts:
Grepalife.
Carmen O, Lapuz applied with Manila Bankers for
2. The medical findings were not conclusive because insurance coverage against accident and injuries. She
Dr. Mejia did not conduct an autopsy on the body of gave the date of her birth as July 11, 1904. She paid
the decedent. The medical certificate stated that the sum of P20.00 representing the premium for
hypertension was “the possible cause of death.” which she was issued the corresponding receipt. The
Hence, the statement of the physician was properly policy was to be effective for 90 days.
considered by the trial court as hearsay.
During the effectivity, Carmen O. Lapuz died in a
Contrary to appellant’s allegations, there was no vehicular accident in the North Diversion Road.
sufficient proof that the insured had suffered from
hypertension. Aside from the statement of the Petitioner Regina L. Edillon, a sister of the insured and
insured’s widow who was not even sure if the the beneficiary in the policy, filed her claim for the
medicines taken by Dr. Leuterio were for proceeds of the insurance. Her claim having been
hypertension, the appellant had not proven nor denied, Regina L. Edillon instituted this action in the
produced any witness who could attest to Dr. trial court.
Leuterio’s medical history. The insurance corporation relies on a provision
Appellant insurance company had failed to establish contained in the contract excluding its liability to pay
that there was concealment made by the insured, claims under the policy in behalf of "persons who are
hence, it cannot refuse payment of the claim.” under the age of sixteen (16) years of age or over the
age of sixty (60) years" They pointed out that the
The fraudulent intent on the part of the insured must insured was over sixty (60) years of age when she
be established to entitle the insurer to rescind the applied for the insurance coverage, hence the policy
contract. Misrepresentation as a defense of the became void.
insurer to avoid liability is an affirmative defense and
the duty to establish such defense by satisfactory and The trial court dismissed the complaint and ordered
convincing evidence rests upon the insurer. edillon to pay P1000. The reason was that a policy of
insurance being a contract of adhesion, it was the
3. A life insurance policy is a valued policy. Unless the duty of the insured to know the terms of the contract
interest of a person insured is susceptible of exact he or she is entering into.
pecuniary measurement, the measure of indemnity
under a policy of insurance upon life or health is the The insured could not have been qualified under the
sum fixed in the policy. The mortgagor paid the conditions stated in said contract and should have
premium according to the coverage of his insurance. asked for a refund of the premium.

In the event of the debtor’s death before his


indebtedness with the creditor shall have been fully Issue:
paid, an amount to pay the outstanding indebtedness
Whether or not the acceptance by the insurance
shall first be paid to the creditor.
corporation of the premium and the issuance of the
DBP foreclosed one of the deceased person’s lots to corresponding certificate of insurance should be
satisfy the mortgage. Hence, the insurance proceeds deemed a waiver of the exclusionary condition of
shall inure to the benefit of the heirs of the deceased coverage stated in the policy.
person or his beneficiaries.

Held: Yes. Petition granted.


from the terms of the policy, the insurer was held
liable.
Ratio:
“... is that although one of conditions of an insurance
The age of Lapuz was not concealed to the insurance
policy is that "it shall not be valid or binding until the
company. Her application clearly indicated her age of
first premium is paid", if it is silent as to the mode of
the time of filing the same to be almost 65 years of
payment, promissory notes received by the company
age. Despite such information which could hardly be
must be deemed to have been accepted in payment
overlooked, the insurance corporation received her
of the premium. In other words, a requirement for
payment of premium and issued the corresponding
the payment of the first or initial premium in advance
certificate of insurance without question.
or actual cash may be waived by acceptance of a
There was sufficient time for the private respondent promissory note...”
to process the application and to notice that the
Harding v. Commercial Union Assurance
applicant was over 60 years of age and cancel the
Company- Willful Misstatement
policy.
38 PHIL 464
Under the circumstances, the insurance corporation
is already deemed in estoppel. It inaction to revoke Facts:
the policy despite a departure from the exclusionary > Henry Harding bought a car for 2T in 1915. He then
condition contained in the said policy constituted a gave the car to his wife Mrs. Harding.
waiver of such condition, similar to Que Chee Gan vs.
Law Union Insurance. > While Mrs. Harding was having the car repaired at
the Luneta Garage (Luneta was an agent of Smith Bell
The insurance company was aware, even before the and Co., which in turn is Commercial Union’s agent),
policies were issued, that in the premises insured the latter induced Mrs. Harding to insure the care
there were only two fire hydrants contrary to the with Commercial.
requirements of the warranty in question.
> Mrs. Harding agreed, and Smith Bell sent an agent
It is usually held that where the insurer, at the time of to Luneta Garage, who together with the manager of
the issuance of a policy of insurance, has knowledge LUneta, appraised the car and declared that its
of existing facts which, if insisted on, would invalidate present value was P3T. This amt was written in the
the contract from its very inception, such knowledge proposal form which Mrs. Harding signed.
constitutes a waiver of conditions in the contract
inconsistent with the known facts, and the insurer is > Subsequently, the car was damaged by
stopped thereafter from asserting the breach of such fire. Commercial refused to pay because the car’s
conditions. present value was only 2.8T and not 3T.
To allow a company to accept one's money for a
policy of insurance which it then knows to be void and Issue:
of no effect, though it knows as it must, that the
assured believes it to be valid and binding, is so Whether or not Commercial is liable.
contrary to the dictates of honesty and fair dealing.
Capital Insurance & Surety Co., Inc. vs. - involved a Held:
violation of the provision of the policy requiring the
Commercial is liable.
payment of premiums before the insurance shall
become effective. The company issued the policy Where it appears that the proposal form, while signed
upon the execution of a promissory note for the by the insured was made out by the person
payment of the premium. A check given subsequent authorized to solicit the insurance (Luneta and Smith
by the insured as partial payment of the premium was Bell) the facts stated in the proposal, even if incorrect,
dishonored for lack of funds. Despite such deviation will not be regarded as warranted by the insured, in
the absence of willful misstatement. Under such
circumstances, the proposal is to be regarded as the authorized to solicit the insurance (Luneta and Smith
act of the insurer. Bell) the facts stated in the proposal, even if incorrect,
will not be regarded as warranted by the insured, in
the absence of willful misstatement. Under such
EN BANC circumstances, the proposal is to be regarded as the
MRS. HENRY E. HARDING vs. COMMERCIAL UNION act of the insurer.
ASSURANCE COMPANY Reason
G.R. No. L-12707, August 10, 1918 Section 163 of the Insurance Law (Act No. 2427)
Procedural History provides that “the effect of a valuation in a policy of
fire insurance is the same as in a policy of marine
This was an action by plaintiffs to recover from insurance.”
defendant the sum of P3,000 and interest, alleged to
be due under the terms of a policy of insurance. The By the terms of section 149 of the Act cited, the
trial court gave plaintiffs judgment for the amount valuation in a policy of marine insurance is conclusive
demanded, with interest and costs, and from that if the insured had an insurable interest and was not
decision the defendant appeals. guilty of fraud.

Statement of Facts Holding

In February 1916, Mrs. Harding applied for car The court, therefore, of the opinion and hold that
insurance for a Studebaker she received as a gift from plaintiff was the owner of the automobile in question
her husband. She was assisted by Smith, Bell and Co and had an insurable interest therein; that there was
which was the duly authorized representative no fraud on her part in procuring the insurance; that
(insurance agent) of Commercial Union in the the valuation of the automobile, for the purposes of
Philippines. The car’s value was estimated with the the insurance, is binding upon the defendant
help of an experienced mechanic (Mr. Server) of the corporation, and that the judgment of the court
Luneta Garage. The car was bought by Mr. Harding for below is, therefore, correct and must be affirmed,
P2,800.00. The mechanic, considering some repairs with interest, the costs of this appeal to be paid by the
done, estimated the value to be at P3,000.00. This appellant.
estimated value was the value disclosed by Mrs.
Harding to Smith, Bell and Co. She also disclosed that
the value was an estimate made by Luneta Garage
(which also acts as an agent for Smith, Bell and Co).
In March 1916, a fire destroyed the Studebaker. Mrs.
Harding filed an insurance claim but Commercial
Union denied it as it insisted that the representations
and averments made as to the cost of the car were
false; and that said statement is a warranty.
Commercial Union also stated that the car does not
belong to Mrs. Harding because such a gift [from her
husband] is void under the Civil Code.
Issue
Whether or not Commercial is liable.
Answer
Yes. Commercial is liable.
Where it appears that the proposal form, while signed
by the insured was made out by the person

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