Professional Documents
Culture Documents
5. When CKS learned of the insurance earlier procured by the Cha spouses
(without its consent), it wrote the insurer (United) a demand letter asking
that the proceeds of the insurance contract (between the Cha spouses and
United) be paid directly to CKS, based on its lease contract with Cha spouses.
6. United refused to pay CKS. Hence, the latter filed a complaint against the
Cha spouses and United.
by the lessee (Cha spouses) over their merchandise inside the leased
premises is deemed assigned or transferred to the lessor (CKS) if said policy
is obtained without the prior written of the latter.
Nilo Cha and Stella Uy-Cha (herein co-petitioners). The insurer (United)
cannot be compelled to pay the proceeds of the fire insurance policy to a
person (CKS) who has no insurable interest in the property insured.
It is, of course, basic in the law on contracts that the stipulations contained in
a contract cannot be contrary to law, morals, good customs, public order or
public policy.[3]
The liability of the Cha spouses to CKS for violating their lease contract in
that Cha spouses obtained a fire insurance policy over their own
merchandise, without the consent of CKS, is a separate and distinct issue
which we do not resolve in this case.
On October 20, 1986, the widow of the late Dr. Leuterio, respondent Medarda
V. Leuterio, filed a complaint with the Regional Trial Court of Misamis
Oriental, Branch 18, against Grepalife for Specific Performance with
Damages.[5] During the trial, Dr. Hernando Mejia, who issued the death
certificate, was called to testify. Dr. Mejias findings, based partly from the
information given by the respondent widow, stated that Dr. Leuterio
complained of headaches presumably due to high blood pressure. The
inference was not conclusive because Dr. Leuterio was not autopsied, hence,
other causes were not ruled out.
Petitioner alleges that the complaint was instituted by the widow of Dr.
Leuterio, not the real party in interest, hence the trial court acquired no
jurisdiction over the case. It argues that when the Court of Appeals affirmed
the trial courts judgment, Grepalife was held liable to pay the proceeds of
insurance contract in favor of DBP, the indispensable party who was not
joined in the suit.
The insured private respondent did not cede to the mortgagee all his rights
or interests in the insurance, the policy stating that: In the event of the
debtors death before his indebtedness with the Creditor [DBP] shall have
been fully paid, an amount to pay the outstanding indebtedness shall first be
paid to the creditor and the balance of sum assured, if there is any, shall
then be paid to the beneficiary/ies designated by the debtor.[10] When DBP
submitted the insurance claim against petitioner, the latter denied payment
thereof, interposing the defense of concealment committed by the insured.
Thereafter, DBP collected the debt from the mortgagor and took the
necessary action of foreclosure on the residential lot of private respondent.
[11] In Gonzales La O vs. Yek Tong Lin Fire & Marine Ins. Co.[12] we held:
Insured, being the person with whom the contract was made, is primarily the
proper person to bring suit thereon. * * * Subject to some exceptions, insured
may thus sue, although the policy is taken wholly or in part for the benefit of
another person named or unnamed, 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 benefit of the mortgagee
and is made payable to him, yet the mortgagor may sue thereon in his own
name, especially where the mortgagees interest is less than the full amount
recoverable under the policy, * * *.
And in volume 33, page 82, of the same work, we read the following:
Insured may be regarded as the real party in interest, although he has
assigned the policy for the purpose of collection, or has assigned as
collateral security any judgment he may obtain.[13]
And since a policy of insurance upon life or health may pass by transfer, will
or succession to any person, whether he has an insurable interest or not, and
such 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,
Grepalife.
The second assigned error refers to an alleged concealment that the
petitioner interposed as its defense to annul the insurance contract.
Petitioner contends that Dr. Leuterio failed to disclose that he had
hypertension, which might have caused his death. Concealment exists where
the assured had knowledge of a fact material to the risk, and honesty, good
faith, and fair dealing requires that he should communicate it to the assured,
but he designedly and intentionally withholds the same.[15]
Petitioner merely relied on the testimony of the attending physician, Dr.
Hernando Mejia, as supported by the information given by the widow of the
decedent. Grepalife asserts that Dr. Mejias technical diagnosis of the cause
of death of Dr. Leuterio was a duly documented hospital record, and that the
widows declaration that her husband had possible hypertension several
years ago should not be considered as hearsay, but as part of res gestae.
On the contrary the medical findings were not conclusive because Dr. Mejia
did not conduct an autopsy on the body of the decedent. As the attending
physician, Dr. Mejia stated that he had no knowledge of Dr. Leuterios any
previous hospital confinement.[16] Dr. Leuterios death certificate stated that
hypertension was only the possible cause of death. The private respondents
statement, as to the medical history of her husband, was due to her
unreliable recollection of events. Hence, the statement of the physician was
properly considered by the trial court as hearsay.
The question of whether there was concealment was aptly answered by the
appellate court, thus:
The insured, Dr. Leuterio, had answered in his insurance application that he
was in good health and that he had not consulted a doctor or any of the
enumerated ailments, including hypertension; when he died the attending
physician had certified in the death certificate that the former died of
cerebral hemorrhage, probably secondary to hypertension. From this report,
the appellant insurance company refused to pay the insurance claim.
Appellant alleged that the insured had concealed the fact that he had
hypertension.
Contrary to appellants allegations, there was no sufficient proof that the
insured had suffered from hypertension. Aside from the statement of the
insureds widow who was not even sure if the medicines taken by Dr. Leuterio
were for hypertension, the appellant had not proven nor produced any
witness who could attest to Dr. Leuterios medical history...
xxx
Appellant insurance company had failed to establish that there was
concealment made by the insured, hence, it cannot refuse payment of the
claim.[17]
The fraudulent intent on the part of the insured must be established to
entitle the insurer to rescind the contract.[18] Misrepresentation as a
defense of the insurer to avoid liability is an affirmative defense and the duty
to establish such defense by satisfactory and convincing evidence rests upon
the insurer.[19] In the case at bar, the petitioner failed to clearly and
satisfactorily establish its defense, and is therefore liable to pay the proceeds
of the insurance.
And that brings us to the last point in the review of the case at bar. Petitioner
claims that there was no evidence as to the amount of Dr. Leuterios
outstanding indebtedness to DBP at the time of the mortgagors death.
Hence, for private respondents failure to establish the same, the action for
specific performance should be dismissed. Petitioners claim is without merit.
A life insurance policy is a valued policy.[20] Unless the interest of a person
insured is susceptible of exact pecuniary measurement, the measure of
indemnity under a policy of insurance upon life or health is the sum fixed in
the policy.[21] The mortgagor paid the premium according to the coverage of
his insurance, which states that:
The policy states that upon receipt of due proof of the Debtors death during
the terms of this insurance, a death benefit in the amount of P86,200.00
shall be paid.
In the event of the debtors death before his indebtedness with the creditor
shall have been fully paid, an amount to pay the outstanding indebtedness
shall first be paid to the Creditor and the balance of the Sum Assured, if
there is any shall then be paid to the beneficiary/ies designated by the
debtor.[22] (Emphasis omitted)
However, we noted that the Court of Appeals decision was promulgated on
May 17, 1993. In private respondents memorandum, she states that DBP
foreclosed in 1995 their residential lot, in satisfaction of mortgagors
outstanding loan. Considering this supervening event, the insurance
proceeds shall inure to the benefit of the heirs of the deceased person or his
beneficiaries. Equity dictates that DBP should not unjustly enrich itself at the
expense of another (Nemo cum alterius detrimenio protest). Hence, it cannot
collect the insurance proceeds, after it already foreclosed on the mortgage.
The proceeds now rightly belong to Dr. Leuterios heirs represented by his
widow, herein private respondent Medarda Leuterio.
WHEREFORE, the petition is hereby DENIED. The Decision and Resolution of
the Court of Appeals in CA-G.R. CV 18341 is AFFIRMED with MODIFICATION
that the petitioner is ORDERED to pay the insurance proceeds amounting to
Eighty-six thousand, two hundred (P86,200.00) pesos to the heirs of the
insured, Dr. Wilfredo Leuterio (deceased), upon presentation of proof of prior
settlement of mortgagors indebtedness to Development Bank of the
Philippines. Costs against petitioner.
Facts:
> Harvardian is a family corporation, the stockholders of which are Ildefonso
Yap, Virginia King Yap and their children.
> Prior to Aug. 9, 1979, an agent of Country Bankers proposed to Harvardian
to insure its school building. Although at first reluctant, Harvardian agreed.
> Country Banks sent an inspector to inspect the school building and agreed
to insure the same for P500,000 for which Harvardian paid an annual
premium of P2,500.
> On Aug. 9, 1979, Country Bankers issued to Harvardian a fire insurance
policy. On March 12, 1980, (39 days before I was born hehehehe )during
the effectivity of said insurance policy, the insured property was totally
burned rendering it a total loss.
> A claim was made by plaintiff upon defendant but defendant denied it
contending that plaintiff had no insurable interest over the building
constructed on the piece of land in the name of the late Ildefonso Yap as
owner.
> It was contended that both the lot and the building were owned by
Ildefonso Yap and NOT by the Harvardian Colleges.
Issue:
Whether or not Harvardian colleges has a right to the proceeds.
SO ORDERED.
Held:
Harvardian has a right to the proceeds.
Regardless of the nature of the title of the insured or even if he did not have
title to the property insured, the contract of fire insurance should still be
upheld if his interest in or his relation to the property is such that he will be
benefited in its continued existence or suffer a direct pecuniary loss from its
destruction or injury. The test in determining insurable interest in property is
whether one will 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.
Harvardian Colleges v. Country Bankers Insurance Corp. CA
1 CARA 2
Here Harvardian was not only in possession of the building but was in fact
using the same for several years with the knowledge and consent of
Ildefonso Yap. It is reasonably fair to assume that had the building not been
burned, Harvardian would have been allowed the continued use of the same
as the site of its operation as an educational institution.
Harvardian
therefore would have been directly benefited by the preservation of the
property, and certainly suffered a pecuniary loss by its being burned.
Ang Ka Yu v. Phoenix Assurance - Insurable Interest
1 CARA 704
June 8, 2006
Facts:
> Ang Ka Yu had a piece of property in his possession. He insured it with
Phoenix.
> The property was lost, so Ang Ka Yu sought to claim the proceeds.
> Phoenix denied liability on the ground that Ang was not the owner but a
mere possessor and as such, had no insurable interest over the property.
Issue:
Whether or not a mere possessor has insurable interest over the property.
Held:
Yes.
A person having a mere right or possession of property may insure it to its
full value and in his own name, even when he is not responsible for its
safekeeping. The reason is that even if a person is NOT interested in the
safety and preservation of material in his possession because they belong to
3rd parties, said person still has insurable interest, because he stands either
to benefit from their continued existence or to be prejudiced by their
destruction.
Before the Court is a petition for review on certiorari of the Decision1 dated
October 11, 2000 of the Court of Appeals (CA) in CA-G.R. CV No. 61848 which
set aside the Decision dated August 31, 1998 of the Regional Trial Court,
Branch 138, Makati (RTC) in Civil Case No. 92-322 and upheld the causes of
action for damages of Insurance Company of North America (respondent)
against Gaisano Cagayan, Inc. (petitioner); and the CA Resolution dated April
11, 2001 which denied petitioner's motion for reconsideration.
The factual background of the case is as follows:
Intercapitol Marketing Corporation (IMC) is the maker of Wrangler Blue Jeans.
Levi Strauss (Phils.) Inc. (LSPI) is the local distributor of products bearing
trademarks owned by Levi Strauss & Co.. IMC and LSPI separately obtained
from respondent fire insurance policies with book debt endorsements. The
insurance policies provide for coverage on "book debts in connection with
ready-made clothing materials which have been sold or delivered to various
customers and dealers of the Insured anywhere in the Philippines."2 The
policies defined book debts as the "unpaid account still appearing in the
Book of Account of the Insured 45 days after the time of the loss covered
under this Policy."3 The policies also provide for the following conditions:
1. Warranted that the Company shall not be liable for any unpaid account in
respect of the merchandise sold and delivered by the Insured which are
outstanding at the date of loss for a period in excess of six (6) months from
the date of the covering invoice or actual delivery of the merchandise
whichever shall first occur.
2. Warranted that the Insured shall submit to the Company within twelve (12)
days after the close of every calendar month all amount shown in their books
of accounts as unpaid and thus become receivable item from their customers
and dealers. x x x4
xxxx
Petitioner is a customer and dealer of the products of IMC and LSPI. On
February 25, 1991, the Gaisano Superstore Complex in Cagayan de Oro City,
owned by petitioner, was consumed by fire. Included in the items lost or
destroyed in the fire were stocks of ready-made clothing materials sold and
delivered by IMC and LSPI.
On February 4, 1992, respondent filed a complaint for damages against
petitioner. It alleges that IMC and LSPI filed with respondent their claims
under their respective fire insurance policies with book debt endorsements;
that as of February 25, 1991, the unpaid accounts of petitioner on the sale
and delivery of ready-made clothing materials with IMC was P2,119,205.00
while with LSPI it was P535,613.00; that respondent paid the claims of IMC
and LSPI and, by virtue thereof, respondent was subrogated to their rights
against petitioner; that respondent made several demands for payment upon
petitioner but these went unheeded.5
In its Answer with Counter Claim dated July 4, 1995, petitioner contends that
it could not be held liable because the property covered by the insurance
policies were destroyed due to fortuities event or force majeure; that
respondent's right of subrogation has no basis inasmuch as there was no
breach of contract committed by it since the loss was due to fire which it
could not prevent or foresee; that IMC and LSPI never communicated to it
that they insured their properties; that it never consented to paying the
claim of the insured.6
At the pre-trial conference the parties failed to arrive at an amicable
settlement.7 Thus, trial on the merits ensued.
On August 31, 1998, the RTC rendered its decision dismissing respondent's
complaint.8 It held that the fire was purely accidental; that the cause of the
fire was not attributable to the negligence of the petitioner; that it has not
been established that petitioner is the debtor of IMC and LSPI; that since the
sales invoices state that "it is further agreed that merely for purpose of
securing the payment of purchase price, the above-described merchandise
remains the property of the vendor until the purchase price is fully paid", IMC
and LSPI retained ownership of the delivered goods and must bear the loss.
Dissatisfied, petitioner appealed to the CA.9 On October 11, 2000, the CA
rendered its decision setting aside the decision of the RTC. The dispositive
portion of the decision reads:
Indeed, when the terms of the agreement are clear and explicit that they do
not justify an attempt to read into it any alleged intention of the parties, the
terms are to be understood literally just as they appear on the face of the
contract.25 Thus, what were insured against were the accounts of IMC and
LSPI with petitioner which remained unpaid 45 days after the loss through
fire, and not the loss or destruction of the goods delivered.
Petitioner argues that IMC bears the risk of loss because it expressly
reserved ownership of the goods by stipulating in the sales invoices that "[i]t
is further agreed that merely for purpose of securing the payment of the
purchase price the above described merchandise remains the property of the
vendor until the purchase price thereof is fully paid."26
The Court is not persuaded.
The present case clearly falls under paragraph (1), Article 1504 of the Civil
Code:
ART. 1504. Unless otherwise agreed, the goods remain at the seller's risk
until the ownership therein is transferred to the buyer, but when the
ownership therein is transferred to the buyer the goods are at the buyer's
risk whether actual delivery has been made or not, except that:
(1) Where delivery of the goods has been made to the buyer or to a bailee
for the buyer, in pursuance of the contract and the ownership in the goods
has been retained by the seller merely to secure performance by the buyer
of his obligations under the contract, the goods are at the buyer's risk from
the time of such delivery; (Emphasis supplied)
xxxx
Thus, when the seller retains ownership only to insure that the buyer will pay
its debt, the risk of loss is borne by the buyer.27 Accordingly, petitioner bears
the risk of loss of the goods delivered.
IMC and LSPI did not lose complete interest over the goods. They have an
insurable interest until full payment of the value of the delivered goods.
Unlike the civil law concept of res perit domino, where ownership is the basis
for consideration of who bears the risk of loss, in property insurance, one's
interest is not determined by concept of title, but whether insured has
substantial economic interest in the property.28
Section 13 of our Insurance Code defines insurable interest as "every interest
in property, whether real or personal, or any relation thereto, or liability in
debtor's fault and before he has incurred in delay will not have the effect of
extinguishing the obligation.35 This rule is based on the principle that the
genus of a thing can never perish. Genus nunquan perit.36 An obligation to
pay money is generic; therefore, it is not excused by fortuitous loss of any
specific property of the debtor.37
No pronouncement as to costs.
SO ORDERED.
With respect to IMC, the respondent has adequately established its claim.
Exhibits "C" to "C-22"38 show that petitioner has an outstanding account
with IMC in the amount of P2,119,205.00. Exhibit "E"39 is the check voucher
evidencing payment to IMC. Exhibit "F"40 is the subrogation receipt executed
by IMC in favor of respondent upon receipt of the insurance proceeds. All
these documents have been properly identified, presented and marked as
exhibits in court. The subrogation receipt, by itself, is sufficient to establish
not only the relationship of respondent as insurer and IMC as the insured, but
also the amount paid to settle the insurance claim. The right of subrogation
accrues simply upon payment by the insurance company of the insurance
claim.41 Respondent's action against petitioner is squarely sanctioned by
Article 2207 of the Civil Code which provides:
Art. 2207. If the plaintiff's property has been insured, and he has received
indemnity from the insurance company for the injury or loss arising out of
the wrong or breach of contract complained of, the insurance company shall
be subrogated to the rights of the insured against the wrongdoer or the
person who has violated the contract. x x x
Petitioner failed to refute respondent's evidence.
As to LSPI, respondent failed to present sufficient evidence to prove its cause
of action. No evidentiary weight can be given to Exhibit "F Levi Strauss",42 a
letter dated April 23, 1991 from petitioner's General Manager, Stephen S.
Gaisano, Jr., since it is not an admission of petitioner's unpaid account with
LSPI. It only confirms the loss of Levi's products in the amount of
P535,613.00 in the fire that razed petitioner's building on February 25, 1991.
Moreover, there is no proof of full settlement of the insurance claim of LSPI;
no subrogation receipt was offered in evidence. Thus, there is no evidence
that respondent has been subrogated to any right which LSPI may have
against petitioner. Failure to substantiate the claim of subrogation is fatal to
petitioner's case for recovery of the amount of P535,613.00.
CRUZ, J.:
When a person's house is razed, the fire usually burns down the efforts of a
lifetime and forecloses hope for the suddenly somber future. The vanished
abode becomes a charred and painful memory. Where once stood a home,
there is now, in the sighing wisps of smoke, only a gray desolation. The dying
embers leave ashes in the heart.
For peace of mind and as a hedge against possible loss, many people now
secure fire insurance. This is an aleatory contract. By such insurance, the
insured in effect wagers that his house will be burned, with the insurer
assuring him against the loss, for a fee. If the house does burn, the insured,
while losing his house, wins the wagers. The prize is the recompense to be
given by the insurer to make good the loss the insured has sustained.
It would be a pity then if, having lost his house, the insured were also to lose
the payment he expects to recover for such loss. Sometimes it is his fault
that he cannot collect, as where there is a defect imputable to him in the
insurance contract. Conversely, the reason may be an unjust refusal of the
insurer to acknowledge a just obligation, as has happened many times.
In the instant case the private respondent has been sustained by the
Insurance Commission in her claim for compensation for her burned property.
The petitioner is now before us to dispute the decision, 1 on the ground that
there was no valid insurance contract at the time of the loss.
The pivotal date is the date the notice of the denial of the motion for
reconsideration was received by MICO.
MICO avers this was June 18, 1982, and offers in evidence its Annex "B," 12
which is a copy of the Order of June 14, 1982, with a signed rubber-stamped
notation on the upper left-hand corner that it was received on June 18, 1982,
by its legal department. It does not indicate from whom. At the bottom,
significantly, there is another signature under which are the ciphers "6-1382," for which no explanation has been given.
Against this document, the private respodent points in her Annex "1," 13 the
authenticated copy of the same Order with a rubber-stamped notation at the
bottom thereof indicating that it was received for the Malayan Insurance Co.,
Inc. by J. Gotladera on "6-13-82." The signature may or may not habe been
written by the same person who signed at the bottom of the petitioner's
Annex "B."
Between the two dates, the court chooses to believe June 13, 1982, not only
because the numbers "6-13-82" appear on both annexes but also because it
is the date authenticated by the administrative division of the Insurance
Commission. Annex "B" is at worst self-serving; at best, it might only indicate
that it was received on June 18, 1982, by the legal department of MICO, after
it had been received earlier by some other of its personnel on June 13, 1982.
Whatever the reason for the delay in transmitting it to the legal department
need not detain us here.
Under Section 416 of the Insurance Code, the period for appeal is thirty days
from notice of the decision of the Insurance Commission. The petitioner filed
its motion for reconsideration on April 25, 1981, or fifteen days such notice,
and the reglementary period began to run again after June 13, 1981, date of
its receipt of notice of the denial of the said motion for reconsideration. As
the herein petition was filed on July 2, 1981, or nineteen days later, there is
no question that it is tardy by four days.
Counted from June 13, the fifteen-day period prescribed under Rule 45,
assuming it is applicable, would end on June 28, 1982, or also four days from
July 2, when the petition was filed.
If it was filed under B.P. 129, then, considering that the motion for
reconsideration was filed on the fifteenth day after MICO received notice of
the decision, only one more day would have remained for it to appeal, to wit,
June 14, 1982. That would make the petition eighteen days late by July 2.
Indeed, even if the applicable law were still R.A. 5434, governing appeals
from administrative bodies, the petition would still be tardy. The law provides
for a fixed period of ten days from notice of the denial of a seasonable
motion for reconsideration within which to appeal from the decision.
Accordingly, that ten-day period, counted from June 13, 1982, would have
ended on June 23, 1982, making the petition filed on July 2, 1982, nine days
late.
It would seem from MICO's own theory, that the policy would have become
effective only upon payment, if accepted and so would have been valid only
from December 24, 1981m but only up to July 22, 1981, according to the
original terms. In others words, the policy would have run for only eight
months although the premium paid was for one whole year.
It is not disputed that the preium was actually paid by Pinca to Adora on
December 24, 1981, who received it on behalf of MICO, to which it was
remitted on January 15, 1982. What is questioned is the validity of Pinca's
payment and of Adora's authority to receive it.
On the merits, it must also fail. MICO's arguments that there was no payment
of premium and that the policy had been cancelled before the occurence of
the loss are not acceptable. Its contention that the claim was allowed without
proof of loss is also untenable.
xxx
xxx
xxx
(b)
conviction of a crime arising out of acts increasing the hazard insured
against;
(c)
(d)
discovery of willful, or reckless acts or commissions increasing the
hazard insured against;
non-payment of premium;
(e)
physical changes in the property insured which result in the property
becoming uninsurable;or
(f)
a determination by the Commissioner that the continuation of the
policy would violate or would place the insurer in violation of this Code.
As for the method of cancellation, Section 65 provides as follows:
SEC. 65.
All notices of cancellation mentioned in the preceding section
shall be in writing, mailed or delivered to the named insured at the address
shown in the policy, and shall state (a) which of the grounds set forth in
section sixty-four is relied upon and (b) that, upon written request of the
named insured, the insurer will furnish the facts on which the cancellation is
based.
A valid cancellation must, therefore, require concurrence of the following
conditions:
(1)
(2)
The notice must be based on the occurrence, after the effective date
of the policy, of one or more of the grounds mentioned;18
(3)
The notice must be (a) in writing, (b) mailed, or delivered to the
named insured, (c) at the address shown in the policy; 19
(4)
It must state (a) which of the grounds mentioned in Section 64 is
relied upon and (b) that upon written request of the insured, the insurer will
furnish the facts on which the cancellation is based. 20
MICO's claims it cancelled the policy in question on October 15, 1981, for
non-payment of premium. To support this assertion, it presented one of its
employees, who testified that "the original of the endorsement and credit
memo" presumably meaning the alleged cancellation "were sent the
assured by mail through our mailing section" 21 However, there is no proof
that the notice, assuming it complied with the other requisites mentioned
above, was actually mailed to and received by Pinca. All MICO's offers to
show that the cancellation was communicated to the insured is its
employee's testimony that the said cancellation was sent "by mail through
our mailing section." without more. The petitioner then says that its "stand is
enervated (sic) by the legal presumption of regularity and due performance
of duty." 22 (not realizing perhaps that "enervated" means "debilitated" not
"strengthened").
On the other hand, there is the flat denial of Pinca, who says she never
received the claimed cancellation and who, of course, did not have to prove
such denial Considering the strict language of Section 64 that no insurance
policy shall be cancelled except upon prior notice, it behooved MICO's to
make sure that the cancellation was actually sent to and received by the
insured. The presumption cited is unavailing against the positive duty
enjoined by Section 64 upon MICO and the flat denial made by the private
respondent that she had received notice of the claimed cancellation.
It stands to reason that if Pinca had really received the said notice, she would
not have made payment on the original policy on December 24, 1981.
Instead, she would have asked for a new insurance, effective on that date
and until one year later, and so taken advantage of the extended period. The
Court finds that if she did pay on that date, it was because she honestly
believed that the policy issued on June 7, 1981, was still in effect and she
was willing to make her payment retroact to July 22, 1981, its stipulated
commencement date. After all, agent Adora was very accomodating and had
earlier told her "to call him up any time" she was ready with her payment on
the policy earlier issued. She was obviously only reciprocating in kind when
she paid her premium for the period beginning July 22, 1981, and not
December 24, 1981.
MICO's suggests that Pinca knew the policy had already been cancelled and
that when she paid the premium on December 24, 1981, her purpose was "to
renew it." As this could not be done by the agent alone under the terms of
the original policy, the renewal thereof did not legally bind MICO. which had
not ratified it. To support this argument, MICO's cites the following exchange:
Q:
Now, Madam Witness, on December 25th you made the alleged
payment. Now, my question is that, did it not come to your mind that after
the lapse of six (6) months, your policy was cancelled?
A:
I have thought of that but the agent told me to call him up at
anytime.
Q:
So if you thought that your policy was already intended to revive
cancelled policy?
A:
A close study of the above transcript will show that Pinca meant to renew the
policy if it had really been already cancelled but not if it was stffl effective. It
was all conditional. As it has not been shown that there was a valid
cancellation of the policy, there was consequently no need to renew it but to
pay the premium thereon. Payment was thus legally made on the original
transaction and it could be, and was, validly received on behalf of the insurer
by its agent Adora. Adora. incidentally, had not been informed of the
cancellation either and saw no reason not to accept the said payment.
The last point raised by the petitioner should not pose much difficulty. The
valuation fixed in fire insurance policy is conclusive in case of total loss in the
absence of fraud, 24 which is not shown here. Loss and its amount may be
determined on the basis of such proof as may be offered by the insured,
which need not be of such persuasiveness as is required in judicial
proceedings. 25 If, as in this case, the insured files notice and preliminary
proof of loss and the insurer fails to specify to the former all the defects
thereof and without unnecessary delay, all objections to notice and proof of
loss are deemed waived under Section 90 of the Insurance Code.
The certification 26 issued by the Integrated National Police, Lao-ang, Samar,
as to the extent of Pinca's loss should be considered sufficient. Notably,MICO
submitted no evidence to the contrary nor did it even question the extent of
the loss in its answer before the Insurance Commission. It is also worth
observing that Pinca's property was not the only building bumed in the fire
that razed the commercial district of Lao-ang, Samar, on January 18, 1982.
27
There is nothing in the Insurance Code that makes the participation of an
adjuster in the assessment of the loss imperative or indespensable, as MICO
suggests. Section 325, which it cites, simply speaks of the licensing and
duties of adjusters.
We see in this cases an obvious design to evade or at least delay the
discharge of a just obligation through efforts bordering on bad faith if not
plain duplicity, We note that the motion for reconsideration was filed on the
fifteenth day from notice of the decision of the Insurance Commission and
that there was a feeble attempt to show that the notice of denial of the said
motion was not received on June 13, 1982, to further hinder the proceedings
and justify the filing of the petition with this Court fourteen days after June
18, 1982. We also look askance at the alleged cancellation, of which the
insured and MICO's agent himself had no knowledge, and the curious fact
that although Pinca's payment was remitted to MICO's by its agent on
January 15, 1982, MICO sought to return it to Adora only on February 5,
1982, after it presumably had learned of the occurrence of the loss insured
against on January 18, 1982. These circumstances make the motives of the
petitioner highly suspect, to say the least, and cast serious doubts upon its
candor and bona fides.
WHEREFORE, the petition is DENIED. The decision of the Insurance
Commission dated April 10, 1981, and its Order of June 4, 1981, are
AFFIRMED in full, with costs against the petitioner. This decision is
immediately executory.
SO ORDERED.
Sec. 77.
An insurer is entitled to the payment of the premium as soon
as the thing is exposed to the peril insured against. Notwithstanding any
agreement to the contrary, no policy or contract of insurance issued by an
insurance company is valid and binding unless and until the premium thereof
has been paid, except in the case of a life or an industrial life policy
whenever the grace period provision applies.
Sometime in early 1982, private respondent American Home Assurance Co.
(AHAC), represented by American International Underwriters (Phils.), Inc.,
issued in favor of petitioner Makati Tuscany Condominium Corporation
(TUSCANY) Insurance Policy No. AH-CPP-9210452 on the latter's building and
premises, for a period beginning 1 March 1982 and ending 1 March 1983,
with a total premium of P466,103.05. The premium was paid on installments
on 12 March 1982, 20 May 1982, 21 June 1982 and 16 November 1982, all of
which were accepted by private respondent.
On 10 February 1983, private respondent issued to petitioner Insurance
Policy No. AH-CPP-9210596, which replaced and renewed the previous policy,
for a term covering 1 March 1983 to 1 March 1984. The premium in the
amount of P466,103.05 was again paid on installments on 13 April 1983, 13
July 1983, 3 August 1983, 9 September 1983, and 21 November 1983. All
payments were likewise accepted by private respondent.
On 20 January 1984, the policy was again renewed and private respondent
issued to petitioner Insurance Policy No. AH-CPP-9210651 for the period 1
March 1984 to 1 March 1985. On this renewed policy, petitioner made two
installment payments, both accepted by private respondent, the first on 6
February 1984 for P52,000.00 and the second, on 6 June 1984 for
P100,000.00. Thereafter, petitioner refused to pay the balance of the
premium.
Consequently, private respondent filed an action to recover the unpaid
balance of P314,103.05 for Insurance Policy No. AH-CPP-9210651.
In its answer with counterclaim, petitioner admitted the issuance of
Insurance Policy No. AH-CPP-9210651. It explained that it discontinued the
payment of premiums because the policy did not contain a credit clause in
its favor and the receipts for the installment payments covering the policy for
1984-85, as well as the two (2) previous policies, stated the following
reservations:
2.
Acceptance of this payment shall not waive any of the company
rights to deny liability on any claim under the policy arising before such
payments or after the expiration of the credit clause of the policy; and
3.
Subject to no loss prior to premium payment. If there be any loss
such is not covered.
Petitioner further claimed that the policy was never binding and valid, and no
risk attached to the policy. It then pleaded a counterclaim for P152,000.00
for the premiums already paid for 1984-85, and in its answer with amended
counterclaim, sought the refund of P924,206.10 representing the premium
payments for 1982-85.
After some incidents, petitioner and private respondent moved for summary
judgment.
On 8 October 1987, the trial court dismissed the complaint and the
counterclaim upon the following findings:
While it is true that the receipts issued to the defendant contained the
aforementioned reservations, it is equally true that payment of the premiums
of the three aforementioned policies (being sought to be refunded) were
made during the lifetime or term of said policies, hence, it could not be said,
inspite of the reservations, that no risk attached under the policies.
Consequently, defendant's counterclaim for refund is not justified.
As regards the unpaid premiums on Insurance Policy No. AH-CPP-9210651, in
view of the reservation in the receipts ordinarily issued by the plaintiff on
premium payments the only plausible conclusion is that plaintiff has no right
to demand their payment after the lapse of the term of said policy on March
1, 1985. Therefore, the defendant was justified in refusing to pay the same. 1
Both parties appealed from the judgment of the trial court. Thereafter, the
Court of Appeals rendered a decision 2 modifying that of the trial court by
ordering herein petitioner to pay the balance of the premiums due on Policy
No. AH-CPP-921-651, or P314,103.05 plus legal interest until fully paid, and
affirming the denial of the counterclaim. The appellate court thus explained
appellate court, where the risk is entire and the contract is indivisible, the
insured is not entitled to a refund of the premiums paid if the insurer was
exposed to the risk insured for any period, however brief or momentary.
WHEREFORE, finding no reversible error in the judgment appealed from, the
same is AFFIRMED. Costs against petitioner.
SO ORDERED.
G.R. No. 102253
June 2, 1995
On 20 January 1984, plaintiff insured the logs, against loss and/or, damage
with defendant South Sea Surety and Insurance Co., Inc. for P2,000,000.00
end the latter issued its Marine Cargo Insurance Policy No. 84/24229 for
P2,000,000.00 on said date.
On 24 January 1984, the plaintiff gave the check in payment of the premium
on the insurance policy to Mr. Victorio Chua.
In the meantime, the said vessel M/V Seven Ambassador sank on 25 January
1984 resulting in the loss of the plaintiffs insured logs.
On 30 January 1984, a check for P5,625.00 (Exh. "E") to cover payment of
the premium and documentary stamps due on the policy was tendered to the
insurer but was not accepted. Instead, the South Sea Surety and Insurance
Co., Inc. cancelled the insurance policy it issued as of the date of inception
for non-payment of the premium due in accordance with Section 77 of the
Insurance Code.
On 2 February 1984, plaintiff demanded from defendant South Sea Surety
and Insurance Co., Inc. the payment of the proceeds of the policy but the
latter denied liability under the policy. Plaintiff likewise filed a formal claim
with defendant Seven Brothers Shipping Corporation for the value of the lost
logs but the latter denied the claim. 1
In its decision, dated 11 May 1988, the trial court rendered judgment in favor
of plaintiff Hardwood.
On appeal perfected by both the shipping firm and the insurance company,
the Court of Appeals affirmed the judgment of the court a quo only against
the insurance corporation; in absolving the shipping entity from liability, the
appellate court ratiocinated:
The primary issue to be resolved before us is whether defendants shipping
corporation and the surety company are liable to the plaintiff for the latter's
lost logs.
It appears that there is a stipulation in the charter party that the ship owner
would be exempted from liability in case of loss.
The court a quo erred in applying the provisions of the Civil Code on common
carriers to establish the liability of the shipping corporation. The provisions
on common carriers should not be applied where the carrier is not acting as
such but as a private carrier.
Under American jurisprudence, a common carrier undertaking to carry a
special or chartered to a special person only, becomes a private carrier.
As a private carrier, a stipulation exempting the owner from liability even for
the negligence of its agent is valid (Home Insurance Company, Inc. vs.
American Steamship Agencies, Inc., 23 SCRA 24).
The shipping corporation should not therefore be held liable for the loss of
the logs. 2
In this petition for review on certiorari brought by South Sea Surety and
Insurance Co., Inc., petitioner argues that it likewise should have been freed
from any liability to Hardwood. It faults the appellate court (a) for having
Supposedly disregarded Section 77 of the insurance Code and (b) for holding
Victorio Chua to have been an authorized representative of the insurer.
Section 77 of the Insurance Code provides:
Sec. 77.
An insurer is entitled to payment of the premium as soon as
the thing insured is exposed to the peril insured against. Notwithstanding
any agreement to the contrary, no policy or contract of insurance issued by
an insurance company is valid and binding unless and until the premium
thereof has been paid, except in the case of a life or an industrial life policy
whenever the grace period provision applies.
Undoubtedly, the payment of the premium is a condition precedent to, and
essential for, the efficaciousness of the contract. The only two statutorily
provided exceptions are (a) in case the insurance coverage relates to life or
industrial life (health) insurance when a grace period applies and (b) when
the insurer makes a written acknowledgment of the receipt of premium, this
acknowledgment being declared by law to be then conclusive evidence of
the premium payment (Secs. 77-78, Insurance Code). The appellate court,
contrary to what the petition suggests, did not make any pronouncement to
the contrary. Indeed, it has said:
Concerning the issue as to whether there is a valid contract of insurance
between plaintiff-appellee and defendant-appellant South Sea Surety and
Insurance Co., Inc., Section 77 of the Insurance Code explicitly provides that
notwithstanding any agreement to the contrary, no policy issued by an
insurance company is valid and binding unless and until premium thereof has
been paid. It is therefore important to determine whether at the time of the
loss, the premium was already paid. 3
No attempt becloud the issues can disguise the fact that the sole question
raised in the instant petition is really evidentiary in nature, i.e., whether or
not Victorio Chua, in receiving the check for the insurance premium prior to
the occurrence of the risk insured against has so acted as an agent of
petitioner. The appellate court, like the trial court, has found in the
affirmative. Said the appellate court:
In the instant case, the Marine Cargo Insurance Policy No. 84/24229 was
issued by defendant insurance company on 20 January 1984. At the time the
vessel sank on 25 January 1984 resulting in the loss of the insured logs, the
insured had already delivered to Victorio Chua the check in payment of
premium. But, as Victorio Chua testified, it was only in the morning of 30
January 1984 or 5 days after the vessel sank when his messenger tendered
the check to defendant South Sea Surety and Insurance Co., Inc. (TSN, pp. 327, 16-17, 22 October 1985).
When the appellant South Sea Surety and Insurance Co., Inc. delivered to Mr.
Chua the marine cargo insurance policy for the plaintiffs logs, he is deemed
to have been authorized by the South Sea Surety and Insurance Co., Inc. to
receive the premium which is due on its behalf.
When therefore the insured logs were lost, the insured had already paid the
premium to an agent of the South Sea Surety and Insurance Co., Inc., which
is consequently liable to pay the insurance proceeds under the policy it
issued to the insured. 4
We see no valid reason to discard the factual conclusions of the appellate
court. Just as so correctly pointed out by private respondent, it is not the
function of this Court to assess and evaluate all over again the evidence,
testimonial and documentary, adduced by the parties particularly where,
such as here, the findings of both the trial court and the appellate court on
the matter coincide.
WHEREFORE, the resolution, dated 01 February 1993, granting due course to
the petition is RECALLED, and the petition is DENIED. Costs against
petitioner.
SO ORDERED.
Sec. 301.
Any person who for any compensation, commission or other
thing of value, acts, or aids in soliciting, negotiating or procuring the making
of any insurance contract or in placing risk or taking out insurance, on behalf
of an insured other than himself, shall be an insurance broker within the
intent of this Code, and shall thereby become liable to all the duties
requirements, liabilities and penalties to which an insurance broker is
subject.
The appellees, upon the other hand, claim that the second paragraph of
Section 306 of the Insurance Code provide as follows:
Sec. 306.
. . . Any insurance company which delivers to an insurance
agent or insurance broker a policy or contract of insurance shall be deemed
to have authorized such agent or broker to receive on its behalf payment of
any premium which is due on such policy of contract of insurance at the time
of its issuance or delivery or which becomes due thereon.
On cross-examination in behalf of South Sea Surety and Insurance Co., Inc.
Mr. Chua testified that the marine cargo insurance policy for the plaintiff's
building located at 5855 Zobel Street, Makati City, together with all their
personal effects therein. The insurance was for P600,000.00 covering the
period from 23 January 1987 to 23 January 1988. On 23 January 1987, of the
total premium of P2,983.50, petitioner Violeta Tibay only paid P600.00 thus
leaving a considerable balance unpaid.
On 8 March 1987 the insured building was completely destroyed by fire. Two
days later or on 10 March 1987 Violeta Tibay paid the balance of the
premium. On the same day, she filed with FORTUNE a claim on the fire
insurance policy. Her claim was accordingly referred to its adjuster, Goodwill
Adjustment Services, Inc. (GASI), which immediately wrote Violeta requesting
her to furnish it with the necessary documents for the investigation and
processing of her claim. Petitioner forthwith complied. On 28 March 1987 she
signed a non-waiver agreement with GASI to the effect that any action taken
by the companies or their representatives in investigating the claim made by
the claimant for his loss which occurred at 5855 Zobel Roxas, Makati on
March 8, 1987, or in the investigating or ascertainment of the amount of
actual cash value and loss, shall not waive or invalidate any condition of the
policies of such companies held by said claimant, nor the rights of either or
any of the parties to this agreement, and such action shall not be, or be
claimed to be, an admission of liability on the part of said companies or any
of them.[1]
In a letter dated 11 June 1987 FORTUNE denied the claim of Violeta for
violation of Policy Condition No. 2 and of Sec. 77 of the Insurance Code.
Efforts to settle the case before the Insurance Commission proved futile. On
3 March 1988 Violeta and the other petitioners sued FORTUNE for damages
in the amount of P600,000.00 representing the total coverage of the fire
insurance policy plus 12% interest per annum, P 100,000.00 moral damages,
and attorneys fees equivalent to 20% of the total claim.
On 19 July 1990 the trial court ruled for petitioners and adjudged FORTUNE
liable for the total value of the insured building and personal properties in
the amount of P600,000.00 plus interest at the legal rate of 6% per annum
from the filing of the complaint until full payment, and attorneys fees
equivalent to 20% of the total amount claimed plus costs of suit.[2]
On 24 March 1995 the Court of Appeals reversed the court a quo by
declaring FORTUNE not to be liable to plaintiff-appellees therein but ordering
defendant-appellant to return to the former the premium of P2,983.50 plus
12% interest from 10 March 1987 until full payment.[3]
Hence this petition for review with petitioners contending mainly that
contrary to the conclusion of the appellate court, FORTUNE remains liable
under the subject fire insurance policy inspite of the failure of petitioners to
pay their premium in full.
We find no merit in the petition; hence, we affirm the Court of Appeals.
Insurance is a contract whereby one undertakes for a consideration to
indemnify another against loss, damage or liability arising from an unknown
or contingent event.[4] The consideration is the premium, which must be
paid at the time and in the way and manner specified in the policy, and if not
so paid, the policy will lapse and be forfeited by its own terms.[5]
The pertinent provisions in the Policy on premium read
THIS POLICY OF INSURANCE WITNESSETH, THAT only after payment to the
Company in accordance with Policy Condition No. 2 of the total premiums by
the insured as stipulated above for the period aforementioned for insuring
against Loss or Damage by Fire or Lightning as herein appears, the Property
herein described x x x
2. This policy including any renewal thereof and/or any endorsement thereon
is not in force until the premium has been fully paid to and duly receipted by
the Company in the manner provided herein.
Any supplementary agreement seeking to amend this condition prepared by
agent, broker or Company official, shall be deemed invalid and of no effect.
xxx xxx xxx
Except only in those specific cases where corresponding rules and
regulations which are or may hereafter be in force provide for the payment of
the stipulated premiums in periodic installments at fixed percentage, it is
hereby declared, agreed and warranted that this policy shall be deemed
effective, valid and binding upon the Company only when the premiums
therefor have actually been paid in full and duly acknowledged in a receipt
signed by any authorized official or representative/agent of the Company in
such manner as provided herein, (Italics supplied).[6]
Clearly the Policy provides for payment of premium in full. Accordingly,
where the premium has only been partially paid and the balance paid only
after the peril insured against has occurred, the insurance contract did not
take effect and the insured cannot collect at all on the policy. This is fully
supported by Sec. 77 of the Insurance Code which provides
It is clear x x x that on April 1, 1960, Fire Insurance Policy No. 9652 was
issued by appellee and delivered to appellant, and that on September 22 of
the same year, the latter paid to the former the sum of P3,000.00 on account
of the total premium of P6,051.95 due thereon. There is, consequently, no
doubt at all that, as between the insurer and the insured, there was not only
a perfected contract of insurance but a partially performed one as far as the
payment of the agreed premium was concerned. Thereafter the obligation of
the insurer to pay the insured the amount, for which the policy was issued in
case the conditions therefor had been complied with, arose and became
binding upon it, while the obligation of the insured to pay the remainder of
the total amount of the premium due became demandable.
The 1967 Phoenix case is not persuasive; neither is it decisive of the instant
dispute. For one, the factual scenario is different. In Phoenix it was the
insurance company that sued for the balance of the premium, i.e., it
recognized and admitted the existence of an insurance contract with the
insured. In the case before us, there is, quite unlike in Phoenix, a specific
stipulation that (t)his policy xxx is not in force until the premium has been
fully paid and duly receipted by the Company x x x. Resultantly, it is correct
to say that in Phoenix a contract was perfected upon partial payment of the
premium since the parties had not otherwise stipulated that prepayment of
the premium in full was a condition precedent to the existence of a contract.
In Phoenix, by accepting the initial payment of P3,000.00 and then later
demanding the remainder of the premium without any other precondition to
its enforceability as in the instant case, the insurer in effect had shown its
intention to continue with the existing contract of insurance, as in fact it was
enforcing its right to collect premium, or exact specific performance from the
insured. This is not so here. By express agreement of the parties, no
vinculum juris or bond of law was to be established until full payment was
effected prior to the occurrence of the risk insured against.
In Makati Tuscany Condominium Corp. v. Court of Appeals[9] the parties
mutually agreed that the premiums could be paid in installments, which in
fact they did for three (3) years, hence, this Court refused to invalidate the
insurance policy. In giving effect to the policy, the Court quoted with approval
the Court of Appeals
The obligation to pay premiums when due is ordinarily an indivisible
obligation to pay the entire premium. Here, the parties x x x agreed to make
the premiums payable in installments, and there is no pretense that the
parties never envisioned to make the insurance contract binding between
them. It was renewed for two succeeding years, the second and third policies
being a renewal/replacement for the previous one. And the insured never
informed the insurer that it was terminating the policy because the terms
were unacceptable.
While it maybe true that under Section 77 of the Insurance Code, the parties
may not agree to make the insurance contract valid and binding without
payment of premiums, there is nothing in said section which suggests that
the parties may not agree to allow payment of the premiums in installment,
or to consider the contract as valid and binding upon payment of the first
premium. Otherwise we would allow the insurer to renege on its liability
under the contract, had a loss incurred (sic) before completion of payment of
the entire premium, despite its voluntary acceptance of partial payments, a
result eschewed by basic considerations of fairness and equity x x x.
These two (2) cases, Phoenix and Tuscany, adequately demonstrate the
waiver, either express or implied, of prepayment in full by the insurer:
impliedly, by suing for the balance of the premium as inPhoenix, and
expressly, by agreeing to make premiums payable in installments as in
Tuscany. But contrary to the stance taken by petitioners, there is no waiver
express or implied in the case at bench. Precisely, the insurer and the
insured expressly stipulated that (t)his policy including any renewal thereof
and/or any indorsement thereon is not in force until the premium has been
fully paid to and duly receipted by the Company x x x and that this policy
shall be deemed effective, valid and binding upon the Company only when
the premiums therefor have actually been paid in full and duly
acknowledged.
Conformably with the aforesaid stipulations explicitly worded and taken in
conjunction with Sec. 77 of the Insurance Code the payment of partial
premium by the assured in this particular instance should not be considered
the payment required by the law and the stipulation of the parties. Rather, it
must be taken in the concept of a deposit to be held in trust by the insurer
until such time that the full amount has been tendered and duly receipted
for. In other words, as expressly agreed upon in the contract, full payment
must be made before the risk occurs for the policy to be considered effective
and in force.
Thus, no vinculum juris whereby the insurer bound itself to indemnify the
assured according to law ever resulted from the fractional payment of
premium. The insurance contract itself expressly provided that the policy
would be effective only when the premium was paid in full. It would have
been altogether different were it not so stipulated. Ergo, petitioners had
absolute freedom of choice whether or not to be insured by FORTUNE under
the terms of its policy and they freely opted to adhere thereto.
Indeed, and far more importantly, the cardinal polestar in the construction of
an insurance contract is the intention of the parties as expressed in the
policy.[10] Courts have no other function but to enforce the same. The rule
that contracts of insurance will be construed in favor of the insured and most
strongly against the insurer should not be permitted to have the effect of
making a plain agreement ambiguous and then construe it in favor of the
insured.[11] Verily, it is elemental law that the payment of premium is
requisite to keep the policy of insurance in force. If the premium is not paid
in the manner prescribed in the policy as intended by the parties the policy is
ineffective. Partial payment even when accepted as a partial payment will
not keep the policy alive even for such fractional part of the year as the part
payment bears to the whole payment.[12]
Applying further the rules of statutory construction, the position maintained
by petitioners becomes even more untenable. The case of South Sea Surety
and Insurance Company, Inc. v. Court of Appeals,[13] speaks only of two (2)
statutory exceptions to the requirement of payment of the entire premium as
a prerequisite to the validity of the insurance contract. These exceptions are:
(a) in case the insurance coverage relates to life or industrial life (health)
insurance when a grace period applies, and (b) when the insurer makes a
written acknowledgment of the receipt of premium, this acknowledgment
being declared by law to, be then conclusive evidence of the premium
payment.[14]
A maxim of recognized practicality is the rule that the expressed exception
or exemption excludes others. Exceptio firm at regulim in casibus non
exceptis. The express mention of exceptions operates to exclude other
exceptions; conversely, those which are not within the enumerated
exceptions are deemed included in the general rule. Thus, under Sec. 77, as
well as Sec. 78, until the premium is paid, and the law has not expressly
excepted partial payments, there is no valid and binding contract. Hence, in
the absence of clear waiver of prepayment in full by the insurer, the insured
cannot collect on the proceeds of the policy.
In the desire to safeguard the interest of the assured, itmust not be ignored
that the contract of insurance is primarily a risk-distributing device, a
mechanism by which all members of a group exposed to a particular risk
contribute premiums to an insurer. From these contributory funds are paid
whatever losses occur due to exposure to the peril insured against. Each
party therefore takes a risk: the insurer, that of being compelled upon the
happening of the contingency to pay the entire sum agreed upon, and the
insured, that of parting with the amount required as premium, without
receiving anything therefor in case the contingency does not happen. To
ensure payment for these losses, the law mandates all insurance companies
The material operative facts upon which the appealed judgment was based
are summarized by the Court of Appeals in its assailed decision as follows:
Plaintiff [herein Respondent] obtained from defendant [herein Petitioner] five
(5) insurance policies (Exhibits "A" to "E", Record, pp. 158-175) on its
properties [in Pasay City and Manila].
All five (5) policies reflect on their face the effectivity term: "from 4:00 P.M. of
22 May 1991 to 4:00 P.M. of 22 May 1992." On June 13, 1992, plaintiff's
properties located at 2410-2432 and 2442-2450 Taft Avenue, Pasay City were
razed by fire. On July 13, 1992, plaintiff tendered, and defendant accepted,
five (5) Equitable Bank Manager's Checks in the total amount of P225,753.45
as renewal premium payments for which Official Receipt Direct Premium No.
62926 (Exhibit "Q", Record, p. 191) was issued by defendant. On July 14,
1992, Masagana made its formal demand for indemnification for the burned
insured properties. On the same day, defendant returned the five (5)
manager's checks stating in its letter (Exhibit "R"/"8", Record, p. 192) that it
was rejecting Masagana's claim on the following grounds:
"a) Said policies expired last May 22, 1992 and were not renewed for another
term;
b) Defendant had put plaintiff and its alleged broker on notice of non-renewal
earlier; and
[G.R. No. 137172. April 4, 2001]
UCPB GENERAL INSURANCE CO. INC., petitioner, vs. MASAGANA
TELAMART, INC., respondent.
RESOLUTION
DAVIDE, JR., C.J.:
c) The properties covered by the said policies were burned in a fire that took
place last June 13, 1992, or before tender of premium payment."
(Record, p. 5)
Hence Masagana filed this case.
In our decision of 15 June 1999 in this case, we reversed and set aside the
assailed decision[1] of the Court of Appeals, which affirmed with modification
the judgment of the trial court (a) allowing Respondent to consign the sum of
P225,753.95 as full payment of the premiums for the renewal of the five
insurance policies on Respondents properties; (b) declaring the replacementrenewal policies effective and binding from 22 May 1992 until 22 May 1993;
and (c) ordering Petitioner to pay Respondent P18,645,000.00 as indemnity
for the burned properties covered by the renewal-replacement policies. The
modification consisted in the (1) deletion of the trial courts declaration that
three of the policies were in force from August 1991 to August 1992; and (2)
reduction of the award of the attorneys fees from 25% to 10% of the total
amount due the Respondent.
Both the Court of Appeals and the trial court found that sufficient proof exists
that Respondent, which had procured insurance coverage from Petitioner for
a number of years, had been granted a 60 to 90-day credit term for the
renewal of the policies. Such a practice had existed up to the time the claims
were filed. Thus:
Fire Insurance Policy No. 34658 covering May 22, 1990 to May 22, 1991 was
issued on May 7, 1990 but premium was paid more than 90 days later on
August 31, 1990 under O.R. No. 4771 (Exhs. "T" and "T-1"). Fire Insurance
Policy No. 34660 for Insurance Risk Coverage from May 22, 1990 to May 22,
1991 was issued by UCPB on May 4, 1990 but premium was collected by
UCPB only on July 13, 1990 or more than 60 days later under O.R. No. 46487
(Exhs. "V" and "V-1"). And so were as other policies: Fire Insurance Policy No.
34657 covering risks from May 22, 1990 to May 22, 1991 was issued on May
7, 1990 but premium therefor was paid only on July 19, 1990 under O.R. No.
46583 (Exhs. "W" and "W-1"). Fire Insurance Policy No. 34661 covering risks
from May 22, 1990 to May 22, 1991 was issued on May 3, 1990 but premium
was paid only on July 19, 1990 under O.R. No. 46582 (Exhs. "X' and "X-1").
Fire Insurance Policy No. 34688 for insurance coverage from May 22, 1990 to
May 22, 1991 was issued on May 7, 1990 but premium was paid only on July
19, 1990 under O.R. No. 46585 (Exhs. "Y" and "Y-1"). Fire Insurance Policy No.
29126 to cover insurance risks from May 22, 1989 to May 22, 1990 was
issued on May 22, 1989 but premium therefor was collected only on July 25,
1990[sic] under O.R. No. 40799 (Exhs. "AA" and "AA-1"). Fire Insurance Policy
No. HO/F-26408 covering risks from January 12, 1989 to January 12, 1990
was issued to Intratrade Phils. (Masagana's sister company) dated December
10, 1988 but premium therefor was paid only on February 15, 1989 under
O.R. No. 38075 (Exhs. "BB" and "BB-1"). Fire Insurance Policy No. 29128 was
issued on May 22, 1989 but premium was paid only on July 25, 1989 under
O.R. No. 40800 for insurance coverage from May 22, 1989 to May 22, 1990
(Exhs. "CC" and "CC-1"). Fire Insurance Policy No. 29127 was issued on May
22, 1989 but premium was paid only on July 17, 1989 under O.R. No. 40682
for insurance risk coverage from May 22, 1989 to May 22, 1990 (Exhs. "DD"
and "DD-1"). Fire Insurance Policy No. HO/F-29362 was issued on June 15,
1989 but premium was paid only on February 13, 1990 under O.R. No. 39233
for insurance coverage from May 22, 1989 to May 22, 1990 (Exhs. "EE" and
"EE-1"). Fire Insurance Policy No. 26303 was issued on November 22, 1988
but premium therefor was collected only on March 15, 1989 under O.R. NO.
38573 for insurance risks coverage from December 15, 1988 to December
15, 1989 (Exhs. "FF" and "FF-1").
Moreover, according to the Court of Appeals the following circumstances
constitute preponderant proof that no timely notice of non-renewal was
made by Petitioner:
The instant case has to rise or fall on the core issue of whether Section 77 of
the Insurance Code of 1978 (P.D. No. 1460) must be strictly applied to
Petitioners advantage despite its practice of granting a 60- to 90-day credit
term for the payment of premiums.
Section 77 of the Insurance Code of 1978 provides:
SEC. 77. An insurer is entitled to payment of the premium as soon as the
thing insured is exposed to the peril insured against. Notwithstanding any
agreement to the contrary, no policy or contract of insurance issued by an
insurance company is valid and binding unless and until the premium thereof
has been paid, except in the case of a life or an industrial life policy
whenever the grace period provision applies.
This Section is a reproduction of Section 77 of P.D. No. 612 (The Insurance
Code) promulgated on 18 December 1974. In turn, this Section has its source
in Section 72 of Act No. 2427 otherwise known as the Insurance Act as
amended by R.A. No. 3540, approved on 21 June 1963, which read:
SEC. 72. An insurer is entitled to payment of premium as soon as the thing
insured is exposed to the peril insured against, unless there is clear
agreement to grant the insured credit extension of the premium due. No
policy issued by an insurance company is valid and binding unless and until
the premium thereof has been paid. (Underscoring supplied)
It can be seen at once that Section 77 does not restate the portion of Section
72 expressly permitting an agreement to extend the period to pay the
premium. But are there exceptions to Section 77?
The answer is in the affirmative.
The first exception is provided by Section 77 itself, and that is, in case of a
life or industrial life policy whenever the grace period provision applies.
The second is that covered by Section 78 of the Insurance Code, which
provides:
SEC. 78. Any acknowledgment in a policy or contract of insurance of the
receipt of premium is conclusive evidence of its payment, so far as to make
the policy binding, notwithstanding any stipulation therein that it shall not be
binding until premium is actually paid.
recovery on the policy should be allowed even though the premium is paid
after the loss but within the credit term.
Moreover, there is nothing in Section 77 which prohibits the parties in an
insurance contract to provide a credit term within which to pay the
premiums. That agreement is not against the law, morals, good customs,
public order or public policy. The agreement binds the parties. Article 1306 of
the Civil Code provides:
ART. 1306. The contracting parties may establish such stipulations clauses,
terms and conditions as they may deem convenient, provided they are not
contrary to law, morals, good customs, public order, or public policy.
Finally in the instant case, it would be unjust and inequitable if recovery on
the policy would not be permitted against Petitioner, which had consistently
granted a 60- to 90-day credit term for the payment of premiums despite its
full awareness of Section 77. Estoppel bars it from taking refuge under said
Section, since Respondent relied in good faith on such practice. Estoppel
then is the fifth exception to Section 77.
WHEREFORE, the Decision in this case of 15 June 1999 is RECONSIDERED
and SET ASIDE, and a new one is hereby entered DENYING the instant
petition for failure of Petitioner to sufficiently show that a reversible error was
committed by the Court of Appeals in its challenged decision, which is
hereby AFFIRMED in toto.
No pronouncement as to cost.
SO ORDERED.
Its motion for reconsideration of the judgment having been denied, petitioner
filed the petition in this case. Petitioner reiterates its stand that there was no
existing insurance contract between the parties. It invokes Section 77 of the
Insurance Code, which provides:
An insurer is entitled to payment of the premium as soon as the thing
insured is exposed to the peril insured against. Notwithstanding any
agreement to the contrary, no policy or contract of insurance issued by an
insurance company is valid and binding unless and until the premium thereof
has been paid, except in the case of life or an industrial life policy whenever
the grace period provision applies.
and cites the case of Arce v. Capital Insurance & Surety Co., Inc.,[2] where
we ruled that unless and until the premium is paid there is no insurance.
Petitioner emphasizes that when the fire occurred on 6 April 1990 the
insurance contract was not yet subsisting pursuant to Article 1249[3] of the
Civil Code, which recognizes that a check can only effect payment once it
has been cashed. Although respondent testified that he gave the check on 5
April to a certain James Uy, the check, drawn against a Manila bank and
deposited in a Cagayan de Oro City bank, could not have been cleared by 6
April, the date of the fire. In fact, the official receipt issued for respondents
check payment was dated 10 April 1990, four days after the fire occurred.
Citing jurisprudence,[4] petitioner also contends that respondents nondisclosure of the other insurance contracts rendered the policy void. It
underscores the trial courts neglect in considering the Commission on Audits
certification that the BIR receipts submitted by respondent were, in effect,
fake since they were issued to other persons. Finally, petitioner argues that
the award of damages was excessive and unreasonable considering that it
did not act in bad faith in denying respondents claim.
Respondent refutes the reason for petitioners denial of his claim. As found by
the trial court, petitioners loss adjuster admitted prior knowledge of
Subject to the payment by the assured of the amount due prior to renewal
date, the policy shall be renewed for the period stated.
Subject to no loss prior to premium payment. If there be any loss, and is not
covered [sic].
Any payment tendered other than in cash is received subject to actual cash
collection.
Petitioner asserts that an insurance contract can only be enforced upon the
payment of the premium, which should have been made before the renewal
period.
Finally, in assailing the excessive damages awarded to respondent petitioner
stresses that the policy in issue was limited to a liability of P200,000; but the
trial court granted the following monetary awards: P200,000 as actual
damages; P200,000 as moral damages; P100,000 as exemplary damages;
and P50,000 as attorneys fees.
The following issues must be resolved: first, whether there was a valid
payment of premium, considering that respondents check was cashed after
the occurrence of the fire; second, whether respondent violated the policy by
his submission of fraudulent documents and non-disclosure of the other
existing insurance contracts; and finally, whether respondent is entitled to
the award of damages.
The general rule in insurance laws is that unless the premium is paid the
insurance policy is not valid and binding. The only exceptions are life and
industrial life insurance.[6] Whether payment was indeed made is a question
of fact which is best determined by the trial court. The trial court found, as
affirmed by the Court of Appeals, that there was a valid check payment by
respondent to petitioner. Well-settled is the rule that the factual findings and
conclusions of the trial court and the Court of Appeals are entitled to great
weight and respect, and will not be disturbed on appeal in the absence of
any clear showing that the trial court overlooked certain facts or
circumstances which would substantially affect the disposition of the case.[7]
We see no reason to depart from this ruling.
According to the trial court the renewal certificate issued to respondent
contained the acknowledgment that premium had been paid. It is not
disputed that the check drawn by respondent in favor of petitioner and
delivered to its agent was honored when presented and petitioner forthwith
issued its official receipt to respondent on 10 April 1990. Section 306 of the
Insurance Code provides that any insurance company which delivers a policy
Is respondent guilty of the policy violations imputed against him? We are not
convinced by petitioners arguments. The submission of the alleged
fraudulent documents pertained to respondents income tax returns for 1987
to 1989. Respondent, however, presented a BIR certification that he had paid
the proper taxes for the said years. The trial court and the Court of Appeals
gave credence to the certification and it being a question of fact, we hold
that said finding is conclusive.
Ordinarily, where the insurance policy specifies as a condition the disclosure
of existing co-insurers, non-disclosure thereof is a violation that entitles the
insurer to avoid the policy. This condition is common in fire insurance policies
and is known as the other insurance clause. The purpose for the inclusion of
this clause is to prevent an increase in the moral hazard. We have ruled on
its validity and the case of Geagonia v. Court of Appeals[10] clearly
illustrates such principle. However, we see an exception in the instant case.
Citing Section 29[11] of the Insurance Code, the trial court reasoned that
respondents failure to disclose was not intentional and fraudulent. The
application of Section 29 is misplaced. Section 29 concerns concealment
which is intentional. The relevant provision is Section 75, which provides
that:
A policy may declare that a violation of specified provisions thereof shall
avoid it, otherwise the breach of an immaterial provision does not avoid the
policy.
Q But in your report you never recommended the denial of the claim simply
because of the non-disclosure of other insurance? [sic]
A Yes, Your Honor.
Q In other words, to be emphatic about this, the only reason you
recommended the denial of the claim, you found three documents to be
spurious. That is your only basis?
A Yes, Your Honor.[13] [Emphasis supplied]
Indubitably, it cannot be said that petitioner was deceived by respondent by
the latters non-disclosure of the other insurance contracts when petitioner
actually had prior knowledge thereof. Petitioners loss adjuster had known all
along of the other existing insurance contracts, yet, he did not use that as
basis for his recommendation of denial. The loss adjuster, being an employee
of petitioner, is deemed a representative of the latter whose awareness of
the other insurance contracts binds petitioner. We, therefore, hold that there
was no violation of the other insurance clause by respondent.
Petitioner is liable to pay its share of the loss. The trial court and the Court of
Appeals were correct in awarding P200,000 for this. There is, however, merit
in petitioners grievance against the damages and attorneys fees awarded.
There is no legal and factual basis for the award of P200,000 for loss of
profit. It cannot be denied that the fire totally gutted respondents business;
thus, respondent no longer had any business to operate. His loss of profit
cannot be shouldered by petitioner whose obligation is limited to the object
of insurance, which was the stock-in-trade, and not the expected loss in
income or profit.
Neither can we approve the award of moral and exemplary damages. At the
core of this case is petitioners alleged breach of its obligation under a
contract of insurance. Under Article 2220 of the Civil Code, moral damages
may be awarded in breaches of contracts where the defendant acted
fraudulently or in bad faith. We find no such fraud or bad faith. It must again
be stressed that moral damages are emphatically not intended to enrich a
plaintiff at the expense of the defendant. Such damages are awarded only to
enable the injured party to obtain means, diversion or amusements that will
serve to obviate the moral suffering he has undergone, by reason of the
defendants culpable action. Its award is aimed at the restoration, within the
limits of the possible, of the spiritual status quo ante, and it must be
proportional to the suffering inflicted.[14] When awarded, moral damages
must not be palpably and scandalously excessive as to indicate that it was
the result of passion, prejudice or corruption on the part of the trial court
judge.[15]
The law[16] is likewise clear that in contracts and quasi-contracts the court
may award exemplary damages if the defendant acted in a wanton,