Professional Documents
Culture Documents
NON-LIFE INSURANCE
Topics
NO
liability
if
insured risk is only
a remote cause or
if proximate cause is an excepted peril
Concept of loss - injury, damage, liability, loss of
income or profits sustained by the insured in
consequence of the happening of one or more perils
insured against (Bonifacio Bros. V. Mora, 20 SCRA 261)
An owner gets fire insurance for his house and all furniture
inside.
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ANSWER
Proximate Cause
Section 87:
Loss in the course of rescue
Suggested Answer
No, Matino is wrong in denying the claim.
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INSURABLE INTEREST
Concept, Section 13
an
existing
Suggested answer
(B) A general creditor on debtors property
Insurable interest in a
mortgaged property (Sec. 8)
Forms, Sec. 14
interest
Factual Expectation
life
Bar 2012
A house and lot is covered by a real estate mortgage (REM) in favor
of ZZZ Bank. The bank required that the house be insured. The
owner of the policy failed to endorse nor assign the policy to the
bank. However, the Deed of Real Estate Mortgage has an express
provision which says that the insurance policy is also endorsed with
the signing of the REM. Will this be sufficient?
A.
B.
C.
D.
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Suggested Answer
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D.
ANSWER
ANSWER
C.
B.
existing at the time of perfection and at the time of
loss for property insurance but only at the time of perfection
for life insurance.
INSURABLE INTEREST:
jurisprudence
Illustration
A sells the car to B. The policy was not included in the sale.
When
insurable
property insurance
interest
must
exist
in
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Illustration
A dies
ANSWER
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For both the Life Insurance and Property Insurance, the insurable
interest is required to be A.
B.
POLICY
KINDS
Open v. Valued
When the insurer has renewed the insurance over the years
under a clear credit term arrangement (UCPB case)
Illustration: Open
Value of the building: to be determined at time of loss
Face Value: P10 Million
Illustration: Valued
Valuation of the car : P15 Million
Face Value
: P 10 Million
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Illustration: Running
As of June 1, 2014 value of goods P1 Million
PREMIUM
Premium by installment:
Makati Tuscany v. CA
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Suggested Answer
P1,200,000.00
P24,000.00
TOTAL
P1,800,000.00
P36,000.00
If the check was properly dated, this means that there was a
valid credit extension scheme or period between the parties.
Hence, there was a valid policy and there should be
payment of proceeds, less the amount of premiums.
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Amount of insurance
Premiums Paid
A company
Suggested Answer
Insurer
ADDITIONAL PREMIUMS
NOTE!
RATABLE RETURN
OVERINSURANCE
OF
PREMIUM
IN
CASE
OF
Insurer- Bancassurance
No insurance product under this section, whether life or nonlife, shall be issued or delivered unless in the form
previously approved by the Commissioner.
How to compute:
STEP 1: Determine amount overinsured
Amount overinsured =
Amount of insurance value of property
P300,000/P1,800,000.00 = 1/6
Ratable Return
STEP 3: Multiply the ratio to the amount of premium paid to every
insurer
A= 1/6 of P24,000 = P4,000 from A Company
B= 1/6 of P12,000 = P2,000 from B Company
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PARTIES
Insurer
InsuredBeneficiary
The beneficiary
Mutualization
Insurer
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A.
B.
C.
A.
B.
C.
Over-insurance
OVER- INSURANCE amount of insurance is beyond the value
of insureds insurable interest
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Self-Regulatory Organizations
Trust Business
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In double insurance, the insurers are considered as coinsurers. Each one is bound to contribute ratably to the loss
in proportion to the amount for which he is liable under his
contract (Sec. 96e)
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X insured the building she owns with two (2) insurance companies for
the same amount. In case of damage, A.
B.
C.
D.
X can not claim from any of the two (2) insurers because with
the double insurance, the insurance coverage becomes
automatically void.
the two (2) insurers will be solidarily liable to the extent of the
loss.
the two (2) insurers will be proportionately liable.
X can choose who he wants to claim against.
ANSWER: D
without extra-ordinary
Reinsurance
Contract by which an insurer procures a third person to insure
him against loss or liability by reason of an original insurance
Illustration
Reinsurance
v.
Double Insurance
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Perils of the ship, under marine insurance law, refer to loss
which in the ordinary course of events results from
A.
B.
C.
D.
Answer
insurer becomes
the insured
subject of
insurance is the
original insurers
risk
Insurer remains
the insurer
subject of
insurance is
property
Illustration
insurance of a
different interest
insurance of the
same interest
original insured is
not a party
insured is the
party in interest
in all contracts
As insurer = P500,000
Bs insurer = P500,000
consent of original
insured is not
necessary
Insured has to
give his consent
FIRE
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Measure of Indemnity
Suggested Answer
Illustration
CASUALTY INSURANCE
Casualty Insurance
Employers liability
At a glance
Suggested Answer
In Life Insurance
WHEN
Exceptions:
annuity
PART FOUR:
PAYMENT OF PROCEEDS
AND FILING OF CLAIMS
Basic Rule in Recovery
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If beneficiary:
is a minor OR
for
NON-LIFE INSURANCE
WHEN
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Ascertainment of loss
A.
C.
B.
D.
ILLUSTRATION
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Accident
Within six months, file written notice of claim.
Filed after six months = waived claim
Notice must contain nature, extent, duration of injuries certified by a licensed physician
Suggested answer
Jack is wrong.
If no agreement is reached
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Must be written
Subrogation
C. No, since the proximate cause of the damage was the breach
of warranty of seaworthiness of the ship.
D. No, since the proximate cause of the damage was due to
ordinary usage of the ship, and thus not due to a peril of the sea.
recoverable
Answer
Marine
Only covers loss due to perils of the sea and not perils of the
ship
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General Average
Particular Average
Suggested Answer
Average
Reshipment
A.
B.
C.
D.
actual.
constructive first and if it fails, then actual.
either actual or constructive.
constructive.
Answer:
A. actual.
Abandonment
Kinds of loss in marine
Loss in marine
Partial
Total
Actual
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Constructive
A.
B.
C.
D.
Answer
If insurer pays for loss as if there was actual total loss, BUT there
was no formal abandonment,Insurer is entitled to whatever may
remain of the thing insured or its proceeds of salvage (147)
Abandonment
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Illustration
HOWEVER,
freightage
earned
before loss will belong to the insurer
of the goods
B will now have the right over the vessel, what remains
of it and proceeds of salvage
Constructive
Actual
Measure of Indemnity
Marine insurer is liable for partial loss only for such proportion
of the amount insured by him as the loss bears to the value of
the whole interest.
Generally allowed
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C.
D.
Answer
Litigation of Claims
(e) Enlist the aid and support of, and/or deputize any and all
enforcement agencies of the government in the
implementation of its powers and functions under this Code;
Administrative Powers
Insurance Commissioner
Administrative Powers
Adjudicatory Powers
Adjudicatory Powers
Administrative Powers
Administrative Powers
(l) Investigate not oftener than once a year from the last
date of examination to determine whether an institution is
conducting its business on a safe and sound basis:
Provided, That, the deficiencies/irregularities found by or
discovered by an audit shall be immediately addressed;
Administrative Powers
Administrative Powers
Administrative Powers
Administrative Powers
has sole and exclusive authority to regulate the issuance and sale
of variable contracts as defined in Section 238 hereof and to provide
for the licensing of persons selling such contracts, and to issue such
reasonable rules and regulations governing the same.
Administrative Powers
Administrative Powers
Administrative Powers
(c) Impose sanctions for the violation of laws and the rules,
regulations and orders issued pursuant thereto;
Resident agent
registration)
Adjusters Actuary
of
foreign
insurer
(certificate
Unlawful Claims
At a glance
At a glance
Actual loss
At a glance
Administrative Powers
Administrative Powers
Framework
PART FIVE
GROUNDS
Concealment
Misrepresentation
CONCEALMENT
CONCEALMENT
Requisites of Concealment
to
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He makes no warranty
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Answer
By terms of insurance OR
Requisites of Concealment
a)
b)
TEST OF MATERIALITY
Determined not by event
TEST OF MATERIALITY
Materiality
CONCEALMENT
In Marine Insurance
in addition to Section 28
CONCEALMENT
In Marine Insurance
Section 110
Concealment as to following does NOT vitiate the entire
contract but exonerates the insurer from loss resulting from risk
concealed.
(a) national character of insured
(b) liability of thing insured to capture and detention
Section 110
INCONTESTABILITY
LIFE INSURANCE
CLAUSE
IN
Section 48, 2nd par if life insurance has been in force during
the lifetime of the insured for a period of 2 years from DATE OF
ISSUE or LAST REINSTATEMENT
the insurer cannot prove that the policy is void ab initio or is
rescindible
by reason of fraudulent concealment or misrepresentation of
the insured or his agent.
5. Aban was the one who filed the insurance application and
designated herself as the beneficiary.
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Illustration
Suggested Answer
Suggested Answer
MISREPRESENTATION
MISREPRESENTATION
MISREPRESENTATION
Statement
When
Incontestability
DOES NOT apply
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Clause
A.
that life insurance proceeds cannot be claimed two (2) years
after the death of the insured.
B.
that two (2) years after date of issuance or reinstatement of
the life insurance policy, the insurer cannot anymore prove that the
policy is void ab initio or rescindable by reason of fraudulent
concealment or misrepresentation of the insured.
C.
that the insured can still claim from the insurance policy
after two (2) years even though premium is not paid.
D.
that the insured can only claim proceeds in a life insurance
policy two (2) years after death.
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On April 10, 1996, Sotero died. Aban filed a claim for the
insurance proceeds on July 9, 1996. Ilocos Life conducted
its
assertion
Misrepresentations
in Life Insurance
no rescission
Misrepresentation
in Marine Insurance
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as
to
Age
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Answer
Answer
Breach of Warranty
Warranty
Nationality
Other
Ground
non life insurance
Seaworthiness - 113
Nationality or neutrality 120
Improper deviation -121
Illegal ventures
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Seaworthiness
Seaworthiness
Improper Deviation
for
Rescission
in
Notice of Cancellation
In writing
Notice of Cancellation
Shall state
grounds relied on