Vda. De Gabriel v.

CA
FACTS:
Marcelino Gabriel was employed by Emerald Construction & Development
Corporation (Emerald Construction for brevity) at its construction project in Iraq. He
was covered by a personal accident insurance in the amount of P100,000.00 under
a group policy procured from Fortune Insurance & Surety Company (Fortune
Insurance for brevity)by Emerald Construction for its overseas workers. The insured
risk was for bodily injury caused by violent accidental external and visible means
which injury would solely and independently of any other cause result in death or
disability. On 22 May 1982, within the life of the policy, Gabriel died in Iraq. On 12
July 1983,Emerald Construction reported Gabriels death to Fortune Insurance by
telephone. Among the documents thereafter submitted to Fortune Insurance were a
copy of the death certificate issued by the Ministry of Health of the Republic of Iraq
which stated that an autopsy report by the National Bureau of Investigation was
conducted to the effect that due to advanced state of post mortem decomposition,
the cause of death of Gabriel could not be determined (emphasis added).Because of
this development Fortune Insurance ultimately denied the claim of Emerald
Construction on the ground of prescription. Gabriels widow, Jacqueline Jimenez,
went to the to the lower court. In her complaint against Emerald Construction and
Fortune Insurance, she averred that her husband died of electrocution while in the
performance of his work. Fortune Insurance alleged that since both the death
certificate issued by the Iraqi Ministry of Health and the autopsy report of the NBI
failed to disclose the cause of Gabriels death, it denied liability under the policy. In
addition, private respondent raised the defense of prescription, invoking Section
384 of the Insurance Code.
ISSUE:
WON Jacqueline Jimenez vda. de Gabriels claim against Fortune Insurance should
be denied on the ground of prescription
HELD:
Yes. Section 384 of the Insurance Code provides :Sec. 384. Any person having any
claim upon the policy issued pursuant to this chapter shall, without any
unnecessary delay, present to the insurance company concerned a written notice of
claim setting forth the nature, extent and duration of the injuries sustained as
certified by a duly licensed physician. Notice of claim must be filed within six
months from date of the accident, otherwise, the claim shall be deemed waived.
Action or suit for recovery of damage due to loss or injury must be brought, in
proper cases, with the Commissioner or the Courts within one year from denial of
the claim, otherwise, the claimants right of action shall prescribe. The notice of
death was given to Fortune Insurance, concededly, more than a year after the death
of vda. de Gabriels husband. Fortune Insurance, in invoking prescription, was not
referring to the one-year period from the denial of the claim within which to file an
action against an insurer but obviously to the written notice of claim that had to be
submitted within six months from the time of the accident. Vda. de Gabriel argues
that Fortune Insurance must be deemed to have waived its right to show that the
cause of death is an excepted peril, by failing to have its answers duly verified. It is
true that a matter of which a written request for admission is made shall be deemed
impliedly admitted unless, within a period designated in the request, which shall not
be less than 10 days after service thereof, or within such further time as the court
may allow on motion and notice, the party to whom the request is directed serves
upon the party requesting the admission a sworn statement either denying
specifically the matters of which an admission is requested or setting forth in detail
the reasons why he cannot truthfully either admit or deny those matters; however,
the verification, like in most cases required by the rules of procedure, is a formal,
not jurisdictional, requirement, and mainly intended to secure an assurance that
matters which are alleged are done in good faith or are true and correct and not of
mere speculation. When circumstances warrant, the court may simply order the
correction of unverified pleadings or act on it and waive strict compliance with the
rules in order that the ends of justice may thereby be served. In the case of answers
to written requests for admission particularly, the court can allow the party making
the admission, whether made expressly or deemed to have been made impliedly, to
withdraw or amend it upon such terms as may be just. The insurance policy
expressly provided that to be compensable, the injury or death should be caused by
violent accidental external and visible means. In attempting to prove the cause of
her husbands death, all that vda. de Gabriel could submit were a letter sent to her
by her husbands co-worker, stating that Gabriel died when he tried to haul water
out of a tank while its submerged motor was still functioning, and vda. de Gabriels
sworn affidavit. The said affidavit, however, suffers from procedural infirmity as it
was not even testified to or identified by vda. de Gabriel herself. This affidavit
therefore is a mere hearsay under the law. In like manner, the letter allegedly
written by the deceaseds co-worker which was never identified to in court by the
supposed author, suffers from the same defect as the affidavit of vda. de Gabriel.
Not one of the other documents submitted, to wit, the POEA decision, the death
certificate issued by the Ministry of Health of Iraq and the NBI autopsy report, could
give any probative value to vda. de Gabriels claim. The POEA decision did not make
any categorical holding on the specific cause of Gabriels death. In summary,
evidence is utterly wanting to establish that the insured suffered from an accidental
death, the risk covered by the policy.

Tiu vs. Arriesgado Case Digest

Tiu vs. Arriesgado
G.R. No. 138060, September 1, 2004

Facts: At about 10:00 p.m. of March 15, 1987, the cargo truck marked "Condor
Hollow Blocks and General Merchandise" bearing plate number GBP-675 was loaded
with firewood in Bogo, Cebu and left for Cebu City. Upon reaching Sitio Aggies,
Poblacion, Compostela, Cebu, just as the truck passed over a bridge, one of its rear
tires exploded. The driver, Sergio Pedrano, then parked along the right side of the
national highway and removed the damaged tire to have it vulcanized at a nearby
shop, about 700 meters away. Pedrano left his helper, Jose Mitante, Jr. to keep watch
over the stalled vehicle, and instructed the latter to place a spare tire six fathoms
away behind the stalled truck to serve as a warning for oncoming vehicles. The
trucks tail lights were also left on. It was about 12:00 a.m., March 16, 1987.
At about 4:45 a.m., D Rough Riders passenger bus with plate number PBP-724
driven by Virgilio Te Laspias was cruising along the national highway of Sitio
Aggies, Poblacion, Compostela, Cebu. The passenger bus was also bound for Cebu
City, and had come from Maya, Daanbantayan, Cebu. Among its passengers were
the Spouses Pedro A. Arriesgado and Felisa Pepito Arriesgado, who were seated at
the right side of the bus, about three (3) or four (4) places from the front seat.

As the bus was approaching the bridge, Laspias saw the stalled truck, which was
then about 25 meters away. He applied the breaks and tried to swerve to the left to
avoid hitting the truck. But it was too late; the bus rammed into the trucks left rear.
The impact damaged the right side of the bus and left several passengers injured.
Pedro Arriesgado lost consciousness and suffered a fracture in his right colles. His
wife, Felisa, was brought to the Danao City Hospital. She was later transferred to the
Southern Island Medical Center where she died shortly thereafter.

Respondent Pedro A. Arriesgado then filed a complaint for breach of contract of

carriage, damages and attorneys fees before the Regional Trial Court of Cebu City,
Branch 20, against the petitioners, D Rough Riders bus operator William Tiu and his
driver, Virgilio Te Laspias on May 27, 1987. The respondent alleged that the
passenger bus in question was cruising at a fast and high speed along the national
road, and that petitioner Laspias did not take precautionary measures to avoid the
accident.

The petitioners, for their part, filed a Third-Party Complaint against the following:
respondent Philippine Phoenix Surety and Insurance, Inc. (PPSII), petitioner Tius
insurer; respondent Benjamin Condor, the registered owner of the cargo truck; and
respondent Sergio Pedrano, the driver of the truck. They alleged that petitioner
Laspias was negotiating the uphill climb along the national highway of Sitio Aggies,
Poblacion, Compostela, in a moderate and normal speed. It was further alleged that
the truck was parked in a slanted manner, its rear portion almost in the middle of
the highway, and that no early warning device was displayed. Petitioner Laspias
promptly applied the brakes and swerved to the left to avoid hitting the truck head-
on, but despite his efforts to avoid damage to property and physical injuries on the
passengers, the right side portion of the bus hit the cargo trucks left rear.

HELD: The rules which common carriers should observe as to the safety of their
passengers are set forth in the Civil Code, Articles 1733, 1755and 1756. It is
undisputed that the respondent and his wife were not safely transported to the
destination agreed upon. In actions for breach of contract, only the existence of
such contract, and the fact that the obligor, in this case the common carrier, failed
to transport his passenger safely to his destination are the matters that need to be
proved. This is because under the said contract of carriage, the petitioners assumed
the express obligation to transport the respondent and his wife to their destination
safely and to observe extraordinary diligence with due regard for all circumstances.
Any injury suffered by the passengers in the course thereof is immediately
attributable to the negligence of the carrier. Upon the happening of the accident,
the presumption of negligence at once arises, and it becomes the duty of a common
carrier to prove that he observed extraordinary diligence in the care of his
passengers. It must be stressed that in requiring the highest possible degree of
diligence from common carriers and in creating a presumption of negligence against
them, the law compels them to curb the recklessness of their drivers. While
evidence may be submitted to overcome such presumption of negligence, it must
be shown that the carrier observed the required extraordinary diligence, which
means that the carrier must show the utmost diligence of very cautious persons as
far as human care and foresight can provide, or that the accident was caused by
fortuitous event. As correctly found by the trial court, petitioner Tiu failed to
conclusively rebut such presumption. The negligence of petitioner Laspias as
driver of the passenger bus is, thus, binding against petitioner Tiu, as the owner of
the passenger bus engaged as a common carrier.

Bonifacio Bros. v. Mora

20 SCRA 262

Facts:

> Enrique Mora mortgaged his Odlsmobile sedan car to HS Reyes Inc. with the
condition that Mora would insure the car with HS Reyes as beneficiary.

> The car was then insured with State Insurance Company and the policy delivered
to Mora.

> During the effectivity of the insurance contract, the car figured in an accident.
The company then assigned the accident to an insurance appraiser for investigation
and appraisal of the damage.

> Mora without the knowledge and consent of HS Reyes, authorized Bonifacio Bros
to fix the car, using materials supplied by the Ayala Auto Parts Company.

> For the cost of Labor and materials, Mora was billed P2,102.73. The bill was sent
to the insurers appraiser. The insurance company drew a check in the amount of
the insurance proceeds and entrusted the check to its appraiser for delivery to the
proper party.

> The car was delivered to Mora without the consent of HS Reyes, and without
payment to Bonifacio Bros and Ayala.
> Upon the theory that the insurance proceeds should be directly paid to them,
Bonifacio and Ayala filed a complaint against Mora and the insurer with the
municipal court for the collection of P2,102.73.

> The insurance company filed its answer with a counterclaim for interpleader,
requiring Bonifacio and HS Reyes to interplead in order to determine who has a
better right to the proceeds.

Issue:

Whether or not there is privity of contract between Bonficacio and Ayala on one
hand and State Insurance on the other.

Held:

NONE.

It is fundamental that contracts take effect only between the parties thereto, except
in some specific instance provided by law where the contract contains some
stipulation in favor of a third person. Such stipulation is known as a stipulation pour
autrui; or a provision in favor of a third person not a party to the contract.

Under this doctrine, a third person is ed to avail himself of a benefit granted to him
by the terms of the contract, provided that the contracting parties have clearly and
deliberately conferred a favor upon such person. Consequently, a third person NOT
a party to the contract has NO action against the aprties thereto, and cannot
generally demand the enforcement of the same.

The question of whether a third person has an enforceable interest in a contract

must be settled by determining whether the contracting parties intended to tender
him such an interest by deliberately inserting terms in their agreement with the
avowed purpose of conferring favor upon such third person. IN this connection, this
court has laid down the rule that the fairest test to determine whether the interest
of a 3rd person in a contract is a stipulation pour autrui or merely an incidental
interest, is to rely upon the intention of the parties as disclosed by their contract.
In the instant case the insurance contract does not contain any words or clauses to
disclose an intent to give any benefit to any repairmen or material men in case of
repair of the car in question. The parties to the insurance contract omitted such
stipulation, which is a circumstance that supports the said conclusion. On the other
hand, the "loss payable" clause of the insurance policy stipulates that "Loss, if any,
is payable to H.S. Reyes, Inc." indicating that it was only the H.S. Reyes, Inc. which
they intended to benefit.

A policy of insurance is a distinct and independent contract between the insured

and insurer, and third persons have no right either in a court of equity, or in a court
of law, to the proceeds of it, unless there be some contract of trust, expressed or
implied, by the insured and third person. In this case, no contract of trust, express
or implied. In this case, no contract of trust, expressed or implied exists. We,
therefore, agree with the trial court that no cause of action exists in favor of the
appellants in so far as the proceeds of insurance are concerned. The appellant's
claim, if at all, is merely equitable in nature and must be made effective through
Enrique Mora who entered into a contract with the Bonifacio Bros Inc. This
conclusion is deducible not only from the principle governing the operation and
effect of insurance contracts in general, but is clearly covered by the express
provisions of section 50 of the Insurance Act (now Sec. 53).

The policy in question has been so framed that "Loss, if any, is payable to H. S.
Reyes, Inc." which unmistakably shows the intention of the parties.

Insular Life vs. Ebrado

80 SCRA 181

Facts:

> Buenaventura Ebrado was issued al life plan by Insular Company. He designated
Capriona as his beneficiary, referring to her as his wife.

> The insured then died and Carponia tried to claim the proceeds of the said plan.

> She admitted to being only the common law wife of the insured.
> Pascuala, the legal wife, also filed a claim asserting her right as the legal wife.
The company then filed an action for interpleader.

Issue:

Whether or not the common law wife named as beneficiary can collect the
proceeds.

Held:

NO.

The civil code prohibitions on donations made between persons guilty of adulterous
concubinage applies to insurance contracts. On matters not specifically provided
for by the Insurance Law, the general rules on Civil law shall apply. A life insurance
policy is no different from a civil donation as far as the beneficiary is concerned,
since both are founded on liberality.

Why was the common law wife not ed to collect the proceeds despite the fact that
she was the beneficiary? Isnt this against Sec. 53?

It is true that SC went against Sec. 53. However, Sec. 53 is NOT the only provision
that the SC had to consider. Art. 739 and 2012 of CC prohibit persons who are
guilty of adultery or concubinage from being beneficiaries of the life insurance
policies of the persons with whom they committed adultery or concubinage. If the
SC used only Sec. 53, it would have gone against Art. 739 and 2012.

Vda. De Consuegra v. GSIS - Retirement Insurance Benefits

37 SCRA 315

Facts:

> Jose Consuegra was employed as a shop foreman of the Office of the District
Engineer in Surigao Del Norte.

> When he was still alive, he contracted two marriages:

o First Rosario Diaz; 2 children = Jose Consuegra Jr. and Pedro but both
predeceased him

o 2nd Basilia Berdin; 7 children. (this was contracted in GF while the first
marriage subsisted)

> Being a GSIS member when he died, the proceeds of his life insurance were paid
by the GSIS to Berdin and her children who were the beneficiaries named in the
policy.

> Since he was in the govt service for 22.5028 years, he was entitled to retirement
insurance benefits, for which no beneficiary was designated.

> Both families filed their claims with the GSIS, which ruled that the legal heirs
were Diaz who is entitled to one-half or 8/16 of the retirement benefits and Berdin
and her children were entitled to the remaining half, each to receive an equal share
of 1/16.

> Berdin went to CFI on appeal. CFI affirmed GSIS decision.

Issue:

To whom should the retirement insurance benefits be paid?

Held:

Both families are entitled to half of the retirement benefits.

The beneficiary named in the life insurance does NOT automatically become the
beneficiary in the retirement insurance. When Consuegra, during the early part of
1943, or before 1943, designated his beneficiaries in his life insurance, he could
NOT have intended those beneficiaries of his life insurance as also the beneficiaries
of his retirement insurance because the provisions on retirement insurance under
the GSIS came about only when CA 186 was amended by RA 660 on June 18, 1951.

Sec. 11(b) clearly indicates that there is need for the employee to file an application
for retirement insurance benefits when he becomes a GSIS member and to state his
beneficiary. The life insurance and the retirement insurance are two separate and
distinct systems of benefits paid out from 2 separate and distinct funds.

In case of failure to name a beneficiary in an insurance policy, the proceeds will

accrue to the estate of the insured. And when there exists two marriages, each
family will be entitled to one-half of the estate.