Insurance Bar Questions Compilation
Insurance Bar Questions Compilation
Insurance Bar Questions Compilation
Insurance Code
1. A group of Malaysians wanted to invest in the Philippines insurance business. After negotiations, they
agreed to FIMA Insurance Corp. with a group of Filipino businessmen. FIMA would have a P50 M paid
up capital. P40 M of which would come up from the Filipino group. All corporate officers would be
Filipinos and 8 out of 10-member Board of Directors would be Filipinos. Can FIMA operate an insurance
business in the Philippines?
a. No, since an insurance company must have at least P74 M paid up capital.
b. Yes, since there is substantial compliance with our nationalization laws respecting paid-up capital
and Filipino dominated Board of Directors.
c. Yes, since FIMAs paid up capital more than meets the countrys nationalization laws.
d. No, since an insurance company should be 100% owned by Filipinos.
Answer:
a. No, since an insurance company must have at least P74 M paid up capital. (BAR 2011)
NB The minimum paid up capital requirement for a new insurance company is now P 1 billion
A. Concept of Insurance
1. May a member of the MILF or its breakaway group, the Abu Sayyaf, be insured with a company licensed
to do business under the Insurance Code of the Philippines? Explain.
b) BD has a bank deposit of half a million pesos. Since the limit of the insurance coverage of the PDIC is
only 1/10 of BDs deposit, he would like some protection for the excess by taking out an insurance
against all risk or contingencies of loss arising from any unsound or unsafe banking practices
including unforeseen adverse effects of the continuing crisis involving the banking and financial
sector in the Asian region. Does BD have an insurable interest within the meaning the Insurance
Code of the Philippines?
Answer:
a) A member of the MILF or the Abu Sayyaf may be insured with a company licensed to do business under the
Insurance Code of the Philippines. What is prohibited to be insured is a public enemy. A public enemy is a
citizen or national of a country with which the Philippines is at war. Such member of the MILF or the Abu
Sayyaf is not a citizen or national of another country, but of the Philippines.
b) Yes. BD has insurable interest in his bank deposit. In case of loss of said deposit, more particularly to the
extent of the amount in excess of the limit covered by the PDIC Act, BD will be damnified. He will suffer
pecuniary loss of P400,000, that is, his bank deposit of half a million pesos minus P100,000 which is the
maximum amount recoverable from the PDIC. (BAR 2000)
Answer:
A mutual insurance company is a cooperative enterprise where the members are both the insurer and the
insured. In it, the members all contribute, by a system of premiums or assessments, to the creation of a fund
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from which all losses and liabilities are paid, and where the profits are divided among themselves, in proportion
of their interest. (BAR 2006)
3. In return for the 20 years of faithful service of X as a house helper to Y, the latter promised to pay
P100,000 to Xs heirs if he (X) dies in an accident by fire. X agreed. Is this an insurance contract?
Answer:
b) No, since Y actually made a conditional donation in Xs favor. (BAR 2011)
1. The Civil Code adopts the theory of cognition, while the Code of Commerce generally recognizes the
theory of manifestation, in the perfection of contracts. How do these two theories differ?
Answer:
Under the theory of cognition, the acceptance is considered to effectively bind the offeror only from the time it
came to his knowledge. Under the theory of manifestation, the contract is perfected at the moment when the
acceptance is declared or made by the offeree. (BAR 1997)
2. An Insurance Contract is a contract of adhesion, which means that in resolving ambiguities in the
provision of the insurance contract
a) The general rule is that, the insurance contract is to be interpreted strictly in accordance with what
is written in the contract;
b) Are to be construed liberally in favor of the insured and strictly against the insurer who drafted the
insurance policy;
c) Are to be construed strictly against the insured and liberally in favor of the insurer;
d) If there is an ambiguity in the insurance contract, this will invalidate the contract.
Answer:
b) Are to be construed liberally in favor of the insured and strictly against the insurer who drafted the insurance
policy. (BAR 2012)
a) An insurer will pay the insured equivalent to the amount of the premium;
b) The obligation of the insurer is to pay depending upon the happening of an uncertain event;
c) The insured pays a fixed premium for the duration of the policy period and the amount of the
premiums paid to the insurer is not necessarily the same amount as what the insured will get upon
the happening of an uncertain future event;
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d) The obligation of the insurer is to pay depending upon the happening of an event that is certain to
happen.
Answer:
b) The obligation of the insurer is to pay depending upon the happening of an uncertain event. (BAR 2012)
1. Insurer
1. X Company procured a group accident insurance policy for its construction employees variously assigned
to its provincial infrastructure projects. Y Insurance Company underwrote the coverage, the premiums
of which were paid for entirely by X Company without any employee contributions. While the policy was
in effect, five of the covered employees perished at sea on their way to their provincial assignments.
Their wives sued Y Insurance Company for payment of death benefits under the policy. While the suit
was pending, the wives signed a power of attorney designating an X Company executive. PJ as their
authorized representative to enter into a settlement with the insurance company. When a settlement
was reached, PJ instructed the insurance company to issue a settlement check to the order of the X
Company, which will undertake the payment to the individual claimants of their respective shares. PJ
misappropriated the settlement amount and the wives pursued their case against Y Insurance
Company. Will the suit prosper? Explain.
Answer:
Yes. The suit will prosper. Y insurance Company is liable. X Company, through its executive, PJ, acted as agent of
Y Insurance Company. The latter is thus bound by the misconduct of its agent. It is the usual practice in the
group insurance business that the employer-policy holder is the agent of the issuer. (BAR 2000)
2. Insured
3. Beneficiary
1. On July 1, 1979, Crispulo, married to Laura with whom he has two legitimate children, was issued Policy
No. 8008 of the Midland Life Insurance Co. on a whole-life plan for P10,000. He designated Angie, his
common-law wife as the recoverable beneficiary. He referred to her, in his application and policy, as his
wife.
Two years later, Crispulo died. Angie filed her claim for the proceeds of the policy as the designated
beneficiary therein. The widow, Laura, also filed her claim as legal wife.
If you were the Legal Counsel for the Insurance Company, to whom would you adjudicate the proceeds
of the insurance policy? Reason out your answer briefly.
Answer:
I would adjudicate the proceeds of the insurance policy to Laura, the legal wife. In the appointment of
beneficiary, the New Civil Code imposed certain limitations; one of them being that the insured may not
appoint, as his beneficiary, one with whom he is guilty of concubinage, at the time of designation. Since Crispulo
was married to Laura at the time when he designated as his beneficiary his concubine Angie, with whom he was
guilty of concubinage at the time of designation, Laura may have said designation of Angie nullified, by mere
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preponderance of evidence in the same action for nullification. There is even no need of the criminal conviction
for concubinage. (Arts. 739 and 2012, N.C.C.; Insular Life assn. Co., Ltd. v. Ebrado, Oct. 28, 1977; 80 SCRA 181)
(BAR 1981, )
2. On December 20, 1974, A took out a life insurance policy and named his wife B, as beneficiary. The
policy was silent with regard to any change of beneficiary. Suspecting that B was committing adultery, A
immediately notified the insurance company in writing that he is substituting his brother C as
beneficiary in place of B. A died later on June 30, 1975. B claims the proceeds of the insurance policy,
contending that as designated beneficiary, she cannot be changed without her consent, she having
acquired a vested right to the proceeds of the policy. Decide. Give reasons for your answer.
Answer:
B cannot claim the proceeds of As life insurance policy. As action in substituting his brother C as his beneficiary in
place of B, his wife, in his insurance policy, is valid. The insured, A, can change the beneficiary in a policy of life
insurance, without the consent of the beneficiary. (BAR 1978)
3. Eduardo Fernandez applied for and was issued Policy No. 0777 by Atlas Life Insurance Corporation on a
whole-life plan for P200,000. Although he was married to Clara, with whom he had 5 legitimate
children, he designated his common-law wife, Diana Cruz, as his revocable beneficiary in the policy, and
referred to Diana in his application and policy, as his wife. 5 years thereafter, he died. Diana
immediately filed her claim for the proceeds of the policy as the designated beneficiary. Clara also filed
her claim as legal wife. The insurance company filed a petition for Interpleader before the RTC of Rizal
to determine who should be entitled to the proceeds of the policy.
If you were the judge, how would you decide the said interpleader action? Explain.
Answer:
If I were the judge, I would decide that the legal wife, Clara, be entitled to the proceeds of insurance taken by
Eduardo Fernandez who named his common-law wife, Diana, as his revocable beneficiary, at the time they were
guilty of concubinage. In that case, the designation of Diana is void, being prohibited by the New Civil Code (Art.
739 and 2012). The guilt of Eduardo and Diana for concubinage may be proved by mere preponderance of
evidence in the same action and there is no need for a criminal conviction for concubinage. (BAR 1985)
4. On October 18, 1980, P, took out a life insurance policy and named his only son Q as beneficiary. The
policy was silent with regard to any change of beneficiary. P later learned that Q was hooked on drugs
and immediately notified the insurance company in writing that he is substituting his sister, R, as his
beneficiary in place of Q. P later died of advanced tuberculosis. In the application form filled up by the
agent of the insurance company prior to the issuance of the life insurance policy by the insurance
company, the agent, without the knowledge of P, filled in a false answer and made it appear that P was
in good health. Upon Ps death, Q claimed the proceeds of the insurance policy contending that as
designated beneficiary, he cannot be changed without his consent, he having acquired a vested right to
the proceeds of the policy.
Answer:
a) No, the designation of the beneficiary is revocable unless the right to revoke is waived. (BAR 1988)
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5. Juan de la Cruz was issued Policy No. 8888 of the midland Life Insurance Co. On a whole life plan for
P20,000 on August 19, 1989. Juan de la Cruz is married to Cynthia with whom he has three legitimate
children. He, however, designated Purita, his common-law-wife, as the revocable beneficiary. Juan de la
Cruz referred to Purita in his application and policy as the legal wife.
3 years later, Juan de la Cruz died. Purita filed her claim for the proceeds of the policy as the designated
beneficiary therein. The widow, Cynthia, also filed a claim as the legal wife. To whom should the
proceeds of the insurance policy be awarded?
Answer:
The proceeds of the insurance policy shall be awarded to the estate of Juan. Purita, the common-law wife, is
disqualified as the beneficiary of the deceased because of illicit relation between the deceased and Purita, the
designated beneficiary. Due to such illicit relation, Purita cannot be a donee of the deceased. Hence, she cannot
also be his beneficiary. (BAR 1998)
6. Jacob obtained a life insurance policy for P1 M designating irrevocably Diwata, a friend, as his
beneficiary, Jacob, however, changed his mind and wants Yob and Jojo, his other friends, to be included
as beneficiaries considering that the proceeds of the policy are sufficient for the three friends.
Can Jacob still add Yob and Jojo as his beneficiaries? Explain.
Answer:
The insured cannot add other beneficiaries as this would diminish the interest of Diwata who is the irrevocably
designated beneficiary. The insured can only do so with the consent of Diwata. (BAR 2005)
7. What are the effects of an irrevocable designation of a beneficiary under the Insurance Code? Explain.
Answer:
The irrevocable beneficiary has a vested interest in the policy, including its incident such as the policy loan and
cash surrender value. (BAR 2005)
8. On January 1, 2000, Antonio Rivera secured a life insurance from SOS Insurance Corp. for P1 M with
Gemma Rivera, his adopted daughter, as the beneficiary. Antonio Rivera died on March 4, 2005 and in
the police investigation, it was ascertained that Gemma Rivera participated as an accessory in the
killing of Antonio Rivera. Can SOS Insurance Corp. avoid liability by setting up as a defense the
participation of Gemma Rivera in the killing of Antonio Rivera? Discuss with reasons.
Answer:
SOS cannot avoid liability under the policy. While Gemmas interest as beneficiary in the policy is considered
forfeited since she is an accessory to the killing of Antonio, the proceeds of the policy should be paid to the
nearest relative of Antonio (if not otherwise disqualified). The Insurance Code provides that the interest of a
beneficiary in a life insurance policy shall be forfeited when the beneficiary is the principal, accomplice, or
accessory in willfully bringing about the death of the insured; in which event, the nearest relative of the insured
shall receive the proceeds of said insurance if not otherwise disqualified. (BAR 2008)
9. X is the common law wife of Y. Y loves X so much that he took out a life insurance on his own life and
made her the sole beneficiary. Y did this to ensure that X will be financially comfortable when he is
gone. Upon the death of Y
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a) X as sole beneficiary under the life insurance policy on the life of Y will be entitled to the proceeds of
the life insurance;
b) Despite the designation of X as the sole beneficiary, the proceeds of the life insurance will go to the
estate of Y;
c) The proceeds of the life insurance will go to the compulsory heirs of Y;
d) The proceeds of the life insurance will be divided equally amongst X and the compulsory heirs of Y.
Answer:
b) Despite the designation of X as the sole beneficiary, the proceeds of the life insurance will go to the estate of
Y; (BAR 2012)
E. Classes
1. Marine
a. Coverage
b. Implied Warranties
Answer:
The following warranties are implied in marine insurance:
1. That the ship is seaworthy to make the voyage and/or to take in certain cargoes;
2. That the ship shall not deviate from the voyage insured;
3. That the ship shall carry the necessary documents to show nationality or neutrality and that it will not
carry document which will cast reasonable suspicion thereon;
4. That the ship shall not carry contraband, especially if it is making voyage through belligerent waters.
(BAR 2000)
2. Paolo, the owner of an ocean-going vessel, offered to transport the logs of Constantino from Manila to
Nagoya. Constantino accepted the offer, not knowing that the vessel was manned by an irresponsible
crew with deep-seated resentments against Paolo, their employer.
Constantino insured the cargo of logs against both perils of the sea and barratry. The logs were
improperly loaded on one side, thereby causing the vessel to tilt on one side. On the way to Nagoya, the
crew unbolted the sea valve of the vessel causing water to flood the ship hold. The vessel sank.
Constantino tried to collect from the insurance company which denied liability, given the unworthiness
of both the vessel and its crew.
Constantino countered that he was not the owner of the vessel and he could therefore not be
responsible for conditions about which he was innocent.
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Answer:
No. the insurance company is not liable because there is an implied warranty in every marine insurance that the
ship is seaworthy whoever is insuring the cargo, whether it be the shipowner or not. There was a breach of
warranty, because the logs were improperly loaded and the crew was irresponsible. It is the obligation of the
owner of the cargo to look for a reliable common carrier which keeps its vessel in seaworthy condition. (BAR
2010)
3. On October 30, 2007, M/V Pacific, a Philippine registered vessel owned by Cebu Shipping Company (CSC),
sank on her voyage from Hong Kong to Manila. Empire Assurance Company (Empire) is the insurer of
the lost cargoes loaded on board the vessel which were consigned to Debenhams Company. After it
indemnified Denbenhams, Empire as subrogee filed an action for damages against CSC.
a) Assume the vessel was not seaworthy as in fact its hull had leaked, causing flooding in the vessel.
Will your answer be the same? Explain.
b) Assume the facts in question b). Can the heirs of the 3 crew members who perished recover from
CSC? Explain fully.
Answer:
a) No, my answer will be different. Allowing the vessel to depart on a voyage when it is not seaworthy is a
violation of the implied warranty of seaworthiness, and thus constitutes negligence on the part of owner of
the ship and the ship captain. The hypothecary principle in maritime commercelimiting the ship owners
liability to the amount of insurance proceedsis not applicable when the unseaworthiness of the vessel is
due to the owners fault or negligence.
b) Yes, the heirs of the 3 crew members perished can recover from CSC for negligence which constitutes a
quasi-delict in this case. (BAR 2008)
c. Insurable Interest
d. Perils of the Sea and Perils of the Ship
1. A marine insurance policy on a cargo states that the insurer shall be liable for losses incident to perils
of the sea. During the voyage, seawater entered the compartment where the cargo was stored due to
the defective drainpipe of the ship. The insured filed an action on the policy for recovery of the damages
caused to the cargo. May the insured recover damages?
Answer:
No. the proximate cause of the damage to the cargo insured was the defective drainpipe of the ship. This is peril
of the ship, and not peril of the sea. The defect in the drainpipe was the result of the ordinary use of the ship. To
recover under a marine insurance policy, the proximate cause of the loss or damage must be peril of the sea.
(BAR 1998)
2. Perils of the ship, under marine insurance law, refer to loss which in the ordinary course of events
results from
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c. Unnatural and inevitable actions of the sea.
d. Unnatural and ordinary actions of the sea.
Answer:
a. Natural and inevitable actions of the sea. (BAR 2011)
3. T Shipping, Co. insured all of its vessels with R insurance, Co. The insurance policies stated that the
insurer shall answer for all damages due to perils of the sea. One of the insureds ship, the MV Don
Priscilla, ran aground in the Panama Canal when its engine pipes leaked and the oil seeped into the
cargo compartment. The leakage was caused by the extensive mileage that the ship had accumulated.
May the insurer be made to answer for the damage to the cargo and the ship?
a. Yes, because the insurance policy covered any or all damage arising from perils of the sea.
b. Yes, since there appears to have been no fault on the part of the shipowner and ship captain.
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 perils of the sea.
Answer:
d. No, since the proximate cause of the damage was due to ordinary usage of the ship, and thus not
due to perils of the sea. (BAR 2011)
e. Concealment
f. Seaworthiness
1. A shipped 100 pieces of plywood from Davao City to Manila. He took a marine insurance policy to insure
the shipment against loss or damage due to perils of the sea, barratry, fire, jettison, pirates and other
such perils.
When the ship left the port of Davao, the shipman in charge forgot to secure one of the portholes, thru
which sea water seeped during the voyage, damaging the plywood. A filed a claim against the insurance
company which refused to pay on the ground that the loss or damage was not due to a peril of the sea or
any of the risks covered by the policy. It was admitted that the sea was reasonably calm during the
voyage and that no strong winds or waves were encountered by the vessel.
Answer:
I would decide in favor of the insured A because the insurer was guilty of breach of the implied warranty of
seaworthiness. The Insurance Code provides that in every contract of marine insurance, there is a warranty that
the ship is seaworthy at the commencement of the risk. Seaworthiness refers not only to the structure of the
ship but also as to its being properly laden. In other words, a ship which is seaworthy for the insurance on the
ship, may, by reason of being unfit to receive the cargo, be unseaworthy for the purpose of insurance upon the
cargo. In this case, the fact that the porthole was not secured at the port of departure made the ship
unseaworthy as far as the cargo of plywood was concerned. Thus, the insurer should be liable for the damage
thereto although the loss was not one due to perils insured against. (BAR 1983)
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2. Jacob, the owner of a barge, offered to transport the logs of Esau from Palawan to Manila. Esau accepted
the offer not knowing that the barge was manned by an irresponsible crew with deep-seated
resentments against Jacob, their employer.
Esau insured his cargo of logs against both perils of the sea and barratry.
The logs were improperly loaded on one side, thereby causing the barge to tilt and to navigate on an
uneven keel. When the strong winds and high waves, normal for that season, started to pound the barge,
the crew took advantage of the situation and unbolted the sea valves of the barge, causing sea water to
come in. the barge sank.
When Esau tried to collect from the insurance firm, the latter stated that it could not be held responsible
considering the unworthiness of both the barge and its crew. Esau countered that he was not the owner
of the barge and he could not be held responsible for conditions about which he was innocent.
Answer:
In marine insurance, the implied warranty of seaworthiness of the vessel applies also to the insurance of the
cargo. In an insurance against perils of the sea, it is the responsibility of the insured rather than the insurer to
see to it that the vessel is seaworthy. That responsibility, however, shifts to the insurer where the covered risks
include perils of the ship. Accordingly, the insurance company in the problem can be held liable. (BAR 1986) g.
Deviation
1. On a clear weather, MV Sundo, carrying insured cargo, left the port of Manila bound for Cebu. While at
sea, the vessel encountered a strong typhoon forcing the captain to steer the vessel to the nearest island
where it stayed for 7 days. The vessel ran out of provisions for its passengers. Consequently, the vessel
proceeded to Leyte to replenish its supplies.
a) Assuming that the cargo was damaged because of such deviation, who between the insurance
company and the owner of the cargo bears the loss? Explain.
b) Under what circumstances can a vessel properly proceed to a port other than its port of destination?
Explain.
Answer:
a) The insurance company should bear the loss. Since the deviation was caused by a strong typhoon, it was
caused by circumstances beyond the control of the captain, and also to avoid a peril whether or not insured
against. Deviation is therefore proper.
b) A vessel can properly proceed to a port other than its port of destination in the following cases:
1. When caused by circumstances over which neither the master or the owner of the ship has any control;
2. When necessary to comply with a warranty, or to avoid a peril, whether or not the peril is insured
against;
3. When made in good faith, and upon reasonable grounds of belief in the necessity to avoid peril;
4. When made in good faith for the purpose of saving human life or relieving another vessel in distress.
(BAR 2005)
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2. On October 30, 2007, M/V Pacific, a Philippine registered vessel owned by Cebu Shipping Company
(CSC), sank on her voyage from Hong Kong to Manila. Empire Assurance Company (Empire) is the
insurer of the lost cargoes loaded on board the vessel which were consigned to Debenhams Company.
After it indemnified Denbenhams, Empire as subrogee filed an action for damages against CSC.
Assume that the vessel was seaworthy. Before departing, the vesse was advised by the Japanese
Meteorological Center that it was safe to travel to its destination. But while at sea, the vessel received a
report of a typhoon moving within its general path. To avoid the typhoon, the vessel changed its course.
However, it was still at the fringe of the typhoon when it was repeatedly hit by huge waves, foundered
and eventually sank. The captain and the crew were saved except 3 who perished. Is CSC liable to
Empire? Explain.
Answer:
No, CSC is not liable to Empire. The doctrine of proper deviation is applicable in this case. The change of course
made by the vessel is proper as it was to avoid the typhoon and the huge waves which are considered perils of
the sea. (BAR 2008)
3. T, the captain of MV Don Alan, while asleep in his cabin, dreamt of an Intensity 8 earthquake along the
path of his ship. On waking up, he immediately ordered the ship to return to port. True enough, the
earthquake and tsunami struck 3 days later and the ship was saved. Was the deviation proper?
a) Yes, because the deviation was made in good faith and on reasonable ground for believing that it was
necessary to avoid a peril.
b) No, because no reasonable ground for avoiding a peril existed at the time of the deviation.
c) No, because T relied merely on his supposed gift of prophecy.
d) Yes, because the deviation took place based on a reasonable belief of the captain.
Answer:
b. No, because no reasonable ground for avoiding a peril existed at the time of the deviation. (BAR 2011)
1. An inter-island vessel, insured for P2 M against total and constructive total loss, sank in 150 ft of
water one mile off Paranaque during a typhoon. After the typhoon, the ship owner gave written notice
of abandonment of his interest in the entire sunken ship to the insurance company. Refusing to accept
the offer of abandonment, the insurer hired salvors to refloat the vessel at a total cost of P40,000.
Because the refloated vessel needed repairs, the insurer issued invitations to bid for repairs. Several
firms submitted separate sealed bids ranging from P1.2 M to P1.3 M for the complete refurbishing
and/or restoration of the vessel to its original condition. On the basis of the following facts, the
insurance company rejected the claim of the ship owner for payment of total loss on the ground that the
ground that there was no constructive total loss.
a) Was the notice of abandonment given by the owner properly made? Reason.
b) Is the position of the insurance company as to the absence of constructive total loss well taken?
Reason.
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c) Assuming that the ship owner failed to give the proper notice of abandonment, may he still recover
from the insurer? Why?
Answer:
a) First Suggested Answer: The notice of abandonment made in writing by the insured to the insurer was
sufficient, had the loss been a constructive total loss of the vessel, meaning more than of the value of the
vessel. (Sec. 139, Corporation Code)
Second Suggested Answer: The notice of abandonment made in writing was not proper, since the existence
of the constructive total loss of the vessel had not yet been determined. (Sec. 141, Insurance Code)
b) Yes, the position of the insurance company as to the absence of constructive total loss is well taken. The sum
total of the damage to the vessel was only P1,340,000.00 (P40,000 for the salvors, and P1,300 for the
restoration of the vessel to its original condition) which amount is not more than of the value of the
vessel (P2 M). (Sec. 139, Corporation Code)
c) Yes, the shipowner may still recover from the insurer, his actual loss, the amount of P1,340,000.00 which is
now only partial loss, being not total loss. But since the said amount was already spent by the insurer on the
vessel, the insurer is no longer liable to the shipowner, except to deliver the vessel. (BAR 1982)
2. An insurance company issued a marine insurance policy covering a shipment by sea from Mindoro to
Batangas of 1,000 pieces of Mindoro garden stones against total loss only. The stones were loaded in
two lighters, the first with 600 pieces and the second with 400 pieces. Because of rough seas, damage
was caused the second lighter resulting in the loss of 325 out of the 400 pieces. The owner of the
shipment filed claims against the insurance company on the ground of constructive total loss inasmuch
as more than of the value of the stones had been lost in one of the lighter.
Answer:
The insurance company is not liable under its policy covering against total loss only the shipment of 1,000
pieces of Mindoro garden stones. There is no constructive total loss that can be claimed since the rule is to be
computed on the total 1,000 pieces of Mindoro garden stones covered by the single policy coverage. (BAR 1992)
3. RC Corporation purchased from Thailand, which it intended to sell locally. Due to stormy weather, the
ship carrying the rice became submerged in sea water and with it the rice cargo. When the cargo arrived
in Manila, RC filed a claim for total loss with the insurer, because the rice was no longer fit for human
consumption. Admittedly, the rice could still be used as animal feed.
Answer:
Yes, RCs claim for total loss is justified. The rice, which was imported from Thailand for sale locally, is obviously
intended for consumption by the public. The complete physical destruction of the rice is not essential to
constitute an actual loss. Such a loss exists in this case since the rice, having been soaked in sea water and
thereby rendered unfit for human consumption, has become totally useless for the purpose for which it was
imported. (BAR 1996)
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4. MV Pearly Shells, a passenger and cargo vessel, was insured for P40 M against constructive total loss.
Due to typhoon, it sank near Palawan. Luckily, there were no casualties, only injured passengers. The
shipowner sent a notice of abandonment of his interest over the vessel to the insurance company which
then hired professionals to afloat the vessel for P900,000. When re-floated, the vessel needed repairs
estimated at P2 M. the insurance company refused to pay the claim of the shipowner, stating that there
was no constructive total loss.
a) Was there constructive total loss to entitle the shipowner to recover from the insurance company?
Explain.
b) Was it proper for the shippowner to send a notice of abandonment to the insurance company?
Explain.
Answer:
a) There was constructive total loss. When the vessel sank, it was likely that it would be totally lost because of
the improbability of recovery.
b) It was proper for the shipowner to send a notice of abandonment to the insurance company, because there
was reliable information of the loss of the vessel. (BAR 2005)
5. X Shipping Co., insured its vessel MV Don Teodoro for P100 M with ABC Insurance Co. through T, an
agent of X Shipping. During a voyage, the vessel accidentally caught fire and suffered damages estimated
at P80 M. T personally informed ABC Insurance that X Shipping was abandoning the ship. Later, ABC
Insurance denied X Shippings claim for loss on the ground that a notice of abandonment through its
agent was improper. Is ABC Insurance right?
Answer:
b. No, since T, as agent of X Shipping who procured the insurance, can also give notice of abandonment for his
principal. (BAR 2011)
6. A cargo ship of X Shipping Co. ran aground off the coast of Cebu during a storm and lost all its cargo
amounting to P50 M. the ship itself suffered damages estimated at P80 M. the cargo owners filed a suit
against X Shipping but it invoked the doctrine of limited liability since it vessel suffered an P80 M
damage, more than the collective value of all lost cargo. Is X Shipping correct?
a) Yes, since under the doctrine, the value of the lost cargo and the damage to the ship can be set-off.
b) No, since each cargo owner has a separate and individual claim for damages.
c) Yes, since the extent of the ships damage was greater than that of the value of the lost cargo.
d) No, since X Shipping neither incurred a total loss nor abandoned its ship.
Answer:
d. No, since X Shipping neither incurred a total loss nor abandoned its ship. (BAR 2011)
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7. For a constructive total loss to exist in marine insurance, it is required that the person insured
relinquish his interest in the thing insured. This relinquishment must be
a) Actual.
b) Constructive first and if it fails, then actual.
c) Either actual or constructive.
d) Constructive.
Answer:
a. Actual. (BAR 2011)
i. Barratry
Answer:
Barratry is any willful misconduct on the part of the master or the crew in pursuance of some unlawful or
fraudulent purpose without the consent of the owner and to the prejudice of the interest of the owner. (BAR
2010)
2. Fire
1. A) Suppose that Fortune owns a house valued at P600,000 and insured the same against fire with 3
insurance companies as follows:
X ------------------- P400,000.00
Y ------------------- P200,000.00
Z ------------------- P600,000.00
In the absence of any stipulation in the policies from which insurance company or companies may
Fortune recover in case of fire should destroy his house completely?
b) If each of the fire insurance policies obtained by Fortune in problem (a) is a valued policy and the
value of his house was fixed in each of the policies at P1 M, how much would Fortune recover from X
if he has already obtained full payment on the insurance policies issued by Y and Z?
c) If each of the policies obtained by Fortune in problem (a) above is an open policy and it was
immediately determined after the fire that the value of Fortunes house was P2.4 M, how much may
he collect from X, Y and Z?
d) In problem (a), what is the extent of the liability of the insurance companies among themselves?
Page | 13
e) Supposing in problem (a) above, Fortune was able to collect from both Y and Z, may he keep the
entire amount he was able to collect from the said 2 insurance companies?
Answer:
a) Fortune may recover from the insurers in such order as he may select up to their concurrent liability.
c) In an open policy, the insured may recover his total loss up to the amount of the insurance coverage. Thus,
the extent of recovery would be P400,000 from X; P200,000 from Y; and P600,000 from Z.
d) In the problem (a), the insurance companies among themselves would be liable, viz:
e) No, he can only be indemnified for his loss, not profit thereby; hence, he must return P200,000 of the
P800,000 he was able to collect. (BAR 1990)
b. Alteration
1. On May 13, 1996, PAM, Inc. obtained a P15 M fire insurance policy from Ilocano Insurance covering its
machineries and equipment effective for 1 year or until May 14, 1997. The policy expressly stated that
the insured properties were located at Sanyo Precision Phils. Building, Phase III, Lots 4 and 6, Block 15,
PEZA, Rosario Cavite. Before its expiration, the policy was renewed on as is basis for another year
until May, 13, 1998. The subject properties were later transferred to Pace Factory also in PEZA. On
October 12, 1997, during the effectivity of the renewed policy, a fire broke out at the Pace Factory which
totally burned the insured properties.
The policy forbade the removal of the insured properties unless sanctioned by Ilocano. Condition 9(c) of
the policy provides that the insurance ceases to attach as regards the property affected unless the
insured, before the occurrence of any loss or damage, obtains the sanction of the company signified by
endorsement upon the policy x x x (c) if the property insured is removed to any building or place other
than in that which is herein stated to be insured. PAM claims that it has substantially complied with
notifying Ilocano for the insurance coverage. Is Ilocano liable under the policy?
Answer:
Page | 14
Ilocano is not liable under the policy. With the transfer of the location of the subject properties, without notice
and without insurers consent, after the renewal of the policy, the insured clearly committed concealment,
misrepresentation and a breach of material warranty. The Insurance Code provides that a neglect to
communicate that which a party knows and ought to communicate, is called concealment. A concealment
entitles the injured party to rescind a contract of insurance in case of an alteration in the use or condition of the
thing insured. An alteration in the use or condition of a thing insured from that to which it is limited by the
policy made without the consent of the insurer, by means within the control of the insured, and increasing the
risks, entitles the insurer to rescind the contract of fire insurance. (BAR 2014)
1. Queens Insurance Company insured X, a resident of Baguio City, against all direct loss and damage by
fire. X lived in a house heated by a furnace. His servant built a fire in the furnace using material that
was highly flammable. The furnace fire caused intense heat and great volumes of smoke and soot that
damaged the furnishings in the rooms of X. when X tried to collect on the policy, Queens Insurance
refused to pay contending that the damage is not covered by the policy, where the fire is confined within
the furnace. Decide.
Answer:
The refusal of Queens to pay is justified. The damage is not covered by the policy which only insures against all
direct loss and damage by fire. The damage being claimed by X was caused by intense heat and great volumes
of smoke and soot and not directly by fire. The stipulation in the policy is paramount, not being contrary to law.
(BAR 1989)
3. Casualty
a. Accident vs Intentional
1. In a course of a voluntary boxing contest, B who had an accident insurance policy, slid and slipped,
enabling his opponent boxer to hit him with a blow that threw him to the ropes, hitting his head against
the canvass, causing Bs eventual death. There is nothing in the insurance contract appertaining to
boxing. Is the Insurance Company liable? Reasons.
Answer:
The insurer is liable because the death in this case was an accident within the meaning of the policy. It was an
accident because the insured did not expect to die by entering such contest. His slipping was accidental and this
caused him to hit his head against the canvass, leading to his death. (BAR 1975)
2. Luis was the holder of an accident insurance policy effective November 1, 1988 to October 31, 1989. At a
boxing contest held on January 1, 1989 and sponsored by his employer, he slipped and was hit on the
face by his opponent so he fell and his head hit one of the posts of the boxing ring. He was rendered
unconscious and was dead on arrival at the hospital due to intracranial hemorrhage.
Can his father who is a beneficiary under said insurance policy successfully claim indemnity from the
insurance company? Explain your answer.
Answer:
Page | 15
Yes, the father who is a beneficiary under the accident insurance can successfully claim indemnity for the death
of the insured. Clearly, the proximate cause of the death was the boxing contest. Death is sustained in a boxing
contest is an accident. (BAR 1990)
3. S Insurance Company issued a Personal Accident Policy to Bob Tan with a face value of P500,000.
In the evening of September 5, 1992, after his birthday party, Tan was in a happy mood but not drunk.
He was playing with his handgun, from which he previously removed the magazine. As his secretary was
watching television, he stood in front of her and pointed the gun at her. She pushed it aside and said that
it may be loaded. He assured her that it was not and then pointed it at his temple. The next moment,
there was an explosion and Tan slumped to the floor lifeless.
The wife of the deceased sought payment on the policy but her claim was rejected. The insurance
company agreed that there was no suicide. However, it was the submission of the insurance company
that there was no accident. In support thereof, it contended (a) that there was no accident when a
deliberated act was performed unless some additional, unexpected, independent and unforeseen
happening occur which produces or brings about the injury or death; and (b) that the insured willfully
exposed himself to needless peril and thus removed himself from the coverage of the insurance policy.
Are the two contentions of the insurance company tenable? Explain.
Answer:
No. these 2 contentions of the insurance company are not tenable. The insurer is liable for injury or death even
due to the insureds gross negligence. The fact that the insured removed the magazine from the handgun means
that the insured did not willfully expose himself to needless peril. At most, the insured is only guilty of
negligence. (BAR 1993)
4. Sun-Moon Insurance issued a Personal Accident Policy to Henry Dy with a face value of P500,000. A
provision in the policy states that the company shall not be liable in respect of bodily injury
consequent upon the insured person attempting to commit suicide or willfully exposing himself to
needless peril except in an attempt to save human life. 6 months later, Henry died of a bullet wound in
his head. Investigation showed that one evening Henry was in a happy mood although he was not drunk.
He was playing with his handgun from which he had previously removed its magazine. He pointed the
gun at his sister who got scared. He assured her it was not loaded. He then pointed the gun at his temple
and pulled the trigger. The gun fires and Henry slumped dead on the floor.
Henrys wife, Beverly, as the designated beneficiary, sought to collect under the policy. Sun-Moon
rejected her claim on the ground that the death of Henry was not accidental. Beverly sued the insurer.
Answer:
Beverly can recover the proceeds of the policy from the insurer. The death of the insured was not due to suicide
or willful exposure to needless peril which are the excepted risks. The insureds act was purely on act of
negligence which is covered by the policy and for which the insured got the insurance for his protection. In fact,
he removed the magazine from the gun and when he pointed the gun to his temple he did so because he thought
that it was safe for him to do so. He did so to assure his sister that the gun was harmless. There is none in the
policy that would relieve the insurer of liability for the death of the insured since the death was an accident.
(BAR 1995)
Page | 16
5. CNI insured SAM under a homeowners policy against claims for accidental injuries by neighbors. SAMs
minor son, BOY, injured 3 children of POS, a neighbor, who sued SAM for damages.
SAMs lawyer was at ATT, who was paid for his services by the insurer for reporting periodically on the
case to CNI. In one report, ATT disclosed to CNI that after his investigations, he found the injuries to the
3 children not accidental but intentional.
SAM lost the case in court, and POS was awarded P1 M in damages which he sought to collect from the
insurer. But CNI used ATTs report to deny the claim on the ground that the injuries to POS 3 children
were intentional, hence excluded from the policys coverage. POS countered that CNI was stopped from
using ATTs report because it was unethical for ATT to provide prejudicial information against his client
to the insurer, CNI.
Who should prevail: the claimant, POS; or the insurer, CNI? Decide with reasons briefly.
Answer:
CNI is not stopped from using ATTs report because CNI, in the first place, commissioned it and paid ATT for it.
On the other hand, ATT has no conflict of interest because SAM and CNI are on the same sidetheir interests
being congruent with each other, namely, to oppose POS claim. It cannot be said that ATT has used the
information to the disadvantage or prejudice of SAM.
However, in Finman General Assurance Corp. v. Court of Appeals, 213 SCRA 493 (1992), it was explained that
there is no accident in the context of an accident policy, if it is the natural result of the insureds voluntary act,
unaccompanied by anything unforeseen except the injury. There is no accident when a deliberate act is
performed, unless some additional and unforeseen happening occurs that brings about the injury. This element
of deliberateness is not clearly shown from the facts of the case, especially considering the fact that BOY is a
minor, and the injured parties are also children. Accordingly, it is possible that CNI may not prosper. ATTs
report is not conclusive on POS or the court. (BAR 2004)
4. Suretyship
5. Life
a. Incontestability Clause
1. On May 5, 1982, Juan applied for a life insurance policy with Acme Life Insurance Co. The policy was
issued to Juan on June 30, 1982 but the date of issue, as appearing on the policy was May 15, 1982, the
date of his application. Juan subsequently realized that some of his answers in the insurance application
were erroneous. Accordingly, he supplied the insurance company with the correct replies. However, his
letter to the insurance company was lost in the mails. Juan died June 1, 1984.
The insurance company now refuses to pay Juans beneficiary contending that Juan misrepresented the
state of his health at the time of his application. Is the insurance company liable? State your reason.
Answer:
Yes. The incontestability clause that must be contained in every individual life insurance policy refers to the
date of its issue as shown in the policy. Since the policy of life insurance had been in force during the lifetime of
the insured, Juan, for a period of 2 years from May 15, 1982, the date of issue as shown in the policy, the policy
has become incontestable. The insurance company can no longer prove that the policy is void ab initio or
rescindable by reason fraudulent concealment or misrepresentation of the insured. (BAR 1984)
Page | 17
2. Manpower Company obtained a group life insurance policy for its employees from Phoenix Insurance
Company. The master policy issued by Phoenix on June 1, 1986 contained a provision that eligible
employees for insurance coverage were all full time employees of Manpower regularly working at least
30 hours per week. The policy had also an incontestable clause. Beforehand, Phoenix sent enrollment
cards to Manpower for distribution to its eligible employees. X filled out the card which contained a
printed clause: I request the insurance for which I may become eligible under said Group Policy. The
cards were then sent to Phoenix and X was among the employees of Manpower who was issued a
certificate of coverage by Phoenix
On July 3, 1988, X was killed on the occasion of a robbery in their house. While processing the claim of
Xs beneficiary, Phoenix found out that X was not an eligible employee as defined in the group policy
since he has not been employed 30 hours a week by Manpower. Phoenix refused to pay. May Xs
beneficiary invoke the incontestability clause against Phoenix? Reasons.
Answer:
The beneficiary of X may validly invoke the incontestability clause. If the incontestability clause can apply even
to cases of intentional concealment and misrepresentation, there would be no cogent reason for denying such
application where the insured had not been guilty thereof. When X filled out the card containing the printed
clause I request the insurance for which I may become eligible under said Group Policy, it behooved the
insurer to look into the qualifications of X whether he can thus be covered or not by the group life insurance
policy. In issuing the certificate of coverage to X, Phoenix may, in fact, be said to have waived the 30-hour per
week requirement. (BAR 1989)
3. Atty. Roberto took out a life insurance policy from Dana Insurance Corp. (DIC) on September 1, 1989. On
August 31, 1990, Roberto died. DIC refused to pay his beneficiaries because it discovered that Roberto
had misrepresented certain material facts in his application. The beneficiaries sued on the basis that
DIC can contest the validity of the insurance policy only within 2 years from the date of issue and during
the lifetime of the insured. Decide the case.
Answer:
I would rule in favor of the insurance company. The incontestability clause, applies only if the policy had been in
effect for at least 2 years. The 2-year period is counted from the time the insurance becomes effective until the
death of the insured and not thereafter. (BAR 1991)
NB The better answer is that the 2 year period is counted from date of issuance as appearing in the policy.
4. On September 23, 1990, Tan took a life insurance policy from Philam. The policy was issued on
November 6, 1990. He died on April 26, 1992 of hepatoma. The insurance company denied the
beneficiaries claim and rescinded the policy by reason of alleged misrepresentation and concealment
of material facts made by Tan in his application. It returned the premiums paid.
The beneficiaries contend that the company had no right to rescind the contract as rescission must be
done during the lifetime of the insured within 2 years and prior to the commencement of the action.
Answer:
Page | 18
No. The incontestability clause does not apply. The insured died within less than 2 years from the issuance of
the policy on September 23, 1990. The insured died on April 26, 1992, or less than 2 years from September 23,
1990.
The right of the insurer to rescind is only lost if the beneficiary has commenced an action on the policy. There is
no such action in this case. (BAR 1994)
5. Renato was issued a life insurance policy on January 2, 1990. He concealed the fact that 3 years prior to
the issuance of his life insurance policy, he had been seeing a doctor about his heart ailment.
On March 1, 1992, Renato died of heart failure. May the heirs file a claim on the proceeds of the life
insurance policy of Renato?
Answer:
Yes. The life insurance policy in question was issued on January 2, 1990. More than 2 years had elapsed when
Renato, the insured, died on March 1, 1992. The incontestability clause applies. (BAR 1998)
a) That life insurance proceeds cannot be claimed 2 years after the death of the insured;
b) That 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 2 years even though premium is not
paid;
d) That the insured can only claim proceeds in a life insurance policy 2 years after death.
Answer:
b) That 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. (BAR 2012)
7. X, in January 30, 2009, or 2 years before reaching the age of 65, insured his life for P20 M. for reason
unknown to his family, he took his own life 2 days after his 65th birthday. The policy contains no
excepted risk. Which statement is most accurate?
Answer:
b) The insurer will be liable. (BAR 2012)
8. On July 3, 1993, Delia Sotero (Delia) took out a life insurance policy from Ilocos Bankers Life Insurance
Corporation (Ilocos Life) designating Creencia Aban (Aban), her niece, as her beneficiary. Ilocos Life
Page | 19
issued Policy No. 747, with a face value of P100,000, in Soteros favor on August 30, 1993, after the
requisite medical examination and payment of the premium.
On April 10, 1996, Sotero died. Aban filed a claim for the insurance proceeds on July 9, 1996. Ilocos Life
conducted an investigation into the claim and came out with the following findings:
1. Sotero did not personally apply for insurance coverage, as she was illiterate.
2. Sotero was sickly since 1990.
3. Sotero did not have the financial capability to pay the premium on the policy.
4. Sotero did not sign the application for insurance.
5. Aban was the one who filed the insurance application and designated herself as the beneficiary.
For the above reasons and claiming fraud, Ilocos Life denied Abans claim on April 16, 1997, but
refunded the premium paid on the policy.
a. May the incontestability period set in even in cases of fraud as alleged in this case?
b. Is Aban entitled to claim the proceeds under the policy?
Answer:
a) Yes. The incontestability clause is a provision in law that after a policy of life insurance made payable on
the death of the insured shall have been in force during the lifetime of the insured for a period of 2 years
from the date of its issue or of its last reinstatement, the insurer cannot prove that the policy is void ab initio
or is rescindable by reason of fraudulent concealment or misrepresentation of the insured or his agent.
In this case, the policy was issued on August 30, 1993, and the insured died on April 10, 1996. The
insurance policy was thus in force for a period of 3 years, 7 months and 24 days. Considering that the
insured died after the 2-year period, Ilocos is, therefore, barred from proving that the policy is void ab
initio by reason of the insureds fraudulent concealment or misrepresentation or want of insurable interest
on the part of the beneficiary.
b) Yes, Aban is entitled to claim the proceeds. After the 2-year period lapse, or when the insured dies within
the period, the insurer must make good on the policy, even though the policy was obtained by fraud,
concealment, or misrepresentation, as in this case, when the insured did not personally apply for the policy
as she was illiterate and that it was the beneficiary who filled up the insurance application designating
herself as beneficiary. (BAR 2014)
1. X was riding a suburban utility vehicle (SUV) covered by a comprehensive motor vehicle liability
insurance (CMVLI) underwritten by FastPay Insurance Company when it collided with a speeding bus
owned by RM Travel, Inc. the collision resulted in serious injuries to X; Y, a passenger of the bus; and Z, a
pedestrian waiting for a ride at the scene of the collision. The police report established that the bus was
the offending vehicle. The bus had a CMVLI policy issued by Dragon Insurance Corporation, X, Y and Z
jointly sued RM Travel and Dragon Insurance for indemnity under the Insurance Code of the
Philippines. The lower court applied the no-fault indemnity policy of the statute, dismissed the suit
against RM Travel, and ordered Dragon insurance to pay indemnity to all three plaintiffs. Do you agree
with the courts judgment? Explain.
Page | 20
Answer:
No. The cause of action of Y is based on the contract of carriage, while that of X and Z is based on torts. The court
should not have dismissed the suit against RM Travel. The court should have ordered Dragon Insurance to pay
each of X, Y, and Z to the extent of the insurance coverage, but whatever amount is agreed upon in the policy
should be answered first by RM Travel and the succeeding amount should be paid by Dragon Insurance up to
the amount of the insurance coverage. The excess of the claims of X, Y and Z, over and above such insurance
coverage, if any, should be answered or paid by RM Travel. (BAR 2000)
2. As a rule, an insurance contract is consensual and voluntary. The exception in the case of:
Answer:
c. Motor Vehicle Liability Life Insurance (BAR 2014)
1. Jose, driving his own car together with his wife Maria, were on their way home from their respective
offices when a car driven by Pedro hit them from behind which was in turn hit by a gasoline tanker
driven by Mario, causing the car of Jose to turn-turtle, thus, resulting in the death of Maria. All motor
vehicles being insured, Jose filed his claim for the death of Maria against the NO FAULT Insurance,
Section 378 of the Insurance Code.
Will Joses claim for the death of Maria against insurers of said three motor vehicles prosper and up to
what amount? Reasons.
Answer:
Joses claim for the death of Maria against the insurer of said three motor vehicles will not prosper. According to
Section 378 of the Insurance Code, Any claim for death or injury to any passenger or third-party pursuant to
the provisions of this chapter shall be paid without necessity of proving fault or negligence of any kind;
Provided, that for purposes of this section.
x x x x
(iii) Claim may be made against one motor vehicle only. In the case of an occupant of a vehicle, claim shall lie
against the insurer of the vehicle in which the occupant is riding, mounting or dismounting from. Clearly, in the
instant case, the NO-FAULT claim against the vehicle in which the deceased was riding is the one authorized,
but the claim against the other vehicle will not prosper.
Jose may claim only up to an amount not exceeding P5,000.00 pursuant to par. (i), Section 378 of the Insurance
Code which provides that the total indemnity in respect to any one person shall not exceed P5,000.00. (NOTE:
amount has been adjusted to P15,000)
If Jose includes in the claim damage for his car, will the claim prosper? Why?
Page | 21
Answer:
Joses claim for damages for his car will not prosper. As may be clearly gleaned from Section 378 of the
Insurance Code on NO-FAULT Insurance applies only to any claim for death or injury to any passenger or third
party. (BAR 1977)
2. X owns and operates several passenger jeepneys in Metro Manila. He entered into a contract with Gold
Mine Insurance & Surety Co., insuring the operation of his jeepneys against accidents with thirdparty-
liability.
During the effectivity of the insurance, one of his jeepneys bumped B, who had just alighted from
another passenger jeepney whose driver unloaded passengers in the middle of the street. B suffered
bodily injury as a consequence and filed a claim against the insurance company. The latter refused to
pay on the ground that the driver of the jeepney from which passenger B alighted was guilty of
negligence in unloading in the middle of the street, and that the driver of the insured operator was not
at fault.
Answer:
Yes, passenger B may recover from the insurance company. The insurance covers the operation of Xs
jeepneys against accidents with third parties; therefore, the insurance covers the liability for death or body
injuries of third persons, like what happened to B, and the claim shall be against the insurer of the directly
offending vehicle (Xs vehicle). Furthermore, any claim of this nature shall be paid without necessity of proving
fault or negligence of any kind, provided that the total indemnity in respect of any person shall be in accordance
as provided under the law. (BAR 1981)
3. Driving his car one night, A crossed an intersection as the signal light turned green. Suddenly he saw an
old woman crossing the street just a few feet from his car. He applied his brakes immediately, but just
the same, he hit the woman who turned out to be senile already. He brought her to the nearest hospital
where she was confined for 3 days due to her injuries. Upon her discharge, A had to pay the hospital bill
which amounted to P2,000 including X-rays, doctors fees and medicines.
Being covered by the compulsory liability policy required of all vehicle owners under the Insurance
Code, A preferred the matter to his insurance company, which refused to reimburse him, claiming that
since A was not at fault (it was admitted that he was not speeding or in any way negligent), there was no
third party liability for which the insurance company could be liable under As policy. Is the insurance
company liable to reimburse A for the hospital expenses? Explain.
Answer:
Yes, the insurance company is liable provided A can present the police report of the accident and the medical
report as well as the hospital receipts. The Insurance Code has the no-fault provision imposing liability for any
claim for death or injury to any third party under the compulsory motor vehicle liability insurance. Under the
provision, the insurance company may be held liable for the maximum amount of P5,000 without necessity of
proving fault or negligence of any kind, provided the aforementioned proofs are submitted under oath.
Page | 22
Note: Sec. 391 of RA No. 10607 now provides that the total indemnity in respect of any person shall not be less
than P15,000.00. (BAR 1983)
4. (1) What do you understand by the no fault indemnity provision in the Insurance Code? What are the
rules on claims under said provision?
Answer:
The no fault indemnity in the Insurance Code provides that any claim for death or injury to a passenger or to a
third party should be paid without the necessity of proving fault or negligence of any kind, subject to the
following rule:
a. The total indemnity in respect of any person shall not be less than P15,000;
b. The following proofs of loss, when submitted under oath, shall be sufficient evidence to substantiate
the claim:
b.1. Police report of accident; and
b.2.Death certificate and evidence sufficient to establish the proper payee; or
b.3. Medical report and evidence of medical or hospital disbursement in respect of which refund is
claimed.
c. Claim may be made against one motor vehicle only. In the case of an occupant of a vehicle, claim, shall
lie against the insurer of the vehicle in which the occupant is riding, mounting or dismounting from.
In any other case, claim shall lie against the insurer of the directly offending vehicle. In all cases, the
right of the party paying the claim to recover against the owner of the vehicle responsible for the
accident shall be maintained. (BAR 1989)
5. What is your understanding of a no fault indemnity clause found in an insurance policy?
Answer:
Under the no fault indemnity clause any claim for the death or injury of any passenger or third party shall be
paid without the necessity of proving fault or negligence of any kind. The indemnity in respect of any one
person shall not exceed P15,000, provided they are under oath, the following proofs shall be sufficient:
Claim may be made against one motor vehicle only. (BAR 1994)
6. While driving his car along EDSA, Cesar sideswiped Roberto, causing injuries to the latter. Roberto sued
Cesar and the third party liability insurer for damages and/or insurance proceeds. The insurance
company moved to dismiss the complaint, contending that the liability of Cesar has not yet been
determined with finality.
Answer:
1. No, the contention of the insurer is not correct. There is no need to wait for the decision of the court
determining Cesars liability with finality before the third party liability insurer could be sued. The
occurrence of the injury to Roberto immediately gave rise to the liability of the insurer under its policy. In
other words, where an insurance policy insures directly against liability, the insurers liability accrues
immediately upon the occurrence of the injury or event upon which the liability depends.
Page | 23
2. The insurer cannot be held solidarily liable with Cesar. The liability of the insurer is based on contract while
that of Cesar is based on tort. If the insurer were solidarily liable with Cesar, it could be made to pay more
than the amount stated in the policy. This would, however, be contrary to the principles underlying
insurance contracts. On the other hand, if the insurer were solidarily liable with Cesar and it is made to pay
only up to the amount stated in the insurance policy, the principles underlying solidary obligations would
be violated. (BAR 1996)
7. X is a passenger of a jeepney for hire being driven by Y. the jeepney collided with another passenger
jeepney being driven by Z who was driving recklessly. As a result of the collision, X suffered injuries.
Both passenger jeepneys are covered by Comprehensive Motor Vehicular Insurance Coverage. If X
wants to claim under the no fault indemnity clause, his claim will lie
a) Against the insurer of the jeepney being driven by Z who was the one at fault;
b) The claim shall lie against the insurer of the passenger jeepeney driven by Y because X was his
passenger;
c) X has a choice against whom he wants to make his claim;
d) None of the above.
Answer:
a) The claim shall lie against the insurer of the passenger jeepney driven by Y because X was his passenger.
(BAR 2012)
1. Mayari obtained a comprehensive insurance policy on his car. The policy carried the standard
authorized driver clause which states that the insurance company is not liable for any loss, accident
or damage sustained while the car is being driven by someone other than a duly authorized driver. One
day, Mayari allowed his friend, Kainigan, to drive the car. Kaibigan figured in a mishap and the car was
a total loss.
Kaibigan had been driving for the past 5 years but it appears that his drivers license was irregularly
issued because he cannot read or write; neither did he take any of the prescribed drivers tests. After
the initial case was issued, he merely asked his wife to go to the LTC office to get a renewal of his license.
Mayari did not know about the irregularity in the drivers license of Kaibigan.
Answer:
Mayari cannot recover under the policy. The standard authorized driver clause requires that the driver at the
time of the accident must be duly authorized and licensed to drive. An irregular license is not a license at all.
(BAR 1986)
2. Sheryl insured her newly acquired car, a NISSAN Maxima against any loss or damage for P50,000 and
against third party liability for P20,000 with the XYZ Insurance Corp. (XYZ). Under the policy, the car
Page | 24
must be driven only by an authorized driver who is either: (1) the insured, or (2) any person driving on
the insureds order or with his permission: provided that the person driving is permitted in
accordance with the licensing or other laws or regulations to drive the motor vehicle and is not
disqualified from driving such motor vehicle by order of a court.
During the effectivity of the policy, the car, then driven by Sheryl herself, who had no drivers license,
met an accident and was extensively damaged. The estimated cost of the repair was P40,000. Sheryl
immediately notified XYZ, but the latter refused to pay on the policy alleging that Sheryl violated the
terms thereof when she drove it without a drivers license.
Answer:
No. the insurer is not correct in denying the claim since the proviso that the person driving is permitted in
accordance with the licensing, etc. qualifies only a person driving the vehicle, other than the insured, at the
time of the accident. (BAR 1991)
2. Theft Clause
1. A was the owner of a car insured with Fortune Insurance Company for Own Damage, Theft, and
Third-Party-Liability effective May 16, 1977 to May 16, 1978. On May 9, 1978, the car was brought to a
machine shop for repairs. On May 11, 1978, while in the custody of the machine shop, the car was taken
by one of the employees to be driven out to a certain place. While travelling along the highway, the car
smashed into parked truck and suffered extensive damage.
A filed a claim for recovery under the policy but was refused payment. The insurance company
averred that the car was not stolen and, therefore, was not covered by the Theft Clause.
Answer:
The insurer is liable to A under the Theft Clause. The taking of a car even though temporary and only for a
joy ride, without the car owners consent is theft; and, therefore, insurer is liable for total loss due to car
accident of insureds car wrongfully taken, without the insureds consent, from the repair shop entrusted for
repairs. (Villacorta v. Insurance Commissioner, Oct. 28, 1980, 100 SCRA 467) (BAR 1981)
2. Rey Bautista insured his 1984 Galant with Alpha Insurance Co., Inc. for own damage, theft and
thirdparty liability effective August 21, 1984 to August 20, 1985. On August 3, 1985 the car was brought
to Car Specialist, a well-known auto repair shop for general check-up. On August 11, 1985, while in the
custody of the said shop, the car was taken by one of the employees of the shop and driven to a hide-out
in Montalban, Rizal. While travelling along a narrow street, the car smashed into a parked gravel and
sand truck and it suffered an extensive damage. Rey filed a claim for total loss with Alpha, but the claim
was denied. Rey then sued Alpha to collect on the policy.
Rule on the said case stating the legal basis in support of your decision.
Answer:
Page | 25
The insurer is liable. The contract of insurance shall be interpreted, in case of doubt, in favor of the insured Rey
Bautista, who is entrusting his car and key to the shop owner; its employees are presumed to have insureds
(Bautista) permission. The theft clause applies, since the aforesaid act of the employees of the shop owner is
within the article on theft of the Revised Penal Code. (BAR 1985)
3. Mr. Gonzales was the owner of a car insured with Masagana Insurance Company for Own Damage,
Theft, and Third Party Liability effective May 14, 1986 to May 14, 1987. On May 2, 1987, the car was
brought to a machine ship for repairs. On May 11, 1987, while in the custody of the machine shop, the
car was taken by one of the employees (of the machine shop) to show off to his girlfriend. While on the
way to his girlfriends house, the car smashed into a parked truck and was extensively damaged. Mr.
Gonzales filed a claim for recovery under the policy but was refused payment. The insurance company
averred that the car was not stolen, and therefore was not covered by the Theft Clause.
Answer:
I would decide in favor of the insured. The coverage of the policy was rather comprehensive in scope. The Theft
Clause particularly, at least by intendment, should cover situations of the loss of the property occasioned by the
taking or use by another without the authority of the insured. Furthermore, doubts on the insurance, being a
contract by adherence must be construed against the insurer. (BAR 1988)
4. HL insured his brand new car with P Insurance Company for comprehensive coverage wherein the
insurance company undertook to indemnify him against loss or damage to the car (a) by accidental
collision xxx (b) by fire, external explosion, burglary, or theft, and (c) malicious act.
After a month, the car was carnapped while parked in the parking space in front of the Intercontinental
Hotel in Makati. HLs wife who was driving the said car when it was carnapped was in possession of an
expired drivers license, a violation of the authorized driver clause of the insurance company.
1. May the insurance company be held liable to indemnify HL for the loss of the insured vehicle?
Explain.
Answer:
1. Yes. The car was lost due to theft. What applies in this case is the theft clause, and not the authorized
driver clause. It is immaterial that HLs wife was driving the car with an expired drivers license at the time
it was carnapped.
5. On May 26, 201, Jess insured with Jack Insurance (Jack) his 2014 Toyota Corolla sedan under a
comprehensive motor vehicle insurance policy for one year. On July 1, 2014, Jess car was unlawfully
taken. Hence, he immediately reported the theft to the Traffic management Command (TMC) of the
Philippine National Police (PNP), which made Jess accomplish a complaint sheet as part of its
procedure. In the complaint sheet, Jess alleged that a certain Ric Silat (Silat) took possession of the
subject vehicle to add accessories and improvements thereon. However, Silat failed to return the
subject vehicle within the agreed 3-day period. As a result, Jess notified Jack of his claim for
reimbursement of the value of the vehicle under the insurance policy. Jack refused to pay claiming that
there is no theft as Jess gave Silat lawful possession of the car. Is Jack correct?
Answer:
Page | 26
No. Jack is not correct. The theft clause of a comprehensive motor vehicle insurance policy has been
interpreted by the Court in several cases to cover situations like (1) when one takes the motor vehicle of
another without the latters consent even if the motor vehicle is later returned, there is theftthere being
intent to gain as the use of the thing unlawfully taken constitutes gain, or (2) when there is taking of a vehicle by
another person without the permission or authority from the owner thereof. (BAR 2014)
6. On February 21, 2013, Barrack entered into a contract of insurance with Matino Insurance Company
(Matino) involving a motor vehicle. The policy obligates Matino to pay Barrack the amount of P600,000
in case of loss or damage to said vehicle during the period covered, which is from February 26, 2013 to
February 26, 2014.
On April 16, 2013, at about 9:00am, Barrack instructed his driver, JJ, to bring the motor vehicle to a
nearby auto shop for tune-up. However, JJ no longer returned and despite diligent efforts to locate the
said vehicle, the efforts proved futile. Resultantly, Barrack promptly notified Matino of the said loss and
demanded payment of the insurance proceeds of P600,000.
In a letter dated July 5, 2013. Matino denied the claim, reasoning as stated in the contract that the
company shall not be liable for any malicious damage caused by the insured, any member of his family
or by a person in the insureds service. Is Matino correct in denying the claim?
Answer:
No. Matino is not correct in denying the claim. An insurance company cannot deny a claim by the owner of a
motor vehicle who insured it against loss or damage because the driver he employed stole it. Matino cannot
invoke the provision excluding malicious damages caused by a person in the service of the insured. In common
ordinary usage, loss means failure to keep possession, while malicious damage is damage resulting from the
willful act of the driver. Words which have different meanings shall be understood in the sense which is most in
keeping with the nature and object of the insurance contract. If a stipulation admits several meanings, is should
be understood as bearing the meaning which is most adequate to render it effectual. It may be shown that the
words have a local, technical or peculiar meaning and were so used and understood by the parties. (BAR 2014)
F. Insurable Interest
1. A owns a house valued at P50,000 which he had insured against fire for P100,000. He obtained a loan
from B in the amount of P100,000, and to secure payment thereof, he executed a deed of mortgage on
the house, but without assigning the insurance policy to the latter. For As failure to pay the loan upon
maturity, B initiated foreclosure proceedings and in the ensuing public sale, the house was sold by the
sheriff to B as highest bidder. Immediately upon issuance of the sheriffs certificate of sale in his favor,
B insured the house against fire for P120,000 with another insurance company. In order to redeem
the house, A borrowed P100,000 from C and, as security device, he assigned the insurance policy of
P100,000 to C. However, before A could pay B his obligation of P100,000, the house was
accidentally and totally burned.
Does A, B or C have any insurance interest in the house? May A, B and C recover under the
policies? If so, how much? (BAR 1982)
Answer:
Page | 27
As to A: He has insurable interest in his house, an existing interest, but only for P50,000, the value of the said
house. But, when he assigned it to C, said A had no more interest in his insurance policy, and A cannot anymore
recover on said insurance policy.
As to B: He has insurable interest on As house, having an interest founded upon an existing interest, but only
for P50,000, the value of As house, and therefore, he can recover only the amount of P50,000.
As to C: He has no insurable interest on As house, being mere contingent or expectant interest not founded on
an actual right or valid contract to As house; besides, the assignment to him of As insurance policy was not
approved by the insurer; hence, C cannot recover.
1. In Life/Health
1. On January 4, 1983, Mr. P joined Alpha Corporation (ALPHA) as President of the company. ALPHA took
out a life insurance policy on the life of Mr. P with Mutual Insurance Company, designating ALPHA as the
beneficiary. ALPHA also carried fire insurance with Beta Insurance Co. on a house owned by it, but
temporarily occupied by Mr. P again with ALPHA as beneficiary.
On September 1, 1983, Mr. P resigned from ALPHA and purchased the company house he had been
occupying. A few days later, a fire occurred resulting in the death of Mr. P and the destruction of the
house.
What are the rights of ALPHA (a) against Mutual Life Insurance Company on the life insurance policy?
Answer:
a) ALPHA can recover against Mutual Life Insurance Co. in the life insurance policy as its insurable interest in
the life of the person insured, Mr. P, existed when the insurance took effect. In life insurance, insurable
interest need not exist thereafter or when the loss occurred. (BAR 1984)
2. Blanco took out a P1 M life insurance policy naming his friend and creditor, Montenegro, as his
beneficiary. When Blanco died, his outstanding loan obligation to Montenegro was only P50,000.
Blancos executor contended that only P50,000 out of the insurance proceeds should be paid to
Montenegro and the balance of P950,000 should be paid to Blancos estate.
Answer:
The contention of the executor is incorrect. The beneficiary of a life insurance need not have any insurable
interest in the life of the insured.
Altenative Answer:
The contention of the executor is incorrect because it was Blanco himself who took out the life insurance policy
on his own life, naming only Montenegro as the beneficiary. It would have been different if it was Montenegro,
as creditor, who took out a life insurance policy on the life of Blanco, as a debtor. In that case, Montenegros
insurable interest in the life of Blanco would be only to the extent of P50,000, which is the amount of his credit.
(BA 1987)
Page | 28
3. On July 14, 1985, X, a homosexual, took an insurance policy on the life of his boyfriend, Y. In the
insurance application, X misrepresented that Y was in perfect health although he knew all the time that
Y was afflicted with AIDS. On October 18, 1987, Y died in a motor accident. Shortly thereafter, X filed his
insurance claim.
Answer:
The insurer is not obliged to pay. Friendship alone is not the insurable interest contemplated in life insurance.
Insurable interest in the life of others (other than ones own life, spouses or children) is merely to the extent of
the pecuniary interest in that life.
Assuming that such pecuniary interest exists, an insurer would be liable despite concealment or
misrepresentation if the insurance had been in effect for more than 2 years (incontestability clause). (BAR
1987)
4. A obtains insurance over his life and names his neighbor B the beneficiary because of As secret love for
B. if A dies, can B successfully claim against the policy?
Answer:
Yes. In life insurance, it is required that the beneficiary must have insurable interest in the life of the insured. It
was the insured himself who took the policy on his own life. (BAR 1997)
5. IS, is an elderly bachelor with no known relatives, obtained life insurance coverage for P250,000 from
Starbrite Insurance Corporation, an entity licensed to engage in the insurable business under the
Insurance Code of the Philippines. He also insured his residential house for twice that amount with the
same corporation. He immediately assigned all his rights to the insurance proceeds to BX, a
friendcompanion living with him. 3 years later, IS died in a fire that gutted his insured house 2 days
after he had sold it. There is no evidence of suicide or arson or involvement of BX in these events. BX
demanded payment of the insurance proceeds from the 2 policies, the premiums for which IS had been
faithfully paying during all the time he was alive. Starbrite, refused payment, contending that BX had no
insurable interest and therefore was not entitled to receive the proceeds from IS insurance coverage on
his life and also on his property. Is Starbrites contention valid? Explain.
Answer:
Starbrite is correct with respect to the insurance coverage on the property of IS. The beneficiary in the property
insurance policy or the assignee thereof must have insurable interest in the property insured. BX, a mere friend-
companion of IS, has no insurable interest in the residential house of IS. BX is not entitled to receive the
proceeds from IS insurance on his property.
As to the insurance coverage on the life of IS, BX is entitled to receive the proceeds. There is no requirement that
BX should have insurable interest in the life of IS. It was IS himself who took the insurance on his own life. (BAR
2000)
6. Distinguish insurable interest in property insurance from insurable interest in life insurance.
Answer:
1) In property insurance, the expectation of benefit must have a legal basis. In life insurance, the expectation of
benefit to be derived from the continued existence of a life need not have any legal basis.
Page | 29
Page | 30
2) In property insurance, the actual value of the interest therein is the limit of the insurance
that can validly be placed thereon. In life insurance, there is no limit to the amount of
insurance that may be taken upon life.
3) In property insurance, an interest insured must exist when the insurance takes effect
and when the loss occurs but need not exist in the meantime. In life insurance, it is
enough that insurable interest exists at the time when the contract is made but it need
not exist at the time of loss. (BAR 2002)
Answer:
b. Both B and C, as they are your partners. (BAR 2011)
8. X has been a long-time household helper of Z. Xs husband, Y, has also been Zs long-
time driver. May Z insure the lives of both X and Y with Z as beneficiary?
Answer:
c. No, since Z has no pecuniary interest in the lives of X and Y arising from their employment
with him. (BAR 2011)
9. For both the Life Insurance and Property Insurance, the insurable interest is required
to be
a) Existing at the time of perfection of the contract and at the time of loss;
b) Existing at the time of perfection and at the time of loss for property;
c) Existing at the time of perfection for property insurance but for life insurance
both at the time of perfection and at the time of loss;
d) Existing at the time of perfection only.
Answer:
b) Existing at the time of perfection and at the time of loss for property. (BAR 2012)
10. X, a minor, contracted an insurance on his own life. Which statement is most
accurate?
Page | 31
b) The life insurance is valid provided it is with the consent of the beneficiary;
c) The life insurance policy is valid provided the beneficiary is his estate or his
parents, or spouse or child;
d) The life insurance is valid provided the disposition of the proceeds will be subject
to the approval of the legal guardian of the minor.
Answer:
c) The life insurance policy is valid provided the beneficiary is his estate or his parents, or
spouse or child. (BAR 2012)
11. In 2010, the PNP declared Kaddafy Benjelani Public Enemy No. 1 because of his
terrorist activities in the country that have resulted in the death of thousands of
Filipinos. A ransom of P15 M was placed on Kaddafy Benjelanis head.
Worried about the future of their family, Kaddafy Benjelanis estranged wife, Aurelia,
secured in December 2010 a life insurance policy on his life and designated herself as
beneficiary.
a) Yes, the policy is valid and binding because Aurelia has an insurable interest on
the life of Kaddafy Benjelani.
b) No, the policy is not valid and binding because Kaddafy Benjelani has been
officially declared a public enemy;
c) Yes, the policy is valid and binding because it has been in force for more than 2
years;
d) No, the policy is not valid and binding since the spouses estrangement removed
Aurelias insurable interest in Benjalanis life;
e) None of the above.
Answer:
a) Yes, the policy is valid and binding because Aurelia has an insurable interest on the life of
Kaddafy Benjelani. (BAR 2013)
12. Carlo and Bianca met in the La Boracay festivities. Immediately, they fell in love with
each other and got married soon after. They have been cohabiting blissfully as
husband and wife, but they did not have any offspring. As the years passed by, Carlo
decided to take out an insurance on Biancas life for P1 M with him (Carlo) as sole
beneficiary, given that he did not have a steady source of income and he always
depended on Bianca both emotionally and financially. During the term of the
insurance, Bianca died of what appeared to be a mysterious cause so that Carlo
immediately requested for an autopsy to be conducted. It was established that Bianca
died of a natural cause. More than that, it was also established that Bianca was a
transgender all alonga fact unknown to Carlo. Can Carlo claim the insurance
benefit?
Answer:
Yes. Carlo can claim the insurance benefit. If a person insures the life or health of another
person with himself as beneficiary, all his rights, title and interests in the policy shall
automatically vest in the person insured. Carlo, as the husband of Bianca, has an insurable
interest in the life of the latter. Also, every person has an insurable interest in the life and
Page | 32
health of any person on whom he depends wholly or in part for support. The insurable
interest in the life of the person insured must exist when the insurance takes effect but need
not exist when the loss occurs. Thus, the subsequent knowledge of Carlo, upon the death of
Bianca, that the latter is a transgender does not destroy his insurable interest on the life of
the insured. (BAR 2014)
13. A person is said to have an insurable interest in the subject matter insured where he
has a relation or connection with, or concern in it that he will derive pecuniary
benefit or advantage from its preservation. Which among the following subject
matters is not considered insurable?
Answer:
a. A partner in a firm on its future profits. (BAR 2014)
14. On July 3, 1993, Delia Sotero (Delia) took out a life insurance policy from Ilocos
Bankers Life Insurance Corporation (Ilocos Life) designating Creencia Aban (Aban),
her niece, as her beneficiary. Ilocos Life issued Policy No. 747, with a face value of
P100,000, in Soteros favor on August 30, 1993, after the requisite medical
examination and payment of the premium.
On April 10, 1996, Sotero died. Aban filed a claim for the insurance proceeds on July
9, 1996. Ilocos Life conducted an investigation into the claim and came out with the
following findings:
6. Sotero did not personally apply for insurance coverage, as she was illiterate.
7. Sotero was sickly since 1990.
8. Sotero did not have the financial capability to pay the premium on the policy.
9. Sotero did not sign the application for insurance.
10. Aban was the one who filed the insurance application and designated herself
as the beneficiary.
For the above reasons and claiming fraud, Ilocos Life denied Abans claim on April
16, 1997, but refunded the premium paid on the policy.
Answer:
c. Yes. Sotero may validly designate her niece, Aban, as beneficiary. Sotero had insurable
interest in her own life, and could validly designate anyone as her beneficiary. (BAR
2014)
Page | 33
2. In Property
1. A owns a house worth P500, 000.00. He insured It against fire for P250, 000.00 for the
period from January 1, 1977 to January 1, 1978. At the instance of B, who is a
judgment creditor of A, the said house was levied upon by the Sheriff and sold at
public auction on March 15, 1977. It was adjudicated to B for P150, 000.00 at the
auction sale. B insured the house against fire for P150, 000.00 for the period from
March 16, 1977 to March 16, 1978. The house was accidentally burned on April 1,
1977. May A recover under his policy? Give reasons.
Answer:
A can recover under his policy. A judgment debtor whose property has been seized on
execution has an insurable interest therein until the right to redeem or have the same set
aside has been lost. Inasmuch as the right of A to redeem has not expired, the 12 months
time after the sale having not elapsed before the loss occurred; A has an insurable interest in
the house at the time of loss.
Answer:
B can recover upon his policy because as purchaser at a judicial sale he has an insurable
interest in the property to the extent of the amount for which he insured it not exceeding his
interest in the property. (BAR 1977)
2. N owns a condominium unit presently insured with Holy Insurance Co. for P1
Million. N later sells the condominium unit to O. Somehow O fails to obtain the
transfer of the insurance policy to his name from N. Subsequently, fire of unknown
origin destroys completely the condominium unit.
Answer:
Neither N nor O may collect. As to N; First Alternative ReasonAn interest in property
insured must exist when the insurance takes effect and when the loss occurs. Although N
had insurable interest when the insurance takes effect, yet he had no more interest when
the loss happened. Second Alternative ReasonA change of interest in any part of a thing
insured unaccompanied by a corresponding change of interest in the insurance, suspends
the insurance to an equivalent extent, until the interest in the thing insured and the interest
in the insurance are vested in the same person.
3. The agent in Davao of the insured A was employed to ship As copra to Manila and
to communicate the shipment to the buyer A in Manila. The said agent wrote the
owner of the copra announcing the sailing of the ship, but failed to state that the ship
had run a ground, which fact he already knew before announcing the sailing. A, the
buyer of the copra, in all good faith, took out a marine insurance on the copra. The
copra was badly damaged and was a total loss. Can the insured recover on the policy?
Reason.
Page | 34
Answer:
The insured may not recover on the policy, since the subject matter of the marine insurance
at the time of contracting the insurance was already lost. An interest in property insured
must exist when the insurance takes effect and when the loss occurs. (BAR 1979)
On September 1, 1983, Mr. P resigned from ALPHA and purchased the company house
he had been occupying. A few days later, a fire occurred resulting in the death of Mr. P
and the destruction of the house.
What are the rights of ALPHA against Beta Insurance Company on the fire insurance?
Answer:
ALPHA cannot recover from Beta Insurance Co. since an interest in the property insured
must exist not only when the insurance took effect but also when the loss occurs. Since the
fire that destroyed the insureds house took effect after ALPHA had sold the house to Mr. P,
the insurable interest of ALPHA in the property insured no longer exists when the loss
occurred. (BAR 1984)
5. On February 3, 1987, while Jose Palacio was in the hospital preparatory to a heart
surgery, he called his only son, Boy Palacio, and showed the latter a will naming the
son as sole heir to all the fathers estate including the family mansion in Forbes Park.
The following day, Boy Palacio took out a fire insurance policy on the Forbes Park
mansion. One week later, the father died. After his fathers death, Boy Palacio moved
his wife and children to the family mansion which he inherited. On March 30, 1987, a
fire occurred razing the mansion to the ground. Boy Palacio then proceeded to collect
on the fire insurance he took earlier on the house.
Answer:
In property insurance, insurable interest must exist both at the time of the taking of the
insurance and at the time the risk insured against occurs. The insurable interest must be an
existing interest. The fact alone that Boy Palacio was the expected sole heir of his fathers
estate does not give the prospective heir any existing interest prior to the death of the
decedent. (BAR 1987)
6. A piece of machinery was shipped to Mr. Pablo on the basis of C&F, Manila. Mr. Pablo
insured said machinery with the Talaga Merchants Insurance Corp. (TAMIC) for loss
or damage during the voyage. The vessel sank en route to Manila. Mr. Pablo then filed
a claim with TAMIC which was denied for the reason that prior to delivery, Mr. Pablo
had no insurable interest. Decide the case.
Answer:
Page | 35
Mr. Pablo had an existing insurable interest on the piece of machinery he bought. The
purchase of goods under a perfected contract of sale already vested equitable interest on the
property in favor of the buyer even while it is pending delivery. (BAR 1991)
7. In a civil suit, the Court ordered Benjie to pay Nat P500,000. To execute the judgment,
the sheriff levied upon Benjies registered property (a parcel of land and the building
thereon), and sold the same at public auction to Nat, the highest bidder. The latter, on
March 18, 1992, registered with the Register of Deeds the certificate of sale issued to
him by the sheriff. Meanwhile, on January 27, 1993, Benjie insured with Garapal
Insurance for P1 M the same building that was sold at public auction to Nat. Benjie
failed to redeem the property by March 18, 1993.
On March 19, 1993, a fire razed the building to the ground. Garapal Insurance refused
to make good its obligation to Benjie under the insurance contract.
Answer:
1. Yes. At the time of the loss, Benjie was no longer the owner of the property insured as he
failed to redeem the property. The law requires in property insurance that a person can
recover the proceeds of the policy if he has insurable interest at the time of the issuance
of the policy and also at the time when the loss occurs. At the time of fire, Benjie no
longer had insurable interest in the property insured.
2. No. While at the time of the loss he has insurable interest in the building, as he was the
owner thereof, Nat did not have any interest in the policy. There was no automatic
transfer clause in the policy that would give him such interest in the policy. (BAR 1994)
8. A obtains a fire insurance on his house and as a generous gesture names his neighbor
as the beneficiary. If As house is destroyed by fire, can B successfully claim against
the policy?
Answer:
No. in property insurance, the beneficiary must have insurable interest in the property
insured. B does not have insurable interest in the house insured. (BAR 1997)
3 months later, a fire of accidental origin broke out and completely destroyed the
grocery including his stocks-in-trade. This prompted the businessman to file with
First Insurance a claim for P5 M representing the full value of his goods.
First Insurance denied the claim because it discovered that at the time of the loss, the
stock-in-trade were mortgaged to a creditor who likewise obtained from Second
Insurance Company fore insurance coverage for the stocks at their full value of P5 M.
a) May the businessman and the creditor obtain separate insurance coverage
over the same stocks-in-trade? Explain.
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b) Suppose you are the Judge, how much would you allow the businessman and
the creditor to recover from their respective insurers. Explain.
Answer:
a) Yes. The businessman, as owner, and the creditor, as mortgagee, have separate insurable
interests in the same stocks-in-trade. Each may insure such interest to protect his own
separate interest.
b) As judge, I would allow the businessman to recover his total loss of P5 M pesos
representing the full value of his goods which were lost through fire. As to the creditor, I
would allow him to recover the amount to the extent of or equivalent to the value of the
credit he extended to the businessman for the stocks-in-trade which were mortgaged by
the businessman. (BAR 1999)
10. IS, is an elderly bachelor with no known relatives, obtained life insurance coverage
for P250,000 from Starbrite Insurance Corporation, an entity licensed to engage in
the insurable business under the Insurance Code of the Philippines. He also insured
his residential house for twice that amount with the same corporation. He
immediately assigned all his rights to the insurance proceeds to BX, a
friendcompanion living with him. 3 years later, IS died in a fire that gutted his insured
house 2 days after he had sold it. There is no evidence of suicide or arson or
involvement of BX in these events. BX demanded payment of the insurance proceeds
from the 2 policies, the premiums for which IS had been faithfully paying during all
the time he was alive. Starbrite, refused payment, contending that BX had no
insurable interest and therefore was not entitled to receive the proceeds from IS
insurance coverage on his life and also on his property. Is Starbrites contention
valid? Explain.
Answer:
Starbrite is correct with respect to the insurance coverage on the property of IS. The
beneficiary in the property insurance policy or the assignee thereof must have insurable
interest in the property insured. BX, a mere friend-companion of IS, has no insurable
interest in the residential house of IS. BX is not entitled to receive the proceeds from IS
insurance on his property.
As to the insurance coverage on the life of IS, BX is entitled to receive the proceeds. There is
no requirement that BX should have insurable interest in the life of IS. It was IS himself who
took the insurance on his own life. (BAR 2000)
11. JQ, owner of a condominium unit, insured the same against fire with XYZ Insurance
Co., and made the loss payable to his brother, MLQ. In case of loss by fire of the said
condominium unit, who may recover on the fire insurance policy? State the reason/s
for your answer.
Answer:
JQ can recover on the fire insurance policy for the loss of the said condominium unit. He has
the insurable interest as owner-insured. As beneficiary in the fire insurance policy, MLQ
cannot recover on the fire insurance policy. For the beneficiary to recover on the fire or
property insurance policy, it is required that he must have insurable interest in the property
insured. In this case, MLQ does not have insurable interest in the condominium unit. (BAR
2001)
Page | 37
12. Distinguish insurable interest in property insurance from insurable interest in life
insurance.
Answer:
1) In property insurance, the expectation of benefit must have a legal basis. In life
insurance, the expectation of benefit to be derived from the continued existence of a life
need not have any legal basis.
2) In property insurance, the actual value of the interest therein is the limit of the insurance
that can validly be placed thereon. In life insurance, there is no limit to the amount of
insurance that may be taken upon life.
3) In property insurance, an interest insured must exist when the insurance takes effect
and when the loss occurs but need not exist in the meantime. In life insurance, it is
enough that insurable interest exists at the time when the contract is made but it need
not exist at the time of loss. (BAR 2002)
13. Ciriaco leased a commercial apartment from Supreme Building Corporation (SBC).
One of the provisions of the 1-year lease contract states:
18. x x x The LESSEE shall not insure against fire the chattels, merchandise, textiles,
goods and effects placed at any stall or store or space in the leased premises without
first obtaining the written consent of the LESSOR. If the LESSEE obtains five insurance
coverage without the consent of the LESSOR, the insurance policy is deemed assigned
and transferred to the LESSRO for the latters benefit.
Notwithstanding the stipulation in the contract, without the consent of SBC, Ciriaco
insured the merchandise inside the premises against loss by fire in the amount of
P500,000 with First United Insurance Corporation (FUIC).
A day before the lease contract expired, fire broke out inside the leased premises,
damaging Ciriacos merchandise. Having learned of the insurance earlier procured by
Ciriaco, SBC demanded from FUIC that the proceeds of the insurance policy be paid
directly to it, as provided in the lease contract.
Answer:
Ciriaco is entitled to receive the proceeds of the insurance policy. The stipulation that the
policy is deemed assigned and transferred to SBC is void, because SBC has no insurable
interest in the merchandise of Ciriaco. (BAR 2009)
14. X owned a house and lot. X insured the house. The house got burned. Then he sold the
partially burnt house and the lot to Y. Which statement is most accurate?
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c) No one is entitled to the proceeds because ownership over the house and lot
was already transferred;
d) Y will be the one entitled to the proceeds because he now owns the partially
burnt house and lot.
Answer:
b) X is still entitled to the proceeds of the insurance policy because what is material is that
at the time of the loss, X is the owner of the house and lot. (BAR 2012)
15. For both the Life Insurance and Property Insurance, the insurable interest is required
to be
a) Existing at the time of perfection of the contract and at the time of loss;
b) Existing at the time of perfection and at the time of loss for property;
c) Existing at the time of perfection for property insurance but for life insurance
both at the time of perfection and at the time of loss;
d) Existing at the time of perfection only.
Answer:
b) Existing at the time of perfection and at the time of loss for property. (BAR 2012)
1. Julie and Alma formed a business partnership. Under the business name Pino Shop,
the partnership engaged in a sale of construction materials. Julie insured the stocks in
trade of Pino Shop with WGC Insurance Company for P350,000. Subsequently, she
again got an insurance contract with RSI for P1 M and then from EIC for P200,000. A
fire of unknown origin gutted the store of the partnership. Julie filed her claims with
the 3 insurance companies. However, her claims were denied separately for breach of
policy condition which required the insured to give notice of any insurance effected
covering the stocks in trade. Julie went to court and contended that she should not be
blamed for the omission, alleging that the insurance agents for WGC, RSI and EIC
knew of the existence of the additional insurance coverage and that she was not
informed about the requirement that such other or additional insurance should be
stated in the policy.
Answer:
No. An insured is required to disclose the other insurances covering the subject matter of
the insurance being applied for. (BAR 1993)
Answer:
Co-insurance is the percentage in the value of the insured property which the insured
himself assumes or undertakes to act as insurer to the extent of the deficiency in the
insurance of the insured property. In case of loss or damage, the insurer will be liable only
Page | 39
for such proportion of the loss or damage as the amount of insurance bears to the
designated percentage of the full value of the property insured.
Reinsurance is where the insurer procures a third party, called the reinsurer, to insure him
against liability by reason of such original insurance. Basically, reinsurance is an insurance
against liability which the original insurer may incur in favor of the original insured. (BAR
1994)
3 months later, a fire of accidental origin broke out and completely destroyed the
grocery including his stocks-in-trade. This prompted the businessman to file with
First Insurance a claim for P5 M representing the full value of his goods.
First Insurance denied the claim because it discovered that at the time of the loss, the
stock-in-trade were mortgaged to a creditor who likewise obtained from Second
Insurance Company for insurance coverage for the stocks at their full value of P5 M.
First Insurance refused to pay claiming that double insurance is contrary to law. Is
this contention tenable?
Answer:
The contention of First Insurance that double insurance is contrary to law is untenable.
There is no law providing that double insurance is illegal per se. moreover, in the problem at
hand, there is no double insurance because the insured with the First Insurance is different
from the insured with the Second Insurance Company. The same is true with respect to the
interests insured in the two policies. (BAR 1999)
Answer:
a) Double insurance exists where the same person is insured by two or more insurers
separately with respect to the same subject matter and interest.
b) In double insurance, the insurers are considered as co-insurers. Each one is bound to
contribute ratably to the loss in proportion to the amount for which he is liable under his
contract. (BAR 2005)
5. Terrazas de Pation Verde, a condominium building, has a value of P50 M. The owner
insured the building against fire with 3 insurance companies for the following
amounts:
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a) Is the owners taking of insurance for the building with 3 insurers valid?
Discuss.
b) The building was totally razed by fire. If the owner decides to claim from
Eastern Insurance Corp. only P50 M, will the claim prosper? Explain.
Answer:
a) The taking of insurance from the 3 insurers is valid. It is a case of double insurance.
The Insurance Code provides that a double insurance exist where the same person is
insured by several insurers separately in respect to the same subject and interest.
Double insurance is valid. What is prohibited is for the insured to recover more than his
interest or value of the property pursuant to the principle of indemnity.
b) Yes, the owner may legally claim the entire P50 M from Eastern Insurance, Corp. The
Insurance Code provides that where the insured is overinsured by double insurance, the
insured, unless the policy otherwise provides, may claim payment from the insurers in
such order as he may select, up to the amount for which the insurers are severally liable
under their respective contracts. Each insurer is bound, as between himself and the
other insurers, to contribute ratably to the loss in proportion to the amount for which he
is liable under his contract. (BAR 2008)
Answer:
a) Avoids the policy. (BAR 2011)
7. X borrowed from CCC Bank. She mortgaged her house and lot in favor of the bank. X
insured her house. The bank also got the house insured.
Answer:
a) No, there is no double insurance. Double insurance exists where the same person is
insured by several insurers separately with respect to the same subject and interest.
b) Yes, X and CCC Bank can both insure the house as they have different insurable interests
therein. X, the borrower-mortgagor, has an insurable interest in the house being the
owner thereof while CCC Bank, the lender, also has an insurable interest in the house as
mortgagee thereof.
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c) Yes. If X obtained an open policy then she could claim an amount corresponding to the
extent of the damage based on the value of the house determined as of the date the
damaged occurred, but not to exceed the face value of the insurance policy; however, if
she obtained a valued policy then she could claim an amount corresponding to the
extent of the damage based on the agreed upon valuation of the house.
As for CCC Bank, it could claim an amount corresponding to the extent of the damage but
not to exceed the amount of the loan it extended to X or so much thereof as may remain
unpaid. (BAR 2012)
8. X insured the building she owns with 2 insurance companies for the same amount. In
case of damage
a) X cannot claim from any of the 2 insurers because with the double insurance,
the insurance coverage becomes automatically void;
b) The 2 insurers will be solidarily liable to the extent of the loss;
c) The 2 insurers will be proportionately liable;
d) X can choose who he wants to claim against.
Answer:
d) X can choose who he wants to claim against. (BAR 2012)
1. To secure a loan of P10 M, O mortgaged his building to C. in accordance with the loan
arrangements, O had the property insured with Acme Insurance Company for P10 M
with C as the beneficiary. C also took an insurance on the building upon his own
interest with Beta Insurance Co. for P5 M.
The building was totally destroyed by fire, a peril insured against in both insurance
policies. It was subsequently determined that the fire had been intentionally started
by O and that, in violation of the loan agreement, O had been storing inflammable
materials in the building.
How much can C recover from either or both insurance companies? What happens to
the P10 M debt of O to C?
Answer:
a) C cannot recover from Acme Insurance Co. unless the policy otherwise provides, where a
mortgagor of property effects insurance in his own name providing that the loss shall be
payable to the mortgagee, the insurance is deemed to be upon the interest of the
mortgagor. Any act of the mortgagor prior to the loss which would otherwise avoid the
insurance will have the same effect. Apart from the storing of the inflammable materials,
the act of the owner-mortgagor, O, caused the peril insured against.
With respect to the Beta Insurance Co., C can recover the full amount of P5 M since the
act of O in intentionally starting the fire that caused the loss cannot be attributable to
the mortgagee, C. The act of O in storing inflammable in the building contrary to the loan
agreement does not affect the insurance policy, unless the insurance policy itself
prohibited any storing of inflammable materials.
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b) The P10 M debt of O to C will be affected by the amount which C is able to collect from
the insurance companies. If C is unable to recover any amount, the full amount of the
debt remains. If C is able to recover P5 M from Beta insurance Co., the great weight of
authority is that the mortgagee is not allowed to retain his claim against O, the
mortgagor, but it passes by subrogation to the insurer to the extent of the money paid.
(Palilieo v. Cosio, 97 Phil. 919). In this case, Beta Ins. Co. will become entitled to collect
P5 M from O, and O will continue to remain liable to C for the balance of P5 M. (BAR
1984)
3 months later, a fire of accidental origin broke out and completely destroyed the
grocery including his stocks-in-trade. This prompted the businessman to file with
First Insurance a claim for P5 M representing the full value of his goods.
First Insurance denied the claim because it discovered that at the time of the loss, the
stock-in-trade were mortgaged to a creditor who likewise obtained from Second
Insurance Company fore insurance coverage for the stocks at their full value of P5 M.
c) May the businessman and the creditor obtain separate insurance coverage over
the same stocks-intrade? Explain.
d) Suppose you are the Judge, how much would you allow the businessman and the
creditor to recover from their respective insurers. Explain.
Answer:
c) Yes. The businessman, as owner, and the creditor, as mortgagee, have separate insurable
interests in the same stocks-in-trade. Each may insure such interest to protect his own
separate interest.
d) As judge, I would allow the businessman to recover his total loss of P5 M pesos
representing the full value of his goods which were lost through fire. As to the creditor, I
would allow him to recover the amount to the extent of or equivalent to the value of the
credit he extended to the businessman for the stocks-in-trade which were mortgaged by
the businessman. (BAR 1999)
Armando also took an insurance on the building upon his own interest with Second
Insurance Company for P5 M.
The building was totally destroyed by fire, a peril insured against under both
insurance policies. It was subsequently determined that the fire had been
intentionally started by Mario and that in violation of the loan agreement, he had
been storing inflammable materials in the building.
1. How much, if any, can Armando recover from either or both insurance companies?
Page | 43
Answer:
Armando can receive P5 M from Second Insurance Company. As mortgagee, he had an
insurable interest in the building. Armando cannot collect anything from First Insurance
Company. First Insurance Company is not liable for the loss of the building. First, it was due
to a willful act of Mario, who committed arson. Second, fire insurance policies contain a
warranty that the insured will not store hazardous materials within the insureds premises.
Mario breached this warranty when he stored inflammable materials in the building. These
two factors exonerate First Insurance Company from liability to Armando as mortgagee
even though it was Mario who committed them.
Answer:
Since Armando would have collected P5 M from Second Insurance Company, this amount
should be considered as partial payment of the loan. Armando can only collect the balance of
P5 M. Second Insurance Company can recover from Mario the amount of P5 M it paid,
because it became subrogated to the rights of Armando. (BAR 2010)
4. X borrowed from CCC Bank. She mortgaged her house and lot in favor of the bank. X
insured her house. The bank also got the house insured.
Answer:
d) No, there is no double insurance. Double insurance exists where the same person is
insured by several insurers separately with respect to the same subject and interest.
e) Yes, X and CCC Bank can both insure the house as they have different insurable interests
therein. X, the borrower-mortgagor, has an insurable interest in the house being the
owner thereof while CCC Bank, the lender, also has an insurable interest in the house as
mortgagee thereof.
f) Yes. If X obtained an open policy then she could claim an amount corresponding to the
extent of the damage based on the value of the house determined as of the date the
damaged occurred, but not to exceed the face value of the insurance policy; however, if
she obtained a valued policy then she could claim an amount corresponding to the
extent of the damage based on the agreed upon valuation of the house.
As for CCC Bank, it could claim an amount corresponding to the extent of the damage but
not to exceed the amount of the loan it extended to X or so much thereof as may remain
unpaid. (BAR 2012)
5. 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 REM has an express provision
which says that the insurance policy is also endorsed with the signing of the REM. Will
this be sufficient?
Page | 44
a) No, insurance policy must be expressly endorsed to the bank so that the bank will
have a right in the proceeds of such insurance in the event of loss;
b) The express provision contained in the Deed of REM to the effect that the policy is
also endorsed is sufficient;
c) Endorsement of the Insurance Policy in any form is not legally allowed;
d) Endorsement of the Insurance Policy must be in a formal document to be valid.
Answer:
b) No, insurance policy must be expressly endorsed to the bank so that the bank will have a
right in the proceeds of such insurance in the event of loss (BAR 2012)
Quirco then requested ALAC for the issuance of a cover note while he was trying to
raise funds to pay the insurance premium. ALAC granted the request. 10 days after he
received the cover note, Quirco had a heart seizure and had to be hospitalized. He
then filed a claim on the policy.
a) Can ALAC validly deny the claim on the ground that the insurance coverage, as
publicly offered was available only to persons 50 to 75 years of age? Why or why
not?
Answer:
No. by approving the application of Quirino who disclosed that he was already 80 years old,
ALAC waived the age requirement. ALAC is now stopped from raising such defense of age of
the insured.
Answer:
Yes. The issuance of a cover note resulted in the perfection of the contract of insurance. In
that case, it is only because there is delay in the issuance of the policy that the cover note
was issued.
The cover note is a receipt whereby the company agrees to insure the insured for 60 days
pending the issuance of a regular policy. No separate premium is to be paid on a cover note.
It is not a separate policy but is integrated in the regular policy to be subsequently issued.
(BAR 2009)
.
Page | 45
1. Offer and Acceptance/Consensual
As fate would have it, Ps daughter died. P sought payment of the proceeds of the
insurance but the company refused on the grounds that there was concealment of a
material fact in the insurance application form and that it had rejected the
application. P contended, on the other hand, that the binding deposit receipt
constituted a temporary contract of life insurance.
Answer:
The insurance company is not liable. The binding deposit receipt is merely conditional and
does not insure outright. Where an agreement is made between the applicant and the
agent, no liability shall attach until the principal (insurance company) approves the risk.
The binding deposit receipt is subordinated to the act of the insurance company in
approving or rejecting the application; thus, in life insurance, a binding slip or binding
receipt does not insure by itself; and, when as in this case the application was
disapproved, before the death of the insured, there was no perfected contract of insurance
in order to make the company liable. (Great Pacific Life Ass. Co. v. C.A., April 30, 1979; 89
SCRA 549.) (BAR 1980)
2. On June 1, 2011, X mailed to Y Insurance, Co. his application for life insurance, with
payment for 5 years of premium enclosed in it. On July 21, 2011, the insurance
company accepted the application and mailed, on the same day, its acceptance plus
the cover note. It reached Xs residence on August 11, 2011. But, as it happened, on
August 4, 2011, X figured in a car accident. He died a day later. May Xs heir recover
on the insurance policy?
a. Yes, since under the Cognition Theory, the insurance contract was perfected
upon acceptance by the insurer of Xs application.
b. No, since there is no privity of contract between the insurer and Xs heirs.
c. No, since X had no knowledge of the insurers acceptance of his application
before he died.
d. Yes, since under the Manifestation Theory, the insurance contract was perfected
upon acceptance of the insurer of Xs application.
Answer:
c. No, since X had no knowledge of the insurers acceptance of his application before he
died. (BAR 2011)
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a. Delay in Acceptance
b. Delivery of Policy
1. On September 25, 2013, Danny Marcial (Danny) procured an insurance on his life
with a face value of P5 M from RN Insurance Company (RN), with his wife Tina
Marcial (Tina) as sole beneficiary. On the same day, Danny issued an undated check
to RN for the full amount of the premium. On October 1, 2013, RN issued the policy
covering Dannys life insurance. On October 5, 2013, Danny met a tragic accident
and died. Tina claimed the insurance benefit, but RN was quick to deny the claim
because at the time of Dannys death, the check was not yet encashed and therefore
the premium remained unpaid.
Is RN correct? Will your answer be the same if the check is dated October 15, 2013?
Answer:
No. RN is not correct. After the issuance of the check by Danny for the full amount of the
premium, the unconditional delivery of an insurance policy of RN to Danny corresponding
to the terms of the application ordinarily consummates the contract, and the policy as
delivered becomes the final contract between the parties. Where the parties, so intend, the
insurance becomes effective at the time of the delivery of the policy notwithstanding the
fact that the check was not yet encashed. My answer will still be the same even if the check
is dated October 15, 2013 since an acknowledgment in a policy of the receipt of premium
is conclusive evidence of its payment for the purpose of making the policy binding. (BAR
2014)
NB Another answer to the second question is that the insured may recover since the loss
occurred prior to the date of the PDC. Acceptance of the PDC as a mode of premium
payment is effectively a grant of credit.
c. Transfer of Policy
1. The policy of insurance upon his life, with a face value of P100,000, was assigned by
Jose, a married man with 2 legitimate children, to his nephew, Y as security for a loan
of P50,000. He did not give the insurer any written notice of such assignment despite
the explicit provision to that effect in the policy. Jose died. Upon the claim on the
policy by the assignee, the insurer refused to pay on the ground that it was not
notified of the assignment. Upon the other hand, the heirs of Jose contended that Y is
not entitled to any amount under the policy because the assignment without due
notice to the insurer was void. Resolve the issues.
Answer:
A life insurance is assignable. A provision, however, in the policy stating that written notice
of such an assignment should be given to the insurer is valid. The failure of the notice of
assignment would thus preclude the assignee from claiming rights under the policy. The
failure of notice did not, however, avoid the policy; hence, upon the death of Jose, the
proceeds would, in the absence of a designated beneficiary, go to the estate of the insured.
The estate, in turn, would be liable for the loan of P50,000 owing in favor of Y. (BAR 1991)
Page | 47
d. Kinds of Policy
1. In 1964, Jose constructed a house worth P50,000.00, which he insured against fire for
the same amount. The insurance for the same amount was renewed every year. In
1974, when the house was already worth P100,00.00 on account of inflationary prices
(in case of a rebuilding), one-fifth (1/5) of the house was destroyed by fire. As nothing
illegal about the contract, how much, if any, can Jose successfully recover from the
Insurance Company? Reason.
Answer:
If the fire policy is a valued one, then Jose can recover 1/5 of P50,000.00. i.e., P10,000.00.
Under the Insurance Code, the valuation in a valued policy is conclusive between the parties
in the absence of fraud. So Jose cannot claim that since his house was worth P100,00.00 at
the time of the loss, he should be able to recover P20,000.00 (actual value of loss1/5 of
P100,00.00)
If the policy is an open policy then under the Iaw, appraisal of loss is made after the fire.
Since the house was worth P100,00.00 at such time, then the loss of Jose is P20,000.00 and
he can recover this amount under such an open policy. (BAR 1975)
2. Premium Payment
1. A insured his house against loss by fire for P100,000.00. The policy provides that the
insurer shall be liable if the property insured shall be damaged or destroyed by fire
after payment of premium, at anytime from, from June 15, 1976 to June 15, 1977.
The policy was delivered to A on June 14, 1976. Instead of paying the premium in
cash, A issued a promissory note dated June 15, 1976, for the amount of premium,
payable within 30 days. The note was accepted. On June 29, 1976, the property
insured was burned. The insurer refused to pay on the ground that the premium had
not been paid, and the note did not have the effect of payment as its value had not
been realized at the time the house was burned. Decide with reasons.
Answer:
Since the case given took place after the effectivity of the Insurance Code, it must be
governed by its provisions. Section 77 thereof provides: 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 Considering that this cited
provision replaces Section 72 of old Insurance Act expressly permitting the granting of
credit extension, the only conclusion is that the law-making power intended by the
amendment to disallow any agreement postponing payment of premium, including a grant
of credit extension. The issuance of a promissory note postpones payment by granting credit
extension. Therefore, the insurer is not liable under this express provision of the new
Insurance Code. The case of Capital Insurance & Surety Co. v. Plastic Era Co which held that
acceptance of a promissory note constitutes waiver of the stipulation that the insurer will be
liable only after the payment of premium and that in the absence of stipulation as to mode of
payment, a promissory note constitutes payment, took place before the Insurance Code
came into effect and was based on Section 72 of the old Insurance Act. It can therefore not
be made applicable to the given case. (BAR 1976)
Page | 48
NB Under the amendatory law, credit extension of not more than 90 days is allowed.
The acceptance of the PN is tantamount to a grant of credit. Since the loss occurred
ruling the credit period, the insured may recover
2. On December 17, 1975, a fire policy, insuring a building and its contents, was
delivered to the insured company. By agreement, it was allowed to pay the premium
within 30 days. On January 8, 1976, it paid the premium by means of a check
postdated January 16, 1976. The check was deposited by the insurance company only
on February 20, but the check bounced, although January 19, the insured has a
sufficient bank balance. On January 18, two days after the premium became due, the
insured property was burned and became a total loss.
Can the insurance company cancel the policy for non-payment of premium? Give
reasons for your answers.
Answer:
Yes, the insurance company can cancel the policy for nonpayment of the premium. The new
Insurance Code provides that notwithstanding any agreement to contrary, no policy or
contract of insurance is valid and binding unless and until the premium thereof has been
paid. (BAR 1978)
3. The Peninsula Insurance Company offered to insure Francis brand new car against
all risks in the sum of P1 M per year. The policy was issued with the premium fixed at
P60,000 payable in 6 months. Francis only paid the first two months installments.
Despite demands, he failed to pay the subsequent installments. 5 months after the
issuance of the policy, the vehicle was carnapped. Francis filed with the insurance
company a claim for its value. However, the company denied his claim on the ground
that he failed to pay the premium resulting in the cancellation of the policy.
Answer:
Yes, Francis can recover from Peninsula considering that his car was carnapped before the 6
month period to pay the premium installments expired. An insurance premium can be paid
in installments, and the insurance contract became valid and binding upon payment of the
first premium. When the insurer granted a credit term for the payment of the premium, it is
liable when the loss occurred before the expiration of such term. It could not deny liability
on the ground that payment was not made in full, for the reason that it agreed to accept
installment payments. For the same reason, it could not validly cancel the policy, more so,
without giving notice to the insured of its cancellation. (BAR 2006)
4. Alfredo took out a policy to insure his commercial building against fire. The broker
for the insurance company agreed to give a 15-day credit within which to pay the
insurance premium. Upon delivery of the policy on May 15, 2006, Alfredo issued a
postdated check payable on May 30, 2006. On May 28, 2006, a fire broke out and
destroyed the building owned by Alfredo.
Page | 49
b) Would your answer in a) be the same if it as found that the proximate cause of
the fire was an explosion and that fire was but the immediate cause of the loss
and there is no excepted peril under the policy?
c) If the fire was found to have been caused by Alfredos own negligence, can he
still recover on the policy?
Answer:
a) Yes, Alfredo may recover on the policy. It is valid to stipulate that the insured will be
granted credit term for the payment of premium. Payment by means of a check which
was accepted by the insurer, bearing a date prior to the loss, would be sufficient. The
subsequent effects of encashment retroact to the date of the check.
b) Yes, recovery under the insurance contract is allowed if the cause of the loss was either
the proximate or the immediate cause as long as an excepted peril, if any, was not the
proximate cause of the loss.
c) Yes, mere negligence on the part of the insured will not prevent recovery under the
insurance policy. The law merely prevents recovery when the cause of loss is the willful
act of the insured, alone or in connivance with others. (BAR 2007)
On April 5, 2010, the car was involved in an accident that resulted in its total loss.
On April 10, 2010, the drawee bank returned Enriques check with the notation
Insufficient Funds. Upon notification, Enrique immediately deposited additional
funds with the bank and asked the insurer to redeposit the check.
Enrique thereupon claimed indemnity from the insurer. Is the insurer liable under
the insurance coverage? Why or why not?
Answer:
The insurer is not liable under the insurance policy. Under Art 1249 of the Civil Code, the
delivery of a check produces the effect of payment only when it is encashed. The loss
occurred on April 5, 2010. When the check was deposited, it was returned on April 10, 2010,
for insufficiency of funds. The check was honored only after Enrique deposited additional
funds with the bank. Hence, it did not produce the effect of payment. (BAR 2010)
6. Stable Insurance Co. (SIC) and St. Peter Manufacturing Co. (SPMC) have had a long-
standing insurance relationship with each other; SPMC secured the comprehensive
fire insurance on its plant and facilities from SIC. The standing business practice
between them has been to allow SPMC a credit period of 90 days from the renewal of
the policy within which to pay the premium.
Soon after the new policy was issued and before premium payments could be made, a
fire gutted the covered plant and facilities to the ground. The day after the fire, SPMC
Page | 50
issued a managers check to SIC for the fire insurance premium, for which it was
issued a receipt; a week later SPMC issued its notice of loss.
SIC responded by issuing its own managers check for the amount of the premiums
SPMC had paid, and denied SPMCs claim on the ground that under the cash and
carry principle governing fire insurance, no coverage existed at the time the fire
occurred because the insurance premium had not been paid.
Answer:
SPMC is entitled to recover for the loss from SIC. SIC granted a credit term to pay the
premiums. This is not against the law, because the standing business practice of allowing
SPMC to pay the premiums after 60 or 90 days, was relied upon in good faith by SPMC. SIC is
in estoppel. (BAR 2013)
1. Name at least 3 instances when an insured is entitled to a return of the premium paid.
Answer:
Three instances when an insured is entitled to a return of premium paid are:
1. To the whole premium, if no part of his interest in the thing insured be exposed to
any of the perils insured against.
2. Where the insurance is made for a definite period of time and the insured
surrenders his policy, to such portion of the premium as corresponds with the
unexpired time at a pro rata rate, unless a short period rate has been agreed upon
and appears on the face of the policy, after deducting from the whole premium any
claim for loss or damage under the policy which has previously accrued.
3. When the contract is voidable on account of the fraud or misrepresentation of the
insurer or of his agent or on account of facts the existence of which the insured was
ignorant without his fault; or when, by any default of the insured other than actual
fraud, the insurer never incurred any liability under the policy. (BAR 2000)
1. Shipowner X, in applying for a marine insurance policy from ABC, Co., stated that his
vessel usually sails middle of August and with normally 100 tons of cargo. It turned
out later that the vessel departed on the first week of September and with only 10
tons of cargo. Will this avoid the policy that was issued?
Page | 51
Answer:
d. No, because there was only representation of intention. (BAR 2011)
a. The insurance policy can be cancelled because of the change in the use;
b. The insurance policy will automatically be changed;
c. The insurance policy need not be changed;
d. The insurance policy is fixed regardless of the changes in the use.
Answer:
Any of the above should be given full credit. (BAR 2012)
1. Concealment
Answer:
Yes, the Insurance Company can rescind the contract on the ground of misrepresentation or
concealment of material fact. The fact of the insureds operation is material to the insurer,
who may have refused to issue the life policy had it known of such fact. This is even more
true in a non-medical insurance where no medical exam is made and the information given
by the insured concerning his past health and diseases is a very important factor which the
insurer takes into consideration in deciding to issue the policy. (BAR 1975)
2. Pedro Reyes applied for fire insurance on his house. In his application, it was asked
the following question: Is the house insured with another Insurance Company? If so,
for how much? His answer was No. The fact, however, is that the house had been
insured with the FGU for P100,000.00. the application was approved and made a part
of the policy. Subsequently, a fire occurred in a neighboring house, and spread to the
house of Pedro Reyes which was completely burned. Demand for payment having
been refused by the insurer, Pedro Reyes filed a complaint. May he recover? Reason.
Answer:
No, Pedro Reyes may not recover. He was guilty of concealment or misrepresentation of a
material fact. The fact of the existence of the other insurance is material because had he
answered truthfully, the insurer would probably have charged him higher premium, or
would have made further inquiries, or would have imposed some other conditions in the
policy to protect its interest. The existence of a large amount of insurance increases the
moral hazard or the temptation to commit arson. Concealment of a material fact is a ground
for rescission and is a valid defense of an insurer in an action based on the policy. (BAR
1976)
3. A fire insurance policy in favor of the insured contained a stipulation that the insured
shall give notice to the company of any insurances already effected or which may
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subsequently be effected, covering the property insured and that unless such notice
be given before the occurrence of any loss, all benefits shall be forfeited. The face of
the policy bore the annotation Co-insurance declared. The things insured were
burned. It turned out that several insurances were obtained on the same goods for
the same term. The insurer refused to pay on the ground of concealment. May the
insured recover? Reason.
Answer:
Yes, the insured may recover since there is no concealment. The face of the policy bore
already the annotation, Co-insurance declared which is a notice to the insurer as to the
existence of other insurance contracts on the property insured. (Gen. Insurance & Surety
Corporation v. Ng Hua, L-14373, Jan. 30, 1960) (BAR 1979)
4. Marine insurance was secured upon goods on board a ship which departed from
Madagascar to Manila, without any disclosure to the insurer of the fact that the ship
had been reported at Lloyd of London as seen at sea, deep in water and leaky. This
report turned out later to be wrong because the ship was at no time during the voyage
leaky or in trouble, but was lost through another insured risk. The insurer refuses to
pay the insured, claiming concealment. The insured counters that the fact not
disclosed was erroneous and did not increase the risk and therefore immaterial.
Decide the dispute with reasons.
Answer:
The insured may not recover from the insurer. The information that the ship in question was
seen at sea, deep in water and leaky, although erroneous, was material, and its concealment
entitled the insurer to rescind the contract of insurance. (BAR 1979)
5. In June 1981, Juan applied for a life insurance policy with a double indemnity
provision in case of death by accident. Despite an express inquiry in the application
form for insurance, he did not mention the fact that he had suffered from viral
hepatitis the previous year. As Juan had fully recovered from the disease, the medical
examination performed by the insurance companys physician did not reveal such
previous illness, and showed that Juan was healthy and was an insurable risk. The
policy was issued forthwith.
The insurance company refused to pay Juans wife, the designated beneficiary, on two
grounds: that Juan was guilty of fraudulent concealment of his liver ailment, and that
Juans death was caused by his own negligence.
The policy is silent as to the effect of the insureds negligence on the right to recover
thereunder. Juans wife insists that she has a right to recover because Juans death
was caused by an accident which had nothing to do whatsoever with his liver ailment.
She therefore insists on double indemnity.
Answer:
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a) No, she is not entitled to any indemnity. Although Juan did not die of a liver ailment, the
fact of his concealment vitiated the insurers consent to the contract of insurance. Under
the Insurance Code, concealment of a material fact is a ground for rescission. And
materiality is determined not by the event which caused the death but by the probable
and reasonable influence of the fact concealed upon the other party in forming his
estimate of the disadvantages of the proposed contract, or in making inquiries. If the
insurer had known of Juans previous liver ailment, it would in all probabilities have at
least made more detailed inquiries about it or make a special examination of his liver
function, or perhaps even charge a higher premium because of the greater risk involved.
The concealment was therefore of a material fact, relieving the insurer from any liability
on the policy, regardless of the cause of death. Since the insurer is relieved from liability,
the question as to whether the event was an accident or not becomes moot. In any case,
under the Insurance Code, negligence of the insured or of others does not exonerate the
insurer.
b) My conclusion would be different. The insurer would be liable despite the fraudulent
concealment because the policy has become uncontestable since more than 2 years had
elapsed from the date thereof. (BAR 1983)
6. X applied for life insurance with Metropolitan Life Insurance Company. The
application contained this question: Have you ever had any ailment or disease of x x
x (b) the stomach or intestines, liver, kidney, or genitourinary organ? X, a
laundrywoman who has no medical knowledge answered No. the application was
approved, premium was paid and 6 months later, X died from cancer of the stomach.
The post medical examination of X shows that she had the cancer at the time she
applied for a policy. Can the beneficiary of X collect on the policy? Reasons.
Answer:
The beneficiary of X cannot collect on the policy. Concealment, as a defense against liability
by the insurer, may either be intentional or unintentional. Lack of knowledge on the part of
the insured about her ailment will not preclude the insurer from raising the defense. The
insurer may be held in estoppel only if, having known of the concealed or misrepresented
fact, still accepts the payment of premium which is not the situation in this case. (BAR 1989)
7. Juan procured a non-medical life insurance from Good Life Insurance. He designed
his wife, Petra, as the beneficiary. Earlier, in his application in response to the
question as to whether or not he had ever been hospitalized, he answered in the
negative. He forgot to mention his confinement at the Kidney Hospital.
After Juan died in a plane crash, Petra filed a claim with Good Life. Discovering Juans
previous hospitalization, Good Life rejected Petras claim on the ground of
concealment and misrepresentation. Petra sued Good Life, invoking good faith on the
part of Juan.
Answer:
No. Petras suit will not prosper (assuming that the policy of life insurance has been in force
for a period of less than 2 years from the date of its issue). The matters which Juan failed to
disclose was material and relevant to the approval and issuance of the insurance policy.
They would have affected Good Lifes action on his application, either by approving it with
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the corresponding adjustment for a higher premium or rejecting the same. Moreover, a
disclosure may have warranted a medical examination of Juan by Good Life in order for it to
reasonably assess the risk involved in accepting the application. In any case, good faith is no
defense in concealment. The waiver of a medical examination in the non-medical life
insurance from Good Life makes it even more necessary that Juan supply complete
information about his previous hospitalization for such information constitutes an
important factor which Good Life takes into consideration in deciding whether to issue the
policy or not.
If the policy of life insurance has been in force for a period of 2 years or more from the date
of its issue (on which point the given facts are vague) then Good Life can no longer prove
that the policy is void ab initio or is rescindable by reason of the fraudulent concealment or
misrepresentation of Juan. (BAR 1996)
8. The assured answers No to the question in the application for a life policy. Are you
suffering from any form of heart illness? In fact, the assured has been a heart patient
for many years. On September 7, 1991, the assured is killed in a plane crash. The
insurance company denies the claim for insurance proceeds and returns the premium
paid.
Answer:
Assuming that the incontestability clause does not apply because the policy has not been in
force for 2 years from date of issue, during the lifetime of the insured, the decision of the
insurance company not to pay is justified. There was fraudulent concealment. It is not
material that the insured died of a different cause than the fact concealed. The fact
concealed, that is the heart ailment, is material to the determination by the insurance
company whether or not to accept the application for insurance and to require the medical
examination of the insured.
However, of the incontestability clause applies t the insurance policy covering the life of the
insured had been in force for 2 years from the issuance thereof, the insurance company
would not be justified in denying the claim for the proceeds of the insurance and in
returning the premium paid. In that case, the insurer cannot prove the policy void ab initio
or rescindable by reason of fraudulent concealment or misrepresentation of the insured.
(BAR 1997)
9. Renato was issued a life insurance policy on January 2, 1990. He concealed the fact
that 3 years prior to the issuance of his life insurance policy, he had been seeing a
doctor about his heart ailment.
On March 1, 1992, Renato died of heart failure. May the heirs file a claim on the
proceeds of the life insurance policy of Renato?
Answer:
Yes. The life insurance policy in question was issued on January 2, 1990. More than 2 years
had elapsed when Renato, the insured, died on March 1, 1992. The incontestability clause
applies. (BAR 1998)
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10. A applied for a non-medical life insurance. The insured did not inform the insurer
that one week prior to his application for insurance, he was examined and confined at
St. Lukes Hospital where he was diagnosed for lung cancer. The insured soon
thereafter died in a plane crash. Is the insurer liable considering that the fact
concealed had no bearing with the cause of death of the insured? Why?
Answer:
No. The concealed fact is material to the approval and issuance of the insurance policy. It is
well settled that the insured need not die of the disease he failed to disclose to the insurer. It
is sufficient that his non-disclosure misled the insurer in forming his estimate of the risks of
the proposed insurance policy or in making inquiries.
(BAR 2001)
11. X, in the hospital for kidney dysfunction, was about to be discharged when he met his
friend Y. X told Y the reason for his hospitalization. A month later, X applied for an
insurance covering serious illness from ABC Insurance, Co., where Y was working as
Corporate Secretary. Since X had already told Y about his hospitalization, he no longer
answered a question regarding it in the application form. Would this constitute
concealment?
a. Yes, since the previous hospitalization would influence the insurer in deciding
whether to grant Xs application.
b. No, since Y may be regarded as ABCs agent and he already knew of Xs
previous hospitalization.
c. Yes, it would constitute concealment that amounts to misrepresentation on Xs
part.
d. No, since the previous illness is not a material fact to the insurance coverage.
Answer:
a. Yes, since the previous hospitalization would influence the insurer in deciding whether to
grant Xs application. (BAR 2011)
12. An insured, who gains knowledge of a material fact already after the effectivity of the
insurance policy, is not obliged to divulge it. The reason for this is that the test of
concealment of material fact is determined.
Answer:
d. any time before the policy becomes effective. (BAR 2011)
13. Benny applied for life insurance for P1.5 M. the insurance company approved his
application and issued an insurance policy effective Nov. 6, 2008. Benny named his
children as his beneficiaries. On April 6, 2010, Benny died of hapatoma, a liver
ailment.
The insurance company denied the childrens claim for the proceeds of the insurance
policy on the ground that Benny failed to disclose in his application 2 previous
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consultations with his doctors for diabetes and hypertension, and that he had been
diagnosed to be suffering from hepatoma. The insurance company also rescinded the
policy and refunded the premiums paid.
Answer:
The insurance company correctly rescinded the policy because of concealment. Benny did
not disclose that he was suffering from diabetes, hypertension, and hepatoma. The
concealment is material because these are serious ailments. Benny died less than 2 years
from the date of the issuance of the policy. (BAR 2013)
14. On May 13, 1996, PAM, Inc. obtained a P15 M fire insurance policy from Ilocano
Insurance covering its machineries and equipment effective for 1 year or until May
14, 1997. The policy expressly stated that the insured properties were located at
Sanyo Precision Phils. Building, Phase III, Lots 4 and 6, Block 15, PEZA, Rosario
Cavite. Before its expiration, the policy was renewed on as is basis for another year
until May, 13, 1998. The subject properties were later transferred to Pace Factory
also in PEZA. On October 12, 1997, during the effectivity of the renewed policy, a fire
broke out at the Pace Factory which totally burned the insured properties.
The policy forbade the removal of the insured properties unless sanctioned by
Ilocano. Condition 9(c) of the policy provides that the insurance ceases to attach as
regards the property affected unless the insured, before the occurrence of any loss or
damage, obtains the sanction of the company signified by endorsement upon the
policy x x x (c) if the property insured is removed to any building or place other than
in that which is herein stated to be insured. PAM claims that it has substantially
complied with notifying Ilocano for the insurance coverage. Is Ilocano liable under
the policy?
Answer:
Ilocano is not liable under the policy. With the transfer of the location of the subject
properties, without notice and without insurers consent, after the renewal of the policy, the
insured clearly committed concealment, misrepresentation and a breach of material
warranty. The Insurance Code provides that a neglect to communicate that which a party
knows and ought to communicate, is called concealment. A concealment entitles the injured
party to rescind a contract of insurance in case of an alteration in the use or condition of the
thing insured. An alteration in the use or condition of a thing insured from that to which it is
limited by the policy made without the consent of the insurer, by means within the control
of the insured, and increasing the risks, entitles the insurer to rescind the contract of fire
insurance. (BAR 2014)
2. Misrepresentation/Omissions
1. A, an agent of life insurance company X, induced B who has been suffering from advance
tuberculosis to apply for P10,000.00 life insurance which B did and he (B) requested A
to fill the application form. Thru the connivance of the physician, it was made to
appear in the application that B is in good health and the P10,000.00 life insurance
policy was issued by X to B. If B dies of tuberculosis, may his beneficiaries recover?
Page | 57
Answer:
It depends. The insurer is bound when its agent writes a false answer into the application
without the knowledge of the insured, in which case his (insured) beneficiaries may recover,
but a collusion between the agent and the insured in misrepresenting the facts will vitiate
the policy; thus, in the instant case, if A obtained from B a correct and truthful answer to
interrogatories contained in the application but without the knowledge of B filed in false
answer and thru the connivance with the company physician, it was made to appear that B
is in good health, the insurer cannot assert the falsity of such answers as a defense to
liability on the policy. (BAR 1976)
2. On October 18, 1980, P, took out a life insurance policy and named his only son Q as
beneficiary. The policy was silent with regard to any change of beneficiary. P later
learned that Q was hooked on drugs and immediately notified the insurance company
in writing that he is substituting his sister, R, as his beneficiary in place of Q. P later
died of advanced tuberculosis. In the application form filled up by the agent of the
insurance company prior to the issuance of the life insurance policy by the insurance
company, the agent, without the knowledge of P, filled in a false answer and made it
appear that P was in good health. Upon Ps death, Q claimed the proceeds of the
insurance policy contending that as designated beneficiary, he cannot be changed
without his consent, he having acquired a vested right to the proceeds of the policy.
Answer:
No, the insurer cannot escape liability. The insurance agent is an agent not of the insured but
of the insurer and the latter must thus suffer for the misconduct of the agent. The result
would have been different had the false answer been made by the agent in connivance with
the insured. (BAR 1988)
3. Breach of Warranties
1. Pabaya paid for a fire insurance policy on his multi storey building. At the time he
applied for the insurance, he told the representative of the insurance company that
he planned to assign a security guard on every floor of the building right away. Except
for the ground floor, no security guards were assigned. 11 months after the policy was
issued, the building was gutted by fire which started on the third floor. Unknown to
Pabaya, the insurance company had incorporated his planned undertaking in the
policy.
Answer:
Pabaya can recover under the insurance policy. The statement of Pabaya that he planned to
assign a security guard on every floor of the insured building, whether incorporated in the
policy or not, did not amount to firm commitment so as to constitute an express warranty or
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representation. The facts indicate that it was simply planned, not obligatory or promissory,
undertaking. (BAR 1986)
2. Julie and Alma formed a business partnership. Under the business name Pino Shop,
the partnership engaged in a sale of construction materials. Julie insured the stocks in
trade of Pino Shop with WGC Insurance Company for P350,000. Subsequently, she
again got an insurance contract with RSI for P1 M and then from EIC for P200,000. A
fire of unknown origin gutted the store of the partnership. Julie filed her claims with
the 3 insurance companies. However, her claims were denied separately for breach of
policy condition which required the insured to give notice of any insurance effected
covering the stocks in trade. Julie went to court and contended that she should not be
blamed for the omission, alleging that the insurance agents for WGC, RSI and EIC
knew of the existence of the additional insurance coverage and that she was not
informed about the requirement that such other or additional insurance should be
stated in the policy.
Answer:
No, because she is guilty of violation of a warranty/ condition. (BAR 1992)
Armando also took an insurance on the building upon his own interest with Second
Insurance Company for P5 M.
The building was totally destroyed by fire, a peril insured against under both
insurance policies. It was subsequently determined that the fire had been
intentionally started by Mario and that in violation of the loan agreement, he had
been storing inflammable materials in the building.
How much, if any, can Armando recover from either or both insurance companies?
Answer:
Armando can receive P5 M from Second Insurance Company. As mortgagee, he had an
insurable interest in the building. Armando cannot collect anything from First Insurance
Company. First Insurance Company is not liable for the loss of the building. First, it was due
to a willful act of Mario, who committed arson. Second, fire insurance policies contain a
warranty that the insured will not store hazardous materials within the insureds premises.
Mario breached this warranty when he stored inflammable materials in the building. These
two factors exonerate First Insurance Company from liability to Armando as mortgagee
even though it was Mario who committed them. (BAR 2010)
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I. Claims Settlement and Subrogation
1. Robin insured his building against fire with EFG Assurance. The insurance policy
contained the usual stipulation that any action or suit must be filed within 1 year
after the rejection of the claim.
After his building burned down, Robin filed his claim for fire loss with EFG. On
February 28, 1994, EFG denied Robins claim. On April 3, 1994, Robin sought
reconsideration of the denial, but EFG reiterated its position. On March 20,1995,
Robin commenced judicial action against EFG.
Answer:
No, Robins action should not be given due course. His filing of the request for
reconsideration did not suspend the running of the prescriptive period of 1 year stipulated
in the insurance policy. Thus, when Robin commenced judicial action against EFG on March
20, 1995, his ability to do so had already prescribed. The 1 year period is counted from
February 28, 1994 when EFG denied Robins claim, not from the date (presumably after
April 3, 1994) when EFG reiterated its position denying Robins claim. The reason for this
rule is to insure that claims against insurance companies are promptly settled and that
insurance suits are brought by the insured while the evidence as to the origin and cause of
the destruction has not yet disappeared. (BAR 1996)
c. Subrogation
1. A helicopter of ABC Co. collided with XYZs tramway steel cables in its logging area in
Surigao resulting in the destruction of the helicopter and death of two pilots. ABC Co.
insured at its expense the helicopter and death of two pilots. ABC Co. insured at its
expense the helicopter for P80,000.00 and the two pilots (life insurance) for
P50,000.00 each, and as a result of the crash, the insurer paid ABC Co. a total
indemnity of P180,000.00. Nevertheless, ABC Co sustained additional damages of
about P100,000.00 which were not covered by insurance.
1) ABC Co. sued XYZ to recover not only the additional damages, but also the
P180,000 which was already compensated by the insurer. Decide. Give
reasons.
2) What right/recourse, if any, has the insurer in order to be reimbursed for the
amount it paid to ABC Co? Give reasons.
Answer:
1) ABC Co may bring the action against XYZ for its claim for the additional damages not
covered by insurance, but not for the P180,000 covered by the insurance. If a property is
insured and the owner received indemnity from the insurer, the latter is deemed
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subrogated to the rights of the insured against the wrongdoer, and if the amount paid by
the insurer does not fully cover the loss, then the aggrieved party is the one entitled to
recover the deficiency.
2) The insurer is deemed subrogated to the rights of ABC Co against XYZ to the extent of
P80,000 insurance paid for the helicopter only, but not for the life insurance of the two
dead pilots, since subrogation in the New Civil Code refers only to property, and not to
the life insurance. (Philippine Air Lines, Inc. v. Herald Lumber Co., G.R. L-11497, August
16, 1957; for both 1 and 2 answers.) (BAR 1978)
2. L borrows P50,000 from M payable 360 days after date, at 12% interest per
annum. To secure the loan, L mortgages his house and lot in favor of M. To protect
himself from certain contingencies, M insures the house for the full amount of the
loan with Rock Insurance Company. A fire breaks out and burns the house and M
collects from the insurance company the full value of the insurance.
Upon maturity of the loan, the insurance company demands payment from L. The
latter refuses to pay on the ground that the loan had been extinguished by the
insurance payment which M received from the insurance company. He argues that
he has not entered into any loan or contract of whatever nature with the insurance
company. He further contends that it is bad enough to lose a house but it is worse if
one has to pay off a paid obligation to somebody who has not extended any loan to
him. Besides, he states, that the insurance payment should inure to his benefit
because he owns the house.
Answer:
Neither the loan of L was extinguished by the insurance payment which M received from the
insurance company; nor the insurance payment inures to Ls benefit; what was then insured
was the interest of M, the secured creditor, and not the interest of L, so the proceeds shall be
applied exclusively to the proper interest of M.
Ls argument that he has not entered into any loan or contract of whatever nature with the
insurance company is also untenable. When the secured creditors interest in the mortgaged
property of the mortgagor, L, was insured and said property would be burned, the insurance
company had to pay the insured, M, and payment by the insurer to the insured creates legal
subrogation and makes the insurer an assignee on equity to run after the mortgagor, L. Said
right of the insurer is not dependent upon nor does it grow out of, any privity of contract, or
upon written assignment of claim, and payment to insured makes the insurer an assignee in
equity; thus, Ls consent to said subrogation is not necessary. (Art. 2207, N.C.C.; Firemans
Fund Insurance Co. v. Jamila & Co., April 7, 1976; 70 SCRA 323) (BAR 1980)
3. Rauls truck bumped the car owned by Luz. The car was insured by Cala Insurance.
For the damage caused, Cala paid Luz P5,000 in amicable settlement. Luz executed a
release claim, subrogating Cala to all her rights against Raul. When Cala demanded
reimbursement from Raul, the latter refused saying that he had already paid Luz
P4,500 for the damage to the car as evidenced by a release of claim executed by Luz
discharging Raul.
So Cala demanded reimbursement from Luz, who refused to pay, saying that the total
damage to the car was P9,500. Since Cala paid P5,000 only, Luz contends that she was
entitled to go after Raul to claim the additional P4,500.
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1. Is Cala, as subrogee of Luz, entitled to reimbursement from Raul?
2. May Cala recover what it has paid Luz?
Answer:
1. No. Luz executed a release in favor of Raul.
2. Yes. Cala lost its right against Raul because of the release executed by Luz. Since the
release was made without the consent of Cala, Cala may recover the amount of P5,000.
(BAR 1994)
4. Where the insurer was made to pay the insured for a loss covered by the insurance
contract, such insurer can run after the third person who caused the loss through
subrogation. What is the basis for conferring the right of subrogation to the insurer?
Answer:
b. The equitable assignment that results from the insurers payment of the insured. (BAR
2011)
5. ELP Insurance, Inc. issued a Marine Policy No. 888 in favor of FCL Corp. to insure the
shipment of 132 bundles of electric copper cathodes against all risks. Subsequently,
the cargoes were shipped on board the vessel M/V Menchu from Leyte to Pier 10,
North Harbor, Manila.
Upon arrival, FCL Corp. engaged the services of CGM, Inc. for the release and
withdrawal of the cargoes from the pier and the subsequent delivery to its
warehouses/plants in Valenzuela City. The goods were loaded on board 12 trucks
owned by CGM, Inc., driven by its employed drivers and accompanied by its employed
truck helpers. Of the 12 trucks en route to Valenzuela City, only 11 reached the
destination. One truck, loaded with 11 bundles of copper cathodes, failed to deliver
its cargo.
Because of this incident, FCL Corp. filed with ELP Insurance, Inc. a claim for insurance
indemnity in the amount of P1.5 M. After the requisite investigation and adjustment,
ELP Insurance, Inc. paid FCL Corp. the amount of P1,350,000.00 as insurance
indemnity.
ELP Insurance, Inc., thereafter, filed a complaint for damages against CGM, Inc. before
the RTC, seeking reimbursement of the amount it had paid to FCL Corp. for the loss of
the subject cargo. CGM, Inc. denied the claim on the basis that it is not privy to the
contract entered into by and between FCL Corp. and ELP Insurance, Inc., and hence, it
is not liable therefor. If you are the judge, how will you decide the case?
Answer:
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CGM, Inc. should be held liable for damages against ELP Insurance, Inc. The insurer, upon
happening of the risk insured against and after payment to the insured is subrogated to the
rights and cause of action of the latter. As such, the insurer has the right to seek
reimbursement for all the expenses paid. (BAR 2014)
IB. Will an insurance policy be binding even if the premium is unpaid? What if it were partially paid?
(3%)
As a general rule, the insurance policy is not valid and binding unless the premium thereof has been paid. This is the
cash and carry rule under the Insurance Code. Premium is the consideration for the undertaking of the insurer to
indemnify the insured against a specified peril. There are exceptions, however, one of them is when there is an
agreement allowing the insured to pay the premium in installments and partial payment has been made at the time of
the loss. ( Makati Tuscany Condominium Corporation vs Court of Appeals, 215 SCRA 463)
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