Prescription of Action

G.R. No. 71360 July 16, 1986

DEVELOPMENT INSURANCE CORPORATION, petitioner,

Balgos & Perez Law Offices for petitioner.

Agustin M. Sundiam for private respondent.

CRUZ, J.:

A fire occurred in the building of the private respondent and it sued for recovery of damages from the petitioner on the basis
of an insurance contract between them. The petitioner allegedly failed to answer on time and was declared in default by the
trial court. A judgment of default was subsequently rendered on the strength of the evidence submitted ex parte by the private
respondent, which was allowed full recovery of its claimed damages. On learning of this decision, the petitioner moved to lift
the order of default, invoking excusable neglect, and to vacate the judgment by default. Its motion was denied. It then went to
the respondent court, which affirmed the decision of the trial court in toto. The petitioner is now before us, hoping presumably
that it will fare better here than before the trial court and the Intermediate Appellate Court. We shall see.

On the question of default, the record argues mightily against it. It is indisputable that summons was served on it, through its
senior vice-president, on June 19,1980. On July 14, 1980, ten days after the expiration of the original 15-day period to answer
(excluding July 4), its counsel filed an ex parte motion for an extension of five days within which to file its answer. On July 18,
1980, the last day of the requested extension-which at the time had not yet been granted-the same counsel filed a second
motion for another 5-day extension, fourteen days after the expiry of the original period to file its answer. The trial court
nevertheless gave it five days from July 14, 1980, or until July 19, 1980, within which to file its answer. But it did not. It did so
only on July 26, 1980, after the expiry of the original and extended periods, or twenty-one days after the July 5, deadline. As a
consequence, the trial court, on motion of the private respondent filed on July 28, 1980, declared the petitioner in default. This
was done almost one month later, on August 25, 1980. Even so, the petitioner made no move at all for two months thereafter.
It was only on October 27, 1980, more than one month after the judgment of default was rendered by the trial court on
September 26, 1980, that it filed a motion to lift the order of default and vacate the judgment by default. 1

The pattern of inexcusable neglect, if not deliberate delay, is all too clear. The petitioner has slumbered on its right and
awakened too late. While it is true that in Trajano v. Cruz, 2 which it cites, this Court declared "that judgments by default are generally looked upon with
disfavor," the default judgment in that case was set aside precisely because there was excusable neglect, Summons in that case was served through "an employee in
petitioners' office and not the person in-charge," whereas in the present case summons was served on the vice-president of the petitioner who however refused to accept it.
Furthermore, as Justice Guerrero noted, there was no evidence showing that the petitioners in Trajano intended to unduly delay the case.

Besides, the petitioners in Trajano had a valid defense against the complaint filed against them, and this justified a relaxation
of the procedural rules to allow full hearing on the substantive issues raised. In the instant case, by contrast, the petitioner
must just the same fail on the merits even if the default orders were to be lifted. As the respondent Court observed, "Nothing
would be gained by having the order of default set aside considering the appellant has no valid defense in its favor." 3

The petitioner's claim that the insurance covered only the building and not the elevators is absurd, to say the least. This Court
has little patience with puerile arguments that affront common sense, let alone basic legal principles with which even law
students are familiar. The circumstance that the building insured is seven stories high and so had to be provided with
elevators-a legal requirement known to the petitioner as an insurance company-makes its contention all the more ridiculous.

No less preposterous is the petitioner's claim that the elevators were insured after the occurrence of the fire, a case of
shutting the barn door after the horse had escaped, so to speak. 4 This pretense merits scant attention. Equally undeserving of serious consideration
is its submission that the elevators were not damaged by the fire, against the report of The arson investigators of the INP 5 and, indeed, its own expressed admission in its
answer 6 where it affirmed that the fire "damaged or destroyed a portion of the 7th floor of the insured building and more particularly a Hitachi elevator control panel." 7

There is no reason to disturb the factual findings of the lower court, as affirmed by the Intermediate Appellate Court, that the
heat and moisture caused by the fire damaged although they did not actually burn the elevators. Neither is this Court justified
in reversing their determination, also factual, of the value of the loss sustained by the private respondent in the amount of
P508,867.00.
The only remaining question to be settled is the amount of the indemnity due to the private respondent under its insurance
contract with the petitioner. This will require an examination of this contract, Policy No. RY/F-082, as renewed, by virtue of
which the petitioner insured the private respondent's building against fire for P2,500,000.00. 8

The petitioner argues that since at the time of the fire the building insured was worth P5,800,000.00, the private respondent
should be considered its own insurer for the difference between that amount and the face value of the policy and should
share pro rata in the loss sustained. Accordingly, the private respondent is entitled to an indemnity of only P67,629.31, the
rest of the loss to be shouldered by it alone. In support of this contention, the petitioner cites Condition 17 of the policy, which
provides:

If the property hereby insured shall, at the breaking out of any fire, be collectively of greater value than the sum insured
thereon then the insured shall be considered as being his own insurer for the difference, and shall bear a ratable proportion of
the loss accordingly. Every item, if more than one, of the policy shall be separately subject to this condition.

However, there is no evidence on record that the building was worth P5,800,000.00 at the time of the loss; only the petitioner
says so and it does not back up its self-serving estimate with any independent corroboration. On the contrary, the building
was insured at P2,500,000.00, and this must be considered, by agreement of the insurer and the insured, the actual value of
the property insured on the day the fire occurred. This valuation becomes even more believable if it is remembered that at the
time the building was burned it was still under construction and not yet completed.

The Court notes that Policy RY/F-082 is an open policy and is subject to the express condition that:

Open Policy

This is an open policy as defined in Section 57 of the Insurance Act. In the event of loss, whether total or partial, it is
understood that the amount of the loss shall be subject to appraisal and the liability of the company, if established, shall be
limited to the actual loss, subject to the applicable terms, conditions, warranties and clauses of this Policy, and in no case
shall exceed the amount of the policy.

As defined in the aforestated provision, which is now Section 60 of the Insurance Code, "an open policy is one in which the
value of the thing insured is not agreed upon but is left to be ascertained in case of loss. " This means that the actual loss, as
determined, will represent the total indemnity due the insured from the insurer except only that the total indemnity shall not
exceed the face value of the policy.

The actual loss has been ascertained in this case and, to repeat, this Court will respect such factual determination in the
absence of proof that it was arrived at arbitrarily. There is no such showing. Hence, applying the open policy clause as
expressly agreed upon by the parties in their contract, we hold that the private respondent is entitled to the payment of
indemnity under the said contract in the total amount of P508,867.00.

The refusal of its vice-president to receive the private respondent's complaint, as reported in the sheriff's return, was the first
indication of the petitioner's intention to prolong this case and postpone the discharge of its obligation to the private
respondent under this agreement. That intention was revealed further in its subsequent acts-or inaction-which indeed enabled
it to avoid payment for more than five years from the filing of the claim against it in 1980. The petitioner has temporized long
enough to avoid its legitimate responsibility; the delay must and does end now.

WHEREFORE, the appealed decision is affirmed in full, with costs against the petitioner.

SO ORDERED.
G.R. No. 92383 July 17, 1992

SUN INSURANCE OFFICE, LTD., petitioner,

CRUZ, J.:

The petitioner issued Personal Accident Policy No. 05687 to Felix Lim, Jr. with a face value of P200,000.00. Two months
later, he was dead with a bullet wound in his head. As beneficiary, his wife Nerissa Lim sought payment on the policy but her
claim was rejected. The petitioner agreed that there was no suicide. It argued, however that there was no accident either.

Pilar Nalagon, Lim's secretary, was the only eyewitness to his death. It happened on October 6, 1982, at about 10 o'clock in
the evening, after his mother's birthday party. According to Nalagon, Lim was in a happy mood (but not drunk) and was
playing with his handgun, from which he had previously removed the magazine. As she watched television, he stood in front
of her and pointed the gun at her. She pushed it aside and said it might he loaded. He assured her it was not and then
pointed it to his temple. The next moment there was an explosion and Lim slumped to the floor. He was dead before he fell. 1

The widow sued the petitioner in the Regional Trial Court of Zamboanga City and was sustained. 2 The petitioner was
sentenced to pay her P200,000.00, representing the face value of the policy, with interest at the legal rate; P10,000.00 as moral
damages; P5,000.00 as exemplary damages; P5,000.00 as actual and compensatory damages; and P5,000.00 as attorney's fees,
plus the costs of the suit. This decision was affirmed on appeal, and the motion for reconsideration was denied. 3 The petitioner then
came to this Court to fault the Court of Appeals for approving the payment of the claim and the award of damages.

The term "accident" has been defined as follows:

The words "accident" and "accidental" have never acquired any technical signification in law, and when used in an insurance
contract are to be construed and considered according to the ordinary understanding and common usage and speech of
people generally. In-substance, the courts are practically agreed that the words "accident" and "accidental" mean that which
happens by chance or fortuitously, without intention or design, and which is unexpected, unusual, and unforeseen. The
definition that has usually been adopted by the courts is that an accident is an event that takes place without one's foresight
or expectation — an event that proceeds from an unknown cause, or is an unusual effect of a known case, and therefore not
expected. 4

An accident is an event which happens without any human agency or, if happening through human agency, an event which,
under the circumstances, is unusual to and not expected by the person to whom it happens. It has also been defined as an
injury which happens by reason of some violence or casualty to the injured without his design, consent, or voluntary co-
operation. 5

In light of these definitions, the Court is convinced that the incident that resulted in Lim's death was indeed an accident. The
petitioner, invoking the case of De la Cruz v. Capital Insurance, 6 says that "there is no accident when a deliberate act is
performed unless some additional, unexpected, independent and unforeseen happening occurs which produces or brings about
their injury or death." There was such a happening. This was the firing of the gun, which was the additional unexpected and
independent and unforeseen occurrence that led to the insured person's death.

The petitioner also cites one of the four exceptions provided for in the insurance contract and contends that the private
petitioner's claim is barred by such provision. It is there stated:

Exceptions —

The company shall not be liable in respect of

1. Bodily injury

xxx xxx xxx

b. consequent upon
i) The insured person attempting to commit suicide or willfully exposing himself to needless peril except in an attempt to save
human life.

To repeat, the parties agree that Lim did not commit suicide. Nevertheless, the petitioner contends that the insured willfully
exposed himself to needless peril and thus removed himself from the coverage of the insurance policy.

It should be noted at the outset that suicide and willful exposure to needless peril are in pari materia because they both
signify a disregard for one's life. The only difference is in degree, as suicide imports a positive act of ending such life whereas
the second act indicates a reckless risking of it that is almost suicidal in intent. To illustrate, a person who walks a tightrope
one thousand meters above the ground and without any safety device may not actually be intending to commit suicide, but
his act is nonetheless suicidal. He would thus be considered as "willfully exposing himself to needless peril" within the
meaning of the exception in question.

The petitioner maintains that by the mere act of pointing the gun to hip temple, Lim had willfully exposed himself to needless
peril and so came under the exception. The theory is that a gun is per se dangerous and should therefore be handled
cautiously in every case.

That posture is arguable. But what is not is that, as the secretary testified, Lim had removed the magazine from the gun and
believed it was no longer dangerous. He expressly assured her that the gun was not loaded. It is submitted that Lim did not
willfully expose himself to needless peril when he pointed the gun to his temple because the fact is that he thought it was not
unsafe to do so. The act was precisely intended to assure Nalagon that the gun was indeed harmless.

The contrary view is expressed by the petitioner thus:

Accident insurance policies were never intended to reward the insured for his tendency to show off or for his miscalculations.
They were intended to provide for contingencies. Hence, when I miscalculate and jump from the Quezon Bridge into the
Pasig River in the belief that I can overcome the current, I have wilfully exposed myself to peril and must accept the
consequences of my act. If I drown I cannot go to the insurance company to ask them to compensate me for my failure to
swim as well as I thought I could. The insured in the case at bar deliberately put the gun to his head and pulled the trigger. He
wilfully exposed himself to peril.

The Court certainly agrees that a drowned man cannot go to the insurance company to ask for compensation. That might
frighten the insurance people to death. We also agree that under the circumstances narrated, his beneficiary would not be
able to collect on the insurance policy for it is clear that when he braved the currents below, he deliberately exposed himself
to a known peril.

The private respondent maintains that Lim did not. That is where she says the analogy fails. The petitioner's hypothetical
swimmer knew when he dived off the Quezon Bridge that the currents below were dangerous. By contrast, Lim did not know
that the gun he put to his head was loaded.

Lim was unquestionably negligent and that negligence cost him his own life. But it should not prevent his widow from
recovering from the insurance policy he obtained precisely against accident. There is nothing in the policy that relieves the
insurer of the responsibility to pay the indemnity agreed upon if the insured is shown to have contributed to his own accident.
Indeed, most accidents are caused by negligence. There are only four exceptions expressly made in the contract to relieve
the insurer from liability, and none of these exceptions is applicable in the case at bar. **

It bears noting that insurance contracts are as a rule supposed to be interpreted liberally in favor of the assured. There is no
reason to deviate from this rule, especially in view of the circumstances of this case as above analyzed.

On the second assigned error, however, the Court must rule in favor of the petitioner. The basic issue raised in this case is,
as the petitioner correctly observed, one of first impression. It is evident that the petitioner was acting in good faith then it
resisted the private respondent's claim on the ground that the death of the insured was covered by the exception. The issue
was indeed debatable and was clearly not raised only for the purpose of evading a legitimate obligation. We hold therefore
that the award of moral and exemplary damages and of attorney's fees is unjust and so must be disapproved.

In order that a person may be made liable to the payment of moral damages, the law requires that his act be wrongful. The
adverse result of an action does not per se make the act wrongful and subject the act or to the payment of moral damages.
The law could not have meant to impose a penalty on the right to litigate; such right is so precious that moral damages may
not be charged on those who may exercise it erroneously. For these the law taxes costs. 7
The fact that the results of the trial were adverse to Barreto did not alone make his act in bringing the action wrongful because in
most cases one party will lose; we would be imposing an unjust condition or limitation on the right to litigate. We hold that the award
of moral damages in the case at bar is not justified by the facts had circumstances as well as the law.

If a party wins, he cannot, as a rule, recover attorney's fees and litigation expenses, since it is not the fact of winning alone
that entitles him to recover such damages of the exceptional circumstances enumerated in Art. 2208. Otherwise, every time a
defendant wins, automatically the plaintiff must pay attorney's fees thereby putting a premium on the right to litigate which
should not be so. For those expenses, the law deems the award of costs as sufficient. 8

WHEREFORE, the challenged decision of the Court of Appeals is AFFIRMED in so far as it holds the petitioner liable to the
private respondent in the sum of P200,000.00 representing the face value of the insurance contract, with interest at the legal
rate from the date of the filing of the complaint until the full amount is paid, but MODIFIED with the deletion of all awards for
damages, including attorney's fees, except the costs of the suit.

SO ORDERED.
G.R. No. 103883 November 14, 1996

JACQUELINE JIMENEZ VDA. DE GABRIEL, petitioner,

VITUG, J.:

The petition for review on certiorari in this case seeks the reversal of the decision 1 of the Court of Appeals setting aside the
judgment of the Regional Trial Court of Manila, Branch 55, which has ordered private respondent Fortune Insurance & Surety
Company, Inc., to pay petitioner Jacqueline Jimenez vda. de Gabriel, the surviving spouse and beneficiary in an accident (group)
insurance of her deceased husband, the amount of P100,000.00, plus legal interest.

Marcelino Gabriel, the insured, was employed by Emerald Construction & Development Corporation ("ECDC") at its
construction project in Iraq. He was covered by a personal accident insurance in the amount of P100,000.00 under a group
policy 2 procured from private respondent by ECDC for its overseas workers. The insured risk was for "(b)odily injury caused by
violent accidental external and visible means which injury (would) solely and independently of any other cause" 3result in death or
disability.

On 22 May 1982, within the life of the policy, Gabriel died in Iraq. A year later, or on 12 July 1983, ECDC reported Gabriel's
death to private respondent by telephone. 4 Among the documents thereafter submitted to private respondent were a copy of the
death certificate 5 issued by the Ministry of Health of the Republic of Iraq — which stated

REASON OF DEATH: UNDER EXAMINATION NOW — NOT YET KNOWN 6 —

and an autopsy report 7 of the National Bureau of Investigation ("NBI") to the effect that "(d)ue to advanced state of postmortem
decomposition, cause of death (could) not be determined." 8 Private respondent referred the insurance claim to Mission Adjustment
Service, Inc.

Following a series of communications between petitioner and private respondent, the latter, on 22 September 1983, ultimately
denied the claim of ECDC on the ground of prescription. 9 Petitioner went to the Regional Trial Court of Manila. In her complaint
against ECDC and private respondent, she averred that her husband died of electrocution while in the performance of his work and
prayed for the recovery of P100,000.00 for insurance indemnification and of various other sums by way of actual, moral, and
exemplary damages, plus attorney's fees and costs of suit.

Private respondent filed its answer, which was not verified, admitting the genuineness and due execution of the insurance
policy; it alleged, however, that since both the death certificate issued by the Iraqi Ministry of Health and the autopsy report of
the NBI failed to disclose the cause of Gabriel's death, it denied liability under the policy. In addition, private respondent
raised the defense of "prescription," invoking Section 384 10 of the Insurance Code. Later, private respondent filed an amended
answer, still unverified, reiterating its original defenses but, this time, additionally putting up a counterclaim and a crossclaim.

The trial court dismissed the case against ECDC for the failure of petitioner to take steps to cause the service of the
fourth alias summons on ECDC. The dismissal was without prejudice.

The case proceeded against private respondent alone. On 28 May 1987, the trial court rendered its decision 11 in favor (partly)
of petitioner's claim. In arriving at its conclusion, the trial court held that private respondent was deemed to have waived the
defense, i.e., that the cause of Gabriel's death was not covered by the policy, when the latter failed to impugn by evidence
petitioner's averment on the matter. With regard to the defense of prescription, the court considered the complaint to have been
timely filed or within one (1) year from private respondent's denial of the claim.

Petitioner and private respondent both appealed to the Court of Appeals. Petitioner contended that the lower court should
have awarded all the claims she had asked for. Private respondent asserted, on its part, that the lower court erred in ruling (a)
that the insurer had waived the defense that Gabriel's death was not caused by the insured peril ("violent accidental external
and visible means") specified in the policy and (b) that the cause of action had not prescribed.

The Court of Appeals, on 18 September 1991, reversed the decision of the lower court. The appellate court held that
petitioner had failed to substantiate her allegation that her husband's death was caused by a risk insured against. The
appellate court observed that the only evidence presented by petitioner, in her attempt to show the circumstances that led to
the death of the insured, were her own affidavit and a letter allegedly written by a co-worker of the deceased in Iraq which,
unfortunately for her, were held to be both
hearsay. 12

The motion for reconsideration was denied. 13

Petitioner's recourse to this Court must also fail.

On the issue of "prescription," private respondent correctly invoked Section 384 of the Insurance Code; viz:

Sec. 384. Any person having any claim upon the policy issued pursuant to this chapter shall, without any unnecessary delay,
present to the insurance company concerned a written notice of claim setting forth the nature, extent and duration of the
injuries sustained as certified by a duly licensed physician. Notice of claim must be filed within six months from date of the
accident, otherwise, the claim shall be deemed waived. Action or suit for recovery of damage due to loss or injury must be
brought, in proper cases, with the Commissioner or the Courts within one year from denial of the claim, otherwise, the
claimant's right of action shall prescribe.

The notice of death was given to private respondent, concededly, more than a year after the death of petitioner's husband.
Private respondent, in invoking prescription, was not referring to the one-year period from the denial of the claim within which
to file an action against an insurer but obviously to the written notice of claim that had to be submitted within six months from
the time of the accident.

Petitioner argues that private respondent must be deemed to have waived its right to controvert the claim, that is, to show that
the cause of death is an excepted peril, by failing to have its answers (to the Request for Admission sent by petitioner) duly
verified. It is true that a matter of which a written request for admission is made shall be deemed impliedly admitted "unless,
within a period designated in the request, which shall not be less than ten (10) days after service thereof, or within such
further time as the court may allow on motion and notice, the party to whom the request is directed serves upon the party
requesting the admission a sworn statement either denying specifically the matters of which an admission is requested or
setting forth in detail the reasons why he cannot truthfully either admit or deny those matters;" 14 however, the verification, like
in most cases required by the rules of procedure, is a formal, not jurisdictional, requirement, and mainly intended to secure an
assurance that matters which are alleged are done in good faith or are true and correct and not of mere speculation. When
circumstances warrant, the court may simply order the correction of unverified pleadings or act on it and waive strict compliance
with the rules in order that the ends of justice may thereby be served. 15 In the case of answers to written requests for admission
particularly, the court can allow the party making the admission, whether made expressly or deemed to have been made impliedly,
"to withdraw or amend it upon such terms as may be just." 16

The appellate court acted neither erroneously nor with grave abuse of discretion when it seconded the court a quo and ruled:

As to the allegation of the plaintiff-appellant that the matters requested by her to be admitted by the defendant-appellant
under the Request for Admission were already deemed admitted by the latter for its failure to answer it under oath, has
already been properly laid to rest when the lower court in its Order of May 28, 1987 correctly ruled:

At the outset, it must be stressed that the defendant indeed filed a written answer to the request for
admission, sans verification. The case of Motor Service Co., Inc. vs. Yellow Taxicab Co., Inc., et al. may not therefore be
controlling, or actually opposite. In said case, there was an absolute failure on the part of the defendant to answer the request
for admission, and thus the court was justified in rendering a summary judgment. Here, however, as clearly intimated
elsewhere above, the defendant answered in writing practically every question posed in the request for admission. The Court
believes, under the peculiar circumstance, that the more controlling jurisprudence on the mater would be those cited by the
defendant in its memorandum, particularly the case of Quimpo vs. de la Victoria, 46 SCRA 139.

Prescinding from the foregoing, there is absolutely no basis in fact and in law for the lower court to hold that the appellant
insurance company was deemed to have waived the defense, that the death of plaintiff-appellant's husband was not caused
by violent accidental external and visible means' as contemplated in the insurance policy. The Death Certificate (Exh. 9) and
the Autopsy Report (Exh. 10), more than controverted the allegation of the plaintiff-appellant as to the cause of death of her
husband. 17

The insurance policy expressly provided that to be compensable, the injury or death should be caused by "violent accidental
external and visible means." In attempting to prove the cause of her husband's death, all that petitioner could submit were a
letter sent to her by her husband's co-worker, stating that Gabriel died when he tried to haul water out of a tank while its
submerged motor was still functioning, 18 and petitioner's sinumpaang
salaysay 19 which merely confirmed the receipt and stated contents of the letter. Said the appellate court in this regard:
. . . . It must be noted that the only evidence presented by her to prove the circumstances surrounding her husband's death
were her purported affidavit and the letter allegedly written by the deceased co-worker in Iraq. The said affidavit however
suffers from procedural infirmity as it was not even testified to or identified by the affiant (plaintiff-appellant) herself. This self-
serving affidavit therefore is a mere hearsay under the rules, . . . .

xxx xxx xxx

In like manner, the letter allegedly written by the deceased's co-worker which was never identified to in court by the supposed
author, suffers from the same defect as the affidavit of the plaintiff-appellant. 20

Not one of the other documents submitted, to wit, the POEA decision, dated 06 June 1984, 21 the death certificate issued by the
Ministry of Health of Iraq and the NBI autopsy report, 22 could give any probative value to petitioner's claim. The POEA decision did
not make any categorical holding on the specific cause of Gabriel's death. Neither did the death certificate issued by the health
authorities in Iraq nor the NBI autopsy report provide any clue on the cause of death. All that appeared to be clear was the fact of
Gabriel's demise on 22 May 1982 in Iraq.

Evidence, in fine, is utterly wanting to establish that the insured suffered from an accidental death, the risk covered by the
policy. In an accident insurance, the insured's beneficiary has the burden of proof in demonstrating that the cause of death is
due to the covered peril. Once that fact is established, the burden then shifts to the insurer to show any excepted peril that
may have been stipulated by the parties. An "accident insurance" is not thus to be likened to an ordinary life insurance where
the insured's death, regardless of the cause thereof, would normally be compensable. The latter is akin in property insurance
to an "all risk" coverage where the insured, on the aspect of burden of proof, has merely to show the condition of the property
insured when the policy attaches and the fact of loss or damage during the period of the policy and where, thereafter, the
burden would be on the insurer to show any "excluded peril." When, however, the insured risk is specified, like in the case
before us, it lies with the claimant of the insurance proceeds to initially prove that the loss is caused by the covered peril.

While petitioner did fail in substantiating her allegation that the death of her husband was due to an accident, considering,
however, the uncertainty on the real cause of death, private respondent might find its way clear into still taking a second look
on the matter and perhaps help ease the load of petitioner's loss.

WHEREFORE, the decision appealed from is AFFIRMED. No costs.

SO ORDERED.