What may be insured/insured against?

Guingon v. del monte Jeepney driver crash – The right of the injured party to sue the
insurer of the party at fault (insured) depends on whether the
contract of insurance is intended to benefit third persons also
or only the insured
Eternal Gardens MPC v. Philam Creditor Group Life Policy (clients of Eternal who purchased
burial lots from it on installment basis would be insured by
Philamlife) – EFFECTIVE DATE OF BENEFIT was ambiguous. 1 st
sentence: effective upon loan with assured; 2 nd sentence:
effective upon approval of insurance application by Philam.
Evidence shows that there was an application that was stamped
by Philam. Also, when the contract is ambiguous, construction
favors the insured.
Blue Cross Health Care v. Olivares Health care program but ailments due to pre-existing conditions
were excluded from coverage; Olivares had a stroke. Olivares
refused to let her doctor release any medical information. Blue
Cross has the burden of proving the stroke was due to a pre-
existing condition and cannot attack on the privilege
communication between physician and patient to compel
Olivares to let her doctor release the medical information. The
mere reliance on a disputable presumption does not meet the
strict standard required under our jurisprudence. When the
terms contain limitations on liability, they should be construed
strictly against the insurer.
Malayan Insurance v. Regis Brokers Lost pieces of motors during transfer – From Fasco (US) to ABB
Koppel (Ph). Paircargos was the warehouse, and Regis was the
one to deliver it from the warehouse to Koppel. When the
shipment arrived, only 65 out of 120 pieces of motors were
delivered.
No Marine insurance policy was presented, but only a Marine
Risk Note. Even assuming that the Marine Risk Note presented
the insurance contract, it was made only after the partial loss
happened.
Loss – 7 March 1995
Marine Risk Note – 21 March 1995
Sec. 3: past event can be insured, but only if unknown to both
parties.
The particular date as to when such insurance contract was
constituted cannot be established with certainty without the
contract itself. No insurance on a risk that had already
occurred by the time the contract was executed.
Eastern Shipping v. Prudential Auto parts from Japan to be delivered to consignee Nissan PH.
The carrier was Eastern Shipping. When the goods arrived,
Arrastre ATI said that 4 cases were damaged. When delivered to
 Nissan, their surveyor said there were damaged items due to
improper handling. Nissan demanded from ATI and Eastern.
Prudential as insurer paid Nissan, and the former sought for
reimbursement from ATI and Eastern as it subrogated the rights
of Nissan.
Again, only presented Marine Risk Note (only an
acknowledgement or declaration of the insurer confirming the
specific shipment covered by its marine open policy).
Marine Risk Note =/= Insurance Policy.
Cargoes delivered – 8 Nov 1995
Arrived in Manila – 16 Nov 1995
Marine Risk Note issued – 16 Nov 1995
(Same as Malayan case)
GR: Must present Marine Insurance Policy
XPN: When the loss of the cargo undoubtedly occurred while
on board the petitioner’s vessel (ICTSI ruling)
- While the loss of the cargo undoubtedly occurred in
Eastern’s custody, Eastern had repeatedly objected to
the non-presentation of the marine insurance policy
(compared to the ICTSI ruling na d nag object)
- Dangerous precedence daw if we follow the rule that
the presentation of the contract is not needed anymore
Paramount Insurance v. Qualified Theft – Sps. Remondeulaz insured their car with
Remondeulaz Paramount. One day, they entrusted their car to Sales for
repairs and add accessories and improvements, which the latter
would return in 3 days time. It was not returned. Sps. Sought to
recover the amount from insurer
Paramount: it was not theft because the sps entrusted the car
SC: there was intent to gain (the use of the car). Having
entrusted the car, Sales misappropriated the car, constituting
Qualified Theft. Therefore, it is under the insurance policy and
Paramount should indemnify the sps.
United Merchants v. Country UMC insured their stocks in trade of Christmas lights against fire
Bankers with Country. A fire gutted their warehouse, and now UMC is
trying to claim insurance from Country.
Country refuses to indemnify since it was allegedly arson, and
UMC had a fraudulent scheme.
SC: Although Country failed to prove it was arson, nevertheless
the receipts of their stock is fraudulent
- Stock in trade = tangible personal property kept for sale
or traffic. Their claim was for 50M
- UMC presented invoices for 20M which were purchased
in one month. Also they presented invoices for raw
materials, and not for stock in trade. Purchases from
Fuze Industries worth 20M were also suspicious since
they were not in the invoices.
- Therefore their invoices were fraudulent
The submission of false invoices to the adjusters establishes a
 clear case of fraud and misrepresentation which voids the
insurer’s liability as per condition of the policy.
Parties to the contract
Valenzuela v. CA Valenzuala (General Agent of Philamgen) solicited marine
insurance for Delta Motors. He was not given his commission of
1.6M. Philamgen offered Valenzuela a 50-50 commission basis
which Valenzuela declined. Philamgen got mad and did not give
him his commission. They even terminated the General Agency
Agreement.
SC: The agency was one “coupled with an interest”. Insurance
agents have a hard time getting clients, and Valenzuela was
able to build up his reputation, just for Philamgen to terminate
it?
As to Valenzuela’s liability to pay Philamgen for the unpaid
and uncollected premiums: Valenzuela is merely an agent, not
a party to the contract of insurance. It is between Philamgen
and Delta Motors. The remedy for the non-payment of
premiums is to put an end to and render the insurance policy
not binding.
RCBC v. CA Goyu had a credit facilities and accommodations agreement
with RCBC for 117M. Goyu mortgaged 4 properties which were
insured by Malaya, Alchester being the agent.
Goyu’s factory building was gutted by fire, so Goyu sought to
claim indemnity from Malaya. Malaya denied the claim saying
that there were other creditors who have better rights. RCBC
also filed to claim from Malaya.
Although in the insurance contract RCBC was not a
beneficiary, it was revealed that the intention of Goyu and
RCBC was that RCBC was to be the beneficiary of the insurance
policy.
- Goyu got the policies from Malaya, a sister company of
RCBC
- Alchester said that the policies were in favor of RCBC
- Goyu and RCBC had an agreement and Goyu already
benefitted from the credit facility that they agreed
upon. SC: equity.
Palileo v. Cosio Palileo obtained a loan from Cosio. As security, Palileo gave a
Conditional Sale of Residential Building in favor of Cosio. Cosio
had this insured with Associated Insurance. When the building
was gutted by fire, Cosio obtained indemnity from Associated.
Palileo is now claiming the proceeds.
SC: Insurance taken by a mortgagee is independent of the
mortgagor.
What should happen:
Associated pays Cosio for indemnity
Associated is subrogated in the rights of Cosio (as mortgagee)
to claim from Palileo (mortgagor). The mortgagee may insure
 his interest in the property independently of the mortgagor.
Great Pacific Life v. CA DBP obtained a Group Life Insurance from Grepalife to insure
the lives of eligible housing loan mortgagors of DBP (Mortgage
Redemption Insurance).
Dr. Wilfredo, a debtor of DBP, applied for this. He then died due
to massive cerebral hemorrhage.
DBP wanted indemnification from Grepalife. Grepalife denied
and said that it was part of the exemption from the coverage
because he concealed his hypertension which caused his
hemorrhage. So DBP foreclosed on the lot of Wilfredo.
Wilfredo’s widow wanted to claim from Grepalife too.
SC: Yes, the widow is a real party-in-interest despite the
mortgage, and when he died, his heirs succeeded thereto.
What happens here:
Grepalife pays the creditor-mortgagee (DBP). Any excess will be
for the beneficiary/ies designated by the debtor.
Since a policy of insurance upon life or health MAY PASS by
transfer, will or succession to any person, whether he has an
insurable interest or not, and such person may recover it
whatever the insured might have recovered, the widow of the
decedent may file suit against the insurer Grepalife.