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SEC 2
Insurance- an agreement whereby one undertakes for a
consideration to indemnify another against lost, damage or
liability arising from an unknown or contingent event.
6. Consensual
Characteristics: (RAPE-ACUCU)
1.
2.
3.
4.
5.
6.
7.
8.
9.
Payment of Premium
Assumption of Risk
Risk of Loss
Insurable Interest
Scheme to Distribute the Losses
Voluntary
Aleatory
Property
Onerous
Risk Distributing Device
Right of Subrogation:
Classifications:
(1) Life Insurance
a. Individual life
b. Group life
c. Industrial life
(2) Non-life
a. Marine
b. Fire
c. Casualty
Surety:
Construction:
SEC 3
SEC 4
SEC 6
Parties of the Contract of Insurance:
1. Insurer/assurer/underwriter-assumes/accepts the risk of
loss, undertakes for a consideration to indemnify the
insured on the happening of a specified contingent or
event.
2. Insured- who is indemnified. (ANYONE EXCEPT PUBLIC
ENEMY)
3. Cestui que vie- a person on whose life the insurance is
written
4. Beneficiary- person designated by the terms of the policy
as one to receive the proceeds of the insurance.
Insurer:
1. Foreign or domestic insurance corporation
Sufficient capital and assets required under the
Insurance Code
SEC 7
Public enemy- designates a nation with whom Philippines is at
war ans it includes every citizen or subjects of that nation.
-Alien enemy
SEC 8
SEC 9
SEC 10
Insurable interest- interest which the law requires the owner of
an insurance policy to have in the person or thing insured.
Pecuniary/financial benefit
Benefit from its existence and prejudice from
destruction
its
Note: Under our law, the consent of the person insured is not
essential to the validity of the policy. So long as it could be proved
that the assured has a legal insurable interest at the inception of the
policy, the insurance is valid even without such consent.
Note: Debtor insures his life for the benefit of the creditor, if there is
full payment, debtors estate will benefit.
SEC 11
Kinds of Beneficiary:
1. Insured himself
2. Third person who paid a consideration
3. Third person through mere bounty of the insured
Cannot be beneficiaries: (Art 739)
Those who are guilty of adultery or concubinage with
the insured at the time of the designation
Those who were found guilty with the insured of the
same criminal offense, committed in the consideration
of the designation
A public officer or his wife, descendants and
ascendants designated by reason of his office.
Right of insured to change beneficiary in Life Insurance:
SEC 12
Interest- right to receive the proceeds
Nearest relatives of the insured:
(1) Legitimate children
(2) Father and mother
(3) Grandmother and grandfather or ascendants in nearest
degree
(4) Illegitimate children
(5) Surviving spouse
(6) Collateral relatives
Brothers and sisters (halfblood and fullblood)
Nephews and nieces
In default, the State shall be entitled to receive the insurance
proceeds.
Liability of insurer on death of the insured:
(1) Death at the hands of the law assumed by the insurer under a
life policy in the absence of a valid policy exception
(2) Death by self-destruction, insurer is not liable in the case that
insured commits suicide intentionally. But death which is
purely accidental, even though due to the insureds own
carelessness or negligence is not excluded from the
coverage by the words self-destruction.
(3) Death by suicide while insane does not discharge the insurer
from his liability on the contract. (Insurer must have known)
(4) Death caused by beneficiary, still can recover if:
a. Killing was accidental/defense
b. Beneficiary was insane
(5) Death caused by violation of law- the insurer must establish
that the commission of the felony or the violation of the law
was the cause or the causal connection with the accident
resulting in the death of the insured.
SEC 16
Mere hope or expectation of benefit uncoupled with any
present legal right will not support a contract of insurance
Insurable interest of a beneficiary under a will- no legal basis
since the will has no legal effect before the death of the
testator.
SEC 19
SEC 13
SEC 14
1. Existing interest- legal title or equitable title
2. Inchoate title
-Even if without title, he will suffer the loss as the
proximate result of its damage or destruction.
3. Expectancy with existing interest
-Expectation of benefit to be derived from the
continued existence of the property must have a basis of a
legal right.
-Such expectation not arising from any legal right or
duty in connection with the property does not constitute an
insurable interest.
SEC 20
Exceptions:
SEC 26
Devices for ascertaining and controlling risk and loss:
(1)
(2)
(3)
(4)
Concealment
Representation
Warranties
Conditions
Requisites of concealment:
1. Knows the fact which he neglects to communicate/disclose to
other
2. Duty bound to disclose such fact
3. The party concealing makes no warranty of the fact concealed
4. The other party has no means of ascertaining the fact
concealed
SEC 27
SEC 28
Test: If the applicant is aware of the existence of some circumstances
which he knows would influence the insurer in acting upon his
application. Good faith requires him to disclose that
circumstance, though unasked.
SEC 31
SEC 34
SEC 36
Representation-statement made by the insured at the time of or
prior to the issuance of the policy relative to the risk to be insured,
as to an existing or past fact or state of facts, or concerning a
future happening, to give information to the insurer and otherwise
induce him to enter into the insurance contract.
SEC 44
Misrepresentation
(1) Fact which is untrue
(2) With an intent to deceive/stated as true without it to be true
which has a tendency to mislead
(3) Such fact is material to the risk
SEC 39
Kinds of Representation:
1. Affirmative representation- allegation as to the existence or
non-existence of a fact when the contract begins.
2. Promissory representation- promise to be fulfilled after the
contract has come into existence or any statement concerning
what is to happen during the existence of the insurance.
SEC 46
Concealment vs Misrepresentation
(1) The insured withholds information of material facts from the
insurer (Concealment)
The insured makes erroneous statements of facts with the
intent of inducing the insurer to enter into the contract.
(Misrepresentation)
(2) Materiality is determined by the same rules of
misrepresentation
(3) Rescind the contract
(4) Whether intentional or not
SEC 48
SEC 43
SEC 49 & 50
Policy- written document embodying the terms and stipulations of the
contract of insurance between the insurer and the insured.
-The insurer must instead take affirmative steps to make sure that the
insured is informed of his remedial rights.
SEC 51
Contents of the Policy:
(1)
(2)
(3)
(4)
(5)
(6)
(1) Open policy- does not predetermine the value of the insured
property but establishes a maximum amount the insurer will
pay in case of a total loss of the property insured.
-establish the FMV of the insureds property at the
time of the loss. If the FMV exceeds the maximum, the
latter will control, if below, the former.
-has no fixed face value, the face value adjusting itself to the
changing value at one specified location or at each of several
location.
Advantages of a running policy:
(1) He is neither underinsured/overinsured
(2) Avoids cancellations- adjustments to the value at each
location
(3) Saved by the trouble of watching the insurance and the
danger of being uninsured
(4) Rate is adjusted to 100% insurance.
SEC 63
actually occurs but from the time when the insured has a right
to bring an action against the insurer.
(1) Stipulated prescriptive period begins from the happening of
the loss
(2) Stipulated prescriptive period begins from the rejection of the
claim
(3) Stipulated prescriptive period begins from filing of the claim
(contradicts public policy)
SEC 64 and 65
Cancellation- right to rescind, abandon, or cancel a contract of
insurance.
-termination by insured or insurer before expiration
(1) Right to renew upon the same terms and conditions of the
original policy upon payment of the premium due on the
effective date of the renewal
(2) Unless insurer at least 45 days in advance gives notice of its
intention not to renew the policy or to condition its renewal
upon reduction of its amount or elimination of some
coverages.
(3) Notice within the prescribed period:
a. Written less than 1 year- considered as if written 1 year
b. Written for a longer term or with no fixed expiration
date is considered as if written for successive policy
period terms for 1 year.