INSURANCE DIGESTS 4222017
In
VDA. DE GABRIEL V. CA G.R. NO. 103883 NOVEMBER
14, 1996
FACTS: Marcelino Gabriel was employed by Emerald
Construction & Development Corporation (Emerald
Construction for brevity) at its construction project in Iraq. He
was covered by a personal accident insurance in the amount
of P100,000.00 under a group policy procured from Fortune
Insurance & Surety Company (Fortune Insurance for brevity)
by Emerald Construction for its overseas workers. The
insured risk was for bodily injury caused by violent accidental
external and visible means which injury would solely and
independently of any other cause result in death or disability.
On 22 May 1982, within the life of the policy, Gabriel died in
Iraq. On 12 July 1983, Emerald Construction reported
Gabriels death to Fortune Insurance by telephone. Among
the documents thereafter submitted to Fortune Insurance
were a copy of the death certificate issued by the Ministry of
Health of the Republic of Iraq which stated that an autopsy
report by the National Bureau of Investigation was conducted
to the effect that due to advanced state of postmortem
decomposition, the cause of death of Gabriel could not be
determined (emphasis added).
Because of this development Fortune Insurance ultimately
denied the claim of Emerald Construction on the ground of
prescription. Gabriels widow, Jacqueline Jimenez, went to the
to the lower court. In her complaint against Emerald
Construction and Fortune Insurance, she averred that her
husband died of electrocution while in the performance of his
work.
Fortune Insurance alleged that since both the death
certificate issued by the Iraqi Ministry of Health and the
autopsy report of the NBI failed to disclose the cause of
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Gabriels death, it denied liability under the policy.
addition, private respondent raised the defense of
prescription, invoking Section 384 of the Insurance Code.
ISSUE: WON Jacqueline Jimenez vda. de Gabriels claim
against Fortune Insurance should be denied on the ground of
prescription
HELD: Yes. Section 384 of the Insurance Code provides:
Sec. 384. Any person having any claim upon the policy
issued pursuant to this chapter shall, without any
unnecessary delay, present to the insurance company
concerned a written notice of claim setting forth the nature,
extent and duration of the injuries sustained as certified by a
duly licensed physician. Notice of claim must be filed within
six months from date of the accident, otherwise, the claim
shall be deemed waived. Action or suit for recovery of
damage due to loss or injury must be brought, in proper
cases, with the Commissioner or the Courts within one year
from denial of the claim, otherwise, the claimants right of
action shall prescribe.
The notice of death was given to Fortune Insurance,
concededly, more than a year after the death of vda. de
Gabriels husband. Fortune Insurance, in invoking
prescription, was not referring to the one-year period from
the denial of the claim within which to file an action against
an insurer but obviously to the written notice of claim that
had to be submitted within six months from the time of the
accident.
Vda. de Gabriel argues that Fortune Insurance must be
deemed to have waived its right to show that the cause of
death is an excepted peril, by failing to have its answers duly
verified. It is true that a matter of which a written request for
admission is made shall be deemed impliedly admitted
unless, within a period designated in the request, which shall
not be less than 10 days after service thereof, or within such
further time as the court may allow on motion and notice, the
party to whom the request is directed serves upon the party
requesting the admission a sworn statement either denying
specifically the matters of which an admission is requested or
setting forth in detail the reasons why he cannot truthfully
either admit or deny those matters; however, the
verification, like in most cases required by the rules of
procedure, is a formal, not jurisdictional, requirement, and
mainly intended to secure an assurance that matters which
are alleged are done in good faith or are true and correct and
not of mere speculation. When circumstances warrant, the
court may simply order the correction of unverified pleadings
or act on it and waive strict compliance with the rules in
order that the ends of justice may thereby be served. In the
case of answers to written requests for admission
particularly, the court can allow the party making the
admission, whether made expressly or deemed to have been
made impliedly, to withdraw or amend it upon such terms as
may be just.
The insurance policy expressly provided that to be
compensable, the injury or death should be caused by violent
accidental external and visible means. In attempting to prove
the cause of her husbands death, all that vda. de Gabriel
could submit were a letter sent to her by her husbands co-
worker, stating that Gabriel died when he tried to haul water
out of a tank while its submerged motor was still functioning,
and vda. de Gabriels sworn affidavit. The said affidavit,
however, suffers from procedural infirmity as it was not even
testified to or identified by vda. de Gabriel herself. This
affidavit therefore is a mere hearsay under the law.
In like manner, the letter allegedly written by the deceaseds
co-worker which was never identified to in court by the
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supposed author, suffers from the same defect as the
affidavit of vda. de Gabriel. Not one of the other documents
submitted, to wit, the POEA decision, the death certificate
issued by the Ministry of Health of Iraq and the NBI autopsy
report, could give any probative value to vda. de Gabriels
claim. The POEA decision did not make any categorical
holding on the specific cause of Gabriels death.
In summary, evidence is utterly wanting to establish that the
insured suffered from an accidental death, the risk covered
by the policy.
TIU VS ARRIESGADO (SEPTEMBER 1, 2004)
FACTS: On March 15, 1987, a Truck marked Condor
Hollow Blocks and General Merchandise was on its way to
Cebu when its rear tire exploded. The driver Sergio Pedrano
then parked the truck on the side of the National Highway,
left the rear lights on, and instructed his helper, Jose Mitante,
to watch over the truck and place a spare tire on the road a
few meters away from the tire to serve as a warning device
as he went and had the faulty tire vulcanized.
After Pedrano left, D Rough Riders passenger bus carrying
the respondent, passed by the same route and hit the truck.
The petitioner was injured in the collision and his wife, Felissa
Arriesgado eventually died after sustaining injuries from the
same. Hence, he filed a complaint against the petitioner for
breach of contract of carriage, damages and for attorneys
fees against the petitioner, the owner of the bus, William Tiu
and his driver, Laspinas.
However, the petitioner filed a third-party complaint alleging
that the said truck was parked in a slanted manner and did
not have any early warning devices displayed while it was
left by the driver which resulted to the collision and would
therefore make, Benjamin Condor, the owner of the truck
liable as well.
Also, the petitioner included that he was covered by
Philippine Phoenix Surety and Insurance (PPSI) at the time of
the incident which would therefore make the same liable for
part of the damages that may arise as well.
PPSI, however argued that it already attended to and settled
claims of those who were injured in the collision and that it
could not accede to the claim of Arriesgado because it was
beyond that of the terms of the insurance.
The trial court found that the contention of the petitioner was
invalid because the said truck had left its tail lights open and
that the said road was well lit at the time of the accident.
Hence, it was the fault of the bus, for traveling at a fast pace,
that the collision happened. The Petitioner, Tiu, appealed to
the CA but was denied which prompted him to seek another
reconsideration.
ISSUE: W/N The owner and driver of the Truck, Benjamin
Condor and Sergio Pedrano, was liable due to their
negligence in the lack of an early warning device and hence
liable to the respondent as well. (Violation of Sec 34 of LTO
Land traffic code.)
W/N Petitioner was negligent
W/N Petitioner was also liable for exemplary damages,
attorneys fees and litigation expenses.
W/N PPSI is also liable.
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HELD: The court found that indeed, the petitioner, was liable
for being negligent while being engaged in the business of
common carriage. The SC could no longer change the facts
that were sustained in the trial court and court of appeals
hence, since it was deemed that the bus was moving in a
very fast speed which was the cause of the accident, the SC
will have to sustain that ruling and hold that indeed, there
was negligence on the part of the petitioner.
Also, the doctrine of Last Clear Chance is inapplicable to
the case because it could only apply to a controversy
between two colliding vehicles. In this case, it was the
passenger and not another driver who was injured and thus,
the said doctrine could not be applied.
However, the respondents Pedrano and Condor was found by
the court to be negligent as well. The court found that there
was merit in the contention of the petitioner that the said
truck violated Section 34 or RA 4136, wherein they did not
have proper warning devices in accordance with the said law.
Lastly, with regard to PPSI, the court held that since it
admitted to being bound by a contract with the petitioner, it
would be liable as well. However, the said liability would only
fall within the amount settled in the said contract. Hence, the
petition was partially granted.
BONIFACIO BROS., INC. V. MORA (G.R. NO. L-20853;
1967)
FACTS:
Enrique Mora, owner of Oldsmobile sedan model 1956,
mortgaged it to H.S. Reyes, Inc., with the condition
that they would be the beneficiary of its insurance
June 23, 1959: The sedan was insured with State
Bonding & Insurance Co., Inc
 During the period of effectivity, the sedan met an
accident and it was appraised by Bayne Adjustment
Co. and repaired it with Bonifacio Bros. and the parts
were supplied by Ayala Auto Parts Co. This was all
done without the knowledge of H.S. Reyes. Enrique
was billed P2,102.73 through Bayne. The insurance
company drew a check deducting P100 for franchise
and entrusted it to Bayne payable to Enrique or H.S.
Reyes.
Still unpaid, the sedan was delivered to Enrique
without the Knowledge of H.S. Reyes
Bonifacio Bros and Ayala Auto filed in the MTC on the
theory that the insurance proceeds should be paid
directly to them
CFI affirmed MTC: H.S. Reyes, Inc. as having a better
right
ISSUE: W/N there is privity between Bonifacio Bro and Ayala
Auto against the insurance company
HELD: NO. Judgment affirmed
GR: contracts take effect only between the parties
thereto
EX: some specific instances provided by law where the
contract contains some stipulation in favor of a third
person - stipulation pour autrui provision in favor of a
third person not a party to the contract
third person is allowed to avail himself of a benefit
granted to him by the terms of the contract, provided
that the contracting parties have clearly and
deliberately conferred a favor upon such person
stipulation pour autrui must be clearly expressed -
none here
"loss payable" clause of the insurance policy stipulates
that "Loss, if any, is payable to H.S. Reyes, Inc."
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indicating that it was only the H.S. Reyes, Inc. which
they intended to benefit.
stipulation merely establishes the procedure that the
insured has to follow in order to be entitled to
indemnity for repair
a policy of insurance is a distinct and independent
contract between the insured and insurer, and third
persons have no right either in a court of equity, or in
a court of law, to the proceeds of it, unless there be
some contract of trust, expressed or implied between
the insured and third person
"loss" in insurance law embraces injury or damage
The injury or damage sustained by the insured in
consequence of the happening of one or more of the
accidents or misfortune against which the insurer, in
consideration of the premium, has undertaken to
indemnify the insured
INSULAR LIFE ASSURANCE COMPANY, LTD. vs.
CARPONIA T. EBRADO
FACTS: On September 1, 1968, Buenaventura Cristor Ebrado
was issued by The Life Assurance Co., Ltd., on a whole-life for
P5,882.00 with a rider for Accidental Death for the same
amount. He designated Carponia T. Ebrado, his common-law
wife as the revocable beneficiary in his policy. He referred to
her as his wife in the policy. On October 21, 1969, He died as
a result of an accident when he was hit by a failing branch of
a tree. As the policy was in force, the insurance company was
liable to pay the coverage in the total amount of P11,745.73,
representing the face value of the policy in the amount of
P5,882.00 plus the additional benefits for accidental death
also in the amount of P5,882.00 and the refund of P18.00
paid for the premium due November, 1969, minus the unpaid
premiums and interest thereon due for January and February,
1969, in the sum of P36.27. Carponia T. Ebrado filed a claim
for the proceeds of the Policy as the designated beneficiary
therein, although she admits that she and the insured
Buenaventura C. Ebrado were merely living as husband and
wife without the benefit of marriage. Pascual T. Ebrado, also
filed a claim to the insurance company, this time claiming to
be the legal wife Buenaventura. She asserts that she has a
better right over the proceeds than Carponia who is a
common-law wife. As the insurance company is at a loss as
to whom to give the proceeds, it commenced an action for
interpleader in court. After the issues have been joined, a
pre-trial conference was held on July 8, 1972, that there is no
possibility of amicable settlement. The Court proceeded to
have the parties submit their evidence for the purpose of the
pre-trial and make admissions for the purpose of pretrial. On
September 25, 1972, the trial court rendered judgment
declaring among others, Carponia T. Ebrado disqualified from
becoming beneficiary of the insured Buenaventura Cristor
Ebrado and directing the payment of the insurance proceeds
to the estate of the deceased insured. From this judgment,
Carponia T. Ebrado appealed to the Court of Appeals, but on
July 11, 1976, the Appellate Court certified the case to Us as
involving only questions of law.
ISSUE: Whether or not a common-law wife named as
beneficiary in the life insurance policy of a legally married
man claim the proceeds thereof in case of death of the latter.
HELD: The appealed judgment of the lower court is hereby
affirmed.
Carponia T. Ebrado is hereby declared disqualified to be the
beneficiary of the late Buenaventura C. Ebrado in his life
insurance policy. As a consequence, the proceeds of the
policy are hereby held payable to the estate of the deceased
insured. Costs against Carponia T. Ebrado.
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A common-law wife named as a beneficiary in the life
insurance policy of a legally married man cannot claim the
proceeds thereof in case the death of the latter. The contract
of insurance is govern by the provisions of the new civil code
on matters not specifically provided for in the insurance
code. Rather, the general rules of civil law should be applied
to resolve this void in the Insurance Law. Article 2011 of the
New Civil Code states: The contract of insurance is governed
by special laws. Matters not expressly provided for in such
special laws shall be regulated by this Code. When not
otherwise specifically provided for by the Insurance Law, the
contract of life insurance is governed by the general rules of
the civil law regulating contracts. And under Article 2012 of
the same Code, any person who is forbidden from receiving
any donation under Article 739 cannot be named beneficiary
of a fife insurance policy by the person who cannot make a
donation to him. Common-law spouses are, definitely, barred
from receiving donations from each other. Also conviction for
adultery or concubinage is not required as only
preponderance of evidence is necessary. In essence, a life
insurance policy is no different from a civil donation insofar
as the beneficiary is concerned. Both are founded upon the
same consideration: liberality. A beneficiary is like a donee,
because the premiums of the policy which the insured pays
out of liberality, the beneficiary will receive the proceeds or
profits of said insurance.
VDA. DE CONSUEGRA VS. GSIS,37 SCRA 315
FACTS:
1. Jose Consuegra contracted two marriages during his
lifetime.
2. The first with herein private respondent Rosario Diaz, and
the second, which was contracted in good faith while the first
marriage was subsisting, with herein petitioner Basilia Berdin.
3. Being a member of the GSIS, the proceeds of Joses life
insurance were paid to Basilia and her seven children, being
named beneficiaries therein.
4. Having been in government service, Jose was also entitled
to receive a retirement insurance benefit. However, no
beneficiary was designated therein.
5. Respondent Rosario filed a claim with the GSIS asking that
the retirement insurance benefits be paid to her as the only
legal heir.
6. Petitioner Basilia likewise filed a similar claim asserting
that since they were the beneficiaries named in the life
insurance policy, they are the ones entitled to receive the
retirement insurance benefit.
7. The GSIS ruled that the Rosario is entitled to or 8/16
while Basilia and her children were also entitled to or 8/16
sharing.
8. Dissatisfied with the apportionment Basilia and her
children filed a petition for Mandamus with Preliminary
Injunction praying that they be declared the legal heirs and
exclusive beneficiaries of the retirement benefit.
9. The court ruled that each spouse is entitle to share.
ISSUE: Whether or not petitioner should be entitled solely to
the retirement benefits.
HELD: The respondent GSIS correctly acted when it ruled that
the proceeds of the retirement insurance of the late Jose
Consuegra should be divided equally between his first living
wife Rosario Diaz, on the one hand, and his second wife
Basilia Berdin and his children by her, on the other; and the
lower court did not commit error when it confirmed the action
of the GSIS, it being accepted as a fact that the second
marriage of Jose Consuegra with Basilia Berdin was
contracted in good faith.
The Supreme Court in construing the rights of two women
who were married to the same man held "that since the
defendants first marriage has not been dissolved or declared
void the conjugal partnership established by that marriage
has not ceased. Nor has the first wife lost or relinquished her
status as putative heir of her husband under the new Civil
Code, entitled to share in his estate upon his death should
she survive him. Consequently, whether as conjugal partner
in a still subsisting marriage or as such putative heir she has
an interest in the husbands share in the property here in
dispute.
And with respect of the right of the second wife, the Court
observed that although the second marriage can be
presumed to be void ab initio as it was celebrated while the
first marriage was still subsisting, still there is a need for
judicial declaration of such nullity. And inasmuch as the
conjugal partnership formed by the second marriage was
dissolved before judicial declaration of its nullity, the only
just and equitable solution in this case would be to recognize
the right of the second wife to her share of one-half in the
property acquired by her and her husband, and consider the
other half as pertaining to the conjugal partnership of the
first marriage.