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Emilio Tan v CA and american insurance However, on that same day, Eulogio died of cardio-respiratory
Violeta Lalican v Insular Life Assurance arrest secondary to electrocution. Violeta, Eulogio's widow filed
New Life Enterprise and sy v CA with the Insular Life a claim for payment of the full proceeds of
Manulife Philppines v Hermegilda the policy but the latter informed her that the claim could not be
Sun life of canada v Daisy Sibya granted since at the time of Eulogio's death, his policy has already
Insular Life Assurance v Paz Khu lapsed and he failed to reinstate the same. Violeta requested a
reconsideration of her claim but the same was also rejected.
Therefore, she filed a complaint for death claim benefits with the
EMILIO TAN vs. COURT OF APPEALS G.R. No. 48049, 29 June 1989 RTC alleging the unfair claim settlement practice of Insular Life
and its deliberate failure to act with reasonable promptness on
her insurance claim. The trial court rendered a decision in favour
FACTS: Tan Lee Siong, father of herein petitioners, applied for life of Insular Life and after the former denied her motion for
insurance in the amount of P80,000.00 with respondent company reconsideration, she directly elevated her case to the Supreme
Philippine American Life Insurance Company. Said application was Court via the petition for review on Certiorari.
approved and a corresponding policy was issued effective
November 5, 1973, with petitioners as the beneficiaries. On April Issue:
26, 1975, Tan Lee Siong died of hepatoma. Hence, petitioners filed Whether or not the policy of Eulogio was reinstated before his
with respondent company their claim for the proceeds of the life death.
insurance policy. However, the insurance company denied the
said claim and rescinded the policy by reason of the alleged
misrepresentation and concealment of material facts made by the Ruling:
deceased Tan Lee Siong in his application for insurance. The Petition lacks merit. RTC's decision has long acquired finality for
premiums paid on the policy were thereupon refunded. The Violeta failed to file a notice of appeal more than five months
petitioners contend that the respondent company no longer had after the decision was rendered. As to the substantial claim of
the right to rescind the contract of insurance as rescission must whether there is insurable interest, the Court says that the matter
allegedly be done during the lifetime of the insured within two of insurable interest is entirely irrelevant and the real point of
years and prior to the commencement of action. contention herein is whether Eulogio was able to reinstate the
lapsed insurance policy on his life before his death. The Court
ISSUE: Whether or not the insurance company has the right to rules in the negative, for the insurance policy is clear on the
rescind the contract of insurance despite the presence of an procedure of the reinstatement of the insurance contract, of
incontestability clause which Eulogio has failed to accomplish before his death. As
provided by the policy, insurance shall be deemed reinstated
HELD: upon the approval of

YES. The so-called “incontestability clause” precludes the insurer _______________________________________________


from raising the defenses of false representations or concealment New Life v CA G.R. No. 94071 March 31, 1992
of material facts insofar as health and previous diseases are J. Regalado
concerned if the insurance has been in force for at least two years
during the insured’s lifetime. The phrase “during the lifetime” Facts:
found in Section 48 of the Insurance Law simply means that the Julian Sy, owner of New Life, insured his building in 3 different
policy is no longer considered in force after the insured has died. insurance agencies for 350,000, 1,000,000, and 200,000. When his
The key phrase in the second paragraph of Section 48 is “for a building and the goods inside burned down, he claimed for
period of two years”. The policy was issued on November 6, 1973 insurance indemnities, but these were rejected by the three
and the insured died on April 26, 1975. The policy was thus in companies for violation of policy conditions.
force for a period of only one year and five months. Considering Sy filed for 3 different suits in the trial court, where he won all
that the insured died before the two-year period has lapsed, suits against the insurance companies. The court of appeals
respondent company is not, therefore, barred from proving that reversed the decision of the trial court.
the policy is void ab initio by reason of the insured’s fraudulent
concealment or misrepresentation. Moreover, respondent Issue: Did the petitioner violate conditions 3 and 27 of the three
company rescinded the contract of insurance and refunded the insurance policies, thereby foreiting collection of indemnities?
premiums paid on November 11, 1975, previous to the
commencement of this action on November 27, 1975. Held: Yes.
WHEREFORE, the petition is hereby DENIED for lack of merit. The
questioned decision of the Court of Appeals is AFFIRMED. Ratio:
Condition 3. The insured shall give notice to the Company of any
__________________________________________ insurance or insurances already effected, or which may
Violeta R. Lalican v. Insular Life Assurance Co. Ltd. subsequently be effected, covering any of the property or
properties consisting of stocks in trade, goods in process and/or
Facts: inventories only hereby insured, and unless such notice be given
and the particulars of such insurance or insurances be stated
Eulogio Lalican applied for an insurance policy with the Insular Life therein or endorsed on this policy pursuant to Section 50 of the
amounting to Php 1,500,000. Under the terms of the policy, Insurance Code, by or on behalf of the Company before the
Eulogio was to pay the premiums on a quarterly basis, having a occurrence of any loss or damage, all benefits under this policy
grace period of 31 days, for the payment of each premium shall be deemed forfeited, provided however, that this condition
subsequent to the first. If any premium was not paid on or before shall not apply when the total insurance or insurances in force at
the due date, the policy would be in default and if the premium the time of loss or damage not more than P200,000.00.
remained unpaid until the end of the grace period, the policy Sy never disclosed co-insurance in the contracts he entered into
would automatically lapse and become void. Eulogio paid the with the three corporations. The insured is specifically required to
premiums due on the first two succeeding payment dates but disclose the insurance that he had contracted with other
failed to pay subsequent premiums even after the lapse of the companies. Sy also contended that the insurance agents knew of
grace period thereby rendering the policy void. He submitted an the co-insurance. However, the theory of imputed knowledge,
application for reinstatement of policy through Josephine that the knowledge of the agent is presumed to be known by the
Malaluan, an agent of Insular Life, together with the payment of principal, is not enough.
the unpaid premiums. However, the Insular Life notified him that When the words of the document are readily understandable by
his application could not be processed because he failed to pay an ordinary reader, there is no need for construction anymore.
the overdue interest of the unpaid premiums. On Sept. 17, 1998, The conformity of the insured to the terms of the policy is implied
Eulogio submitted to Malaluan's house a second application for with his failure to disagree with the terms of the contract.
reinstatement including the payment for the overdue interest as Since Sy, was a businessman, it was incumbent upon him to read
well as for the premiums due for April and July of that year, which the contracts.
was received by Malaluan's husband on her behalf and was Pioneer Insurance and Surety Corporation vs. Yap- The obvious
thereby issued a receipt for the amount Eulogio deposited. purpose of the aforesaid requirement in the policy is to prevent
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over-insurance and thus avert the perpetration of fraud. The On June 23, 1999, Felipe's policy lapsed due to non-payment of
public, as well as the insurer, is interested in preventing the the premium covering the period from June 22, 1999 to June 23,
situation in which a fire would be profitable to the insured. 2000
“Also, policy condition 15 was used. It stated: 15.. . . if any false
declaration be made or used in support thereof, . . . all benefits On September 7, 1999, Felipe applied for the reinstatement of his
under this Policy shall be forfeited . . .” policy and paid P25,020.00 as premium
As for condition number 27, the stipulation read:
27. Action or suit clause. — If a claim be made and rejected and On October 12, 1999, Insular Life advised Felipe that his
an action or suit be not commenced either in the Insurance application for reinstatement may only be considered if he agreed
Commission or any court of competent jurisdiction of notice of to certain conditions such as payment of additional premium and
such rejection, or in case of arbitration taking place as provided the cancellation of the riders pertaining to premium waiver and
herein, within twelve (12) months after due notice of the award accidental death benefits. Felipe agreed to these conditions[8]
made by the arbitrator or arbitrators or umpire, then the claim and on December 27, 1999 paid the agreed additional premium of
shall for all purposes be deemed to have been abandoned and P3,054.50
shall not thereafter be recoverable hereunder.
This is regarding Sy’s claim for one of the companies. Recovery On September 22, 2001, Felipe died
was filed in court by petitioners only on January 31, 1984, or after
more than one (1) year had elapsed from petitioners' receipt of On October 5, 2001, Paz Y. Khu, Felipe Y. Khu, Jr. .and Frederick Y.
the insurers' letter of denial on November 29, 1982. This made it Khu (collectively, Felipe's beneficiaries or respondents) filed with
void. Insular Life a claim for benefit under the reinstated policy. This
claim was denied.
_________________________________________________
Issues:
Manulife Philppines v Hermegilda
Insular Life countered that Felipe did not disclose the ailments
FACTS: •Manulife instituted a Complaint for Rescission of (viz., Type 2 Diabetes Mellitus, Diabetes Nephropathy and
Insurance Contracts against Ybañez and the BPI Family Savings Alcoholic Liver Cirrhosis with Ascites) that he already had prior to
Bank (BPI Family). ○It was alleged that the Insurance Policies his application for reinstatement of his insurance policy; and that
which Manulife issued in favor of Dr. Gumersindo Ybañez it would not have reinstated the insurance policy had Felipe
(insured), were void due to concealment or misrepresentation of disclosed the material information on his adverse health
material facts in the latter's applications for life insurance. ○For condition. It contended that when Felipe died, the policy was still
this reason, Manulife accordingly denied Hermenegilda's death contestable... whether Felipe's reinstated life insurance policy is
claims and refunded the premiums that the insured paid on the already incontestable at the time of his death.
subject insurance policies. •In her Answer, Hermenegilda
(beneficiary) countered that: ○Manulife's own insurance agent, Ruling:
Monteclaros assured that there would be no problem regarding
the application for the insurance policy. ○In fact, it was this Court adopts the interpretation favorable to the insured in
Monteclaros who filled up everything in the questionnaire, so that determining the date when the reinstatement was approved.
all that the insured needed to do was signed and it's done. ○It was
also Monteclaros who herself checked in advance all the boxes We deny the Petition.
that the insured was required to answer. ○Manulife accepted the
insured's application, and now that a claim for the benefits is Based on the foregoing, we find that the CA did not commit any
made, Manulife now says that the insured misrepresented and error in holding that the subject insurance policy be considered as
concealed his past illnesses. ➢In the form filled up by Dr. reinstated on June 22, 1999. This finding must be upheld not only
Lumapas, Manulife's company physician, the insured checked the because it accords with the evidence, but also because this is
column which says ''yes" to the question: Have you seen a doctor, favorable to the insured who was not responsible for causing the
or had treatment operation on hospital case during the last five ambiguity or obscurity in the insurance contract.
years? ○Hermenegilda asserts that Manulife ought to have noted
the fact that the insured was at that time already 65 years old, WHEREFORE, the Petition is DENIED. The assailed June 24, 2010
that he had a previous operation, and that his health was "below Decision and December 13, 2010 Resolution of the Court of
average. Appeals in CA-GR. CV No. 81730 are AFFIRMED.

ISSUE: Whether or not there was concealment. Principles:

HELD: No. Manulife failed to prove concealment on the part of that given the obscurity/ambiguity in the language of these two
the insured. The RTC correctly held that the medical records that documents, the construction/interpretation that favors the
might have established the insured’s purported insured's right to recover should be adopted; a... that the CA
misrepresentation/s or concealment/s was inadmissible for being erred in declaring that resort to the principles of statutory
hearsay, given the fact that Manulife failed to present the construction is still necessary to resolve that question given that
physician or any responsible official who could confirm or attest the Application for Reinstatement,... The court below is correct.
to the due execution and authenticity of the alleged medical Given the obscurity of the language, the construction favorable to
records. For failure of Manulife to prove intent to defraud on the the insured will be adopted by the courts.
part of the insured, it cannot validly sue for rescission of insurance
contracts.

Insular Life Assurance v Paz Khu

INSULAR LIFE ASSURANCE COMPANY v. PAZ Y. KHU, GR No.


195176, 2016-04-18

Facts:

On March 6, 1997, Felipe N. Khu, Sr. (Felipe) applied for a life


insurance policy with Insular Life under the latter's Diamond
Jubilee Insurance Plan. Felipe accomplished the required medical
questionnaire wherein he did not declare any illness or adverse
medical condition. Insular Life thereafter issued him Policy
Number A000015683 with a face value of PI million. This took
effect on June 22, 1997.