Life Insurance

Jacqueline Jimenez vda. De Gabriel v. Court of Appeals & Fortune Insurance

G.R. No. 103883 | November 14, 1996

Facts:

Marcelino Gabriel, the insured, was employed by Emerald Construction in Iraq. He was covered
by a personal accident insurance amounting to P100,000 under a group policy along with his
fellow workers. The insured risk was for “bodily injury caused by violent accidental external and
visible means which injury would solely and independently result in death or disability.” He died
soon after and his remains were brought back to the Philippines. His wife received the pertinent
documents but found out that the death certificate issued by the Ministry of Health of Iran said
“Cause of death: Unknown.” She later asked the NBI to conduct an autopsy but the NBI could
not anymore identify the cause of death because of advanced decomposition. The only evidence
she received was a letter from an employee of Emerald stating that Marcelino died because of
electrocution. Thus, her repeated claims with Fortune Insurance was denied because the latter
contended that she did not prove the risk.

Issue: Whether Fortune may be held liable for the death of Marcelino.

Held:

Fortune is free from liability. 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. Not one of the other
documents submitted, to wit, the POEA decision, dated 06 June 1984, the death certificate
issued by the Ministry of Health of Iraq and the NBI autopsy report, 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.

Insular Life v. Serafin Feliciano

G.R. No. L-47593 | December 29, 1943

Facts:

Evaristo Feliciano, who died on September 29, 1935, was suffering with advanced pulmonary
tuberculosis when he signed his applications for insurance with the petitioner on October 12,
1934. On that same date Doctor Trepp, who had taken X-ray pictures of his lungs, informed the
respondent Dr. Serafin D. Feliciano, brother of Evaristo, that the latter "was already in a very
serious ad practically hopeless condition." Nevertheless the question contained in the
application — "Have you ever suffered from any ailment or disease of the lungs, pleurisy,
pneumonia or asthma?" — appears to have been answered , "No" And above the signature of
the applicant he stated that “each of the above answers is full, complete and true, and that to
the best of my knowledge and belief I am a proper subject for life insurance.” The false answer

LIZ INTIA & JONO SANCHEZ

and statement was done in collusion with the insurance company’s soliciting agent and the
medical examiner Dr. Valdez. for the purpose of securing the Company's approval of the
application so that the policy to be issued thereon might be credited to said agent in connection
with the inter-provincial contest which the Company was then holding among its soliciting agents
to boost the sales of its policies. After Evaristo died, Serafin tried claiming the proceeds but
Insular life denied upon discovery of the fraudulent transactions.

Issue: Whether Insular Life may be held liable for the proceeds under the life insurance.

Held:

No. When Evaristo Feliciano, the applicant for insurance, signed the application in blank and
authorized the soliciting agent and/or medical examiner of the Company to write the answers for
him, he made them his own agents for that purpose, and he was responsible for their acts in that
connection. If they falsified the answers for him, he could not evade the responsibility for he
falsification. He was not supposed to sign the application in blank. He knew that the answers to
the questions therein contained would be "the basis of the policy," and for that every reason he
was required with his signature to vouch for truth thereof.

The Court cannot believe that the insured did not take the trouble to read the answers contained
in the photostatic copy of the application attached to and made a part of the policy before he
accepted it and paid the premium thereon. He must have notice that the answers to the
questions therein asked concerning his clinical history were false, and yet he accepted the first
policy and applied for another.

Thus, the conclusion of the Court is that the insured was a co-participant and co-responsible
with David and Valdez in the fraudulent procurement of the policies in question and by that
reason the policies are void.

Francisco Del Val, et. Al., v. Andres Del Val

G.R. No. L-9374 | February 16, 1915

Facts:

The parties are siblings who were the only heirs of one Gregorio Del Val who passed away
intestate. During the lifetime of Gregorio, he insured his own life for the amount of P40,000 and
made it payable to Andres Del Val as sole beneficiary. After Gregorio’s death, Andres claimed
the entire proceeds and paid part thereof to redeem a certain property sold by the decedent to
a third person. His siblings are contending that the proceeds of the insurance policy should inure
to the estate and not to Andres alone. Further, the property repurchased should also inure to the
entire estate since the money used to purchase it belongs to the estate. Further, the plaintiffs
wish to divide the property equally notwithstanding the assertion of Andres that he is the sole
owner of the property repurchased and the money from the proceeds.

Issue: Whether the proceeds form part of the estate of the late Gregorio.

Held:

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No. The proceeds of the life-insurance policy belong exclusively to the defendant as his
individual and separate property. The proceeds of an insurance policy belong exclusively to
the beneficiary and not to the estate of the person whose life was insured, and that such
proceeds are the separate and individual property of the beneficiary, not of the heirs of the
person whose life was insured, is the common law doctrine prevalent in America. The doctrine is
codified in the Code of Commerce where:

“The amount which the underwriter must deliver to the person insured, in fulfillment of the
contract, shall be the property of the latter, even against the claims of the legitimate heirs or
creditors of any kind whatsoever of the person who effected the insurance in favor of the former.”

The plaintiffs invoked Article 1035 of the Civil Code, where it reads:

“An heir by force of law surviving with others of the same character to a succession must bring
into the hereditary estate the property or securities he may have received from the deceased
during the life of the same, by way of dowry, gift, or for any good consideration, in order to
compute it in fixing the legal portions and in the account of the division.”

They also invoked Article 819. This article provides that "gifts made to children which are not
betterments shall be considered as part of their legal portion."

The court did not agree because the contract of life insurance is a special contract and the
destination of the proceeds is determined by special laws which deal exclusively with that
subject. The Civil Code has no provisions which relate directly and specifically to life-
insurance contracts or to the destination of life insurance proceeds. That was under the Code of
Commerce. The plaintiffs claim that the property repurchased with the insurance proceeds
belongs to the heirs in common and not to the defendant alone. This wasn’t agreed upon by the
court unless the facts appeared that Andres acted as he did with the intention that the other
heirs should enjoy with him the ownership of the estate.

Luz Pineda v. Court of Appeals & Insular Life Assurance

G.R. No. 105562 | September 27, 1993

Facts:

Prime Marine Services (PMS) obtained a group insurance for its sailors. Unfortunately, six of
those insured sailors perished due to the sinking of PMS’s ship in Morocco. The families wanted
to claim the proceeds of the insurance from PMS and authorized Capt. Nuval to “follow up, ask,
demand, collect and receive" for their benefit the indemnities. Insular drew against its account 6
checks, four for P200,00.00 each, one for P50,000.00 and another for P40,00.00, payable to the
order the families. The checks were given to PMSI. Nuval, the PMSI president, pocketed the
amounts in his bank account. When the families went to insular to get the benefits, their request
was denied because Insular claimed that the checks were already given to PMSI. The families
filed a petition with the Insurance Commission. They won and Insular was ordered to pay them
500 a day until the amount was furnished to them. The insurance Commission held that the
special powers of attorney executed by complainants do not contain in unequivocal
and clear terms authority to Nuval to obtain and receive from respondent company insurance
proceeds arising from the death of the seaman-insured; also, that Insular Life did not
convincingly refuted the claim of Mrs. Alarcon that neither she nor her husband executed a

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special power of authority in favor of Capt. Nuval and that it did not observe Sec 180(3), when it
released the benefits due to the minor children of Ayo and Lontok, when the said complainants
did not post a bond as required- Insular Life appealed to the CA. CA modified the decision of
the Insurance Commission, eliminating the award to the minor children. Hence, this petition by
the beneficiary families.

Issue: Whether Insular may still be held liable for the proceeds notwithstanding its payment to
Capt. Nuval.

Held:

Insular is liable to the beneficiaries. The special powers of attorney "do not contain in unequivocal
and clear terms authority to Capt. Nuval to obtain, receive, receipt from respondent company
insurance proceeds arising from the death of the seaman-insured. Insular Life knew that a power
of attorney in favor of Capt. Nuval for the collection and receipt of such proceeds was a deviation
from its practice with respect to group policies. They gave the proceeds to the policyholder
instead of the beneficiaries themselves. Even the Insular rep admitted that he gave the checks
to the policyholder. Insular Life recognized Capt. Nuval as the attorney-in-fact of the petitioners.
However, it acted imprudently and negligently in the premises by relying without question on the
special power of attorney.

LIZ INTIA & JONO SANCHEZ