Case Doctrine Insurance Law
Case Doctrine Insurance Law
INSURABLE INTEREST
GERCIO v. SUNLIFE ASSURANCE OF CANADA Whether the insured the husband has the power to change
(1925 case) the beneficiary the former wife and to name instead his
actual wife, where the insured and the beneficiary have been
divorced and where the policy of insurance does not expressly
reserve to the insured the right to change the beneficiary.
The wife has an insurable interest in the life of her husband. The
beneficiary has an absolute vested interest in the policy from the
date of its issuance and delivery. So when a policy of life
insurance is taken out by the husband in which the wife is named
as beneficiary, she has a subsisting interest in the policy. And this
applies to a policy to which there are attached the incidents of a
loan value, cash surrender value, an automatic extension by
premiums paid, and to an endowment policy, as well as to an
ordinary life insurance policy. If the husband wishes to retain to
himself the control and ownership of the policy he may so
provide in the policy. But if the policy contains no provision
authorizing a change of beneficiary without the beneficiary's
consent, the insured cannot make such change. Accordingly, it is
held that a life insurance policy of a husband made payable to the
wife as beneficiary, is the separate property of the beneficiary
and beyond the control of the husband.
LALICAN v. INSULAR LIFE ASSURANCE An insurable interest is one of the most basic and essential
requirements in an insurance contract. In general, an insurable
interest is that interest which a person is deemed to have in the
subject matter insured, where he has a relation or connection
with or concern in it, such that the person will derive pecuniary
benefit or advantage from the preservation of the subject matter
insured and will suffer pecuniary loss or damage from its
destruction, termination, or injury by the happening of the event
insured against.[35] The existence of an insurable interest gives a
person the legal right to insure the subject matter of the policy
of insurance.[36] Section 10 of the Insurance Code indeed
provides that every person has an insurable interest in his own
life.[37] Section 19 of the same code also states that an interest in
the life or health of a person insured must exist when the
insurance takes effect, but need not exist thereafter or when the
loss occurs.
MANILA BANKERS LIFE INSURANCE v. ABAN The "incontestability clause" is a provision in law that after a
policy of life insurance made payable on the death of the insured
shall have been in force during the lifetime of the insured for a
period of two (2) years from the date of its issue or of its last
reinstatement, the insurer cannot prove that the policy is void ab
initio or is rescindible by reason of fraudulent concealment or
misrepresentation of the insured or his agent.
At least two (2) years from the issuance of the policy or its last
reinstatement, the beneficiary is given the stability to recover
under the policy when the insured dies. The provision also
makes clear when the two-year period should commence in case
the policy should lapse and is reinstated, that is, from the date of
the last reinstatement.
In this case, the insurable interest of IMC and LSPI pertain to the
unpaid accounts appearing in their Books of Account 45 days
after the time of the loss covered by the policies.
FILIPINO MERCHANT INSURANCE v. COURT OF Section 13 of the Insurance Code defines insurable interest in
APPEALS property as every interest in property, whether real or personal,
or any relation thereto, or liability in respect thereof, of such
nature that a contemplated peril might directly damnify the
insured. In principle, anyone has an insurable interest in
property who derives a benefit from its existence or would suffer
loss from its destruction whether he has or has not any title in,
or lien upon or possession of the property y. 16 Insurable interest
in property may consist in (a) an existing interest; (b) an
inchoate interest founded on an existing interest; or (c) an
expectancy, coupled with an existing interest in that out of which
the expectancy arises. 17
GEOGONIA v. COURT OF APPEALS As to a mortgaged property, the mortgagor and the mortgagee
have each an independent insurable interest therein and both
interests may be one policy, or each may take out a separate
policy covering his interest, either at the same or at separate
times. 18 The mortgagor's insurable interest covers the full value
of the mortgaged property, even though the mortgage debt is
equivalent to the full value of the property.19 The mortgagee's
insurable interest is to the extent of the debt, since the property
is relied upon as security thereof, and in insuring he is not
insuring the property but his interest or lien thereon. His
insurable interest is prima facie the value mortgaged and
extends only to the amount of the debt, not exceeding the value
of the mortgaged property. 20 Thus, separate insurances
covering different insurable interests may be obtained by the
mortgagor and the mortgagee.
GREAT PACIFIC LIFE ASSURANCE CORP. v. The rationale of a group insurance policy of mortgagors,
COURT OF APPEALS otherwise known as the mortgage redemption insurance, is a
device for the protection of both the mortgagee and the
mortgagor. On the part of the mortgagee, it has to enter into such
form of contract so that in the event of the unexpected demise of
the mortgagor during the subsistence of the mortgage contract,
the proceeds from such insurance will be applied to the payment
of the mortgage debt, thereby relieving the heirs of the
mortgagor from paying the obligation. In a similar vein, ample
protection is given to the mortgagor under such a concept so that
in the event of death; the mortgage obligation will be
extinguished by the application of the insurance proceeds to the
mortgage indebtedness. Consequently, where the mortgagor
pays the insurance premium under the group insurance policy,
making the loss payable to the mortgagee, the insurance is on the
mortgagors interest, and the mortgagor continues to be a party
to the contract. In this type of policy insurance, the mortgagee is
simply an appointee of the insurance fund, such loss-payable
clause does not make the mortgagee a party to the contract.
SPS. CHA v. COURT OF APPEALS A non-life insurance policy such as the fire insurance policy
taken by petitioner-spouses over their merchandise is primarily
a contract of indemnity. Insurable interest in the property
insured must exist at the time the insurance takes effect and at
the time the loss occurs.[4] The basis of such requirement of
insurable interest in property insured is based on sound public
policy: to prevent a person from taking out an insurance policy
on property upon which he has no insurable interest and
collecting the proceeds of said policy in case of loss of the
property.In such a case, the contract of insurance is a mere
wager which is void under Section 25 of the Insurance Code.
PREMIUM
UCPB GEN. INSURANCE v. MASAGANA While the import of Section 77 is that prepayment of premiums
TELEMART is strictly required as a condition to the validity of the contract,
We are not prepared to rule that the request to make installment
payments duly approved by the insurer would prevent the entire
contract of insurance from going into effect despite payment and
acceptance of the initial premium or first installment. Section 78
of the Insurance Code in effect allows waiver by the insurer of
the condition of prepayment by making an acknowledgment in
the insurance policy of receipt of premium as conclusive
evidence of payment so far as to make the policy binding despite
the fact that premium is actually unpaid. Section 77 merely
precludes the parties from stipulating that the policy is valid
even if premiums are not paid, but does not expressly prohibit
an agreement granting credit extension, and such an agreement
is not contrary to morals, good customs, public order or public
policy (De Leon, The Insurance Code, p. 175). So is an
understanding to allow insured to pay premiums in installments
not so prescribed. At the very least, both parties should be
deemed in estoppel to question the arrangement they have
voluntarily accepted.
MAKATI TUSCANY CONDOMINIUM v. COURT OF It argues that where the premiums is not actually paid in full, the
APPEALS policy would only be effective if there is an acknowledgment in
the policy of the receipt of premium pursuant to Sec. 78 of the
Insurance Code. The absence of an express acknowledgment in
the policies of such receipt of the corresponding premium
payments, and petitioner's failure to pay said premiums on or
before the effective dates of said policies rendered them invalid.
Petitioner thus concludes that there cannot be a perfected
contract of insurance upon mere partial payment of the
premiums because under Sec. 77 of the Insurance Code, no
contract of insurance is valid and binding unless the premium
thereof has been paid, notwithstanding any agreement to the
contrary. As a consequence, petitioner seeks a refund of all
premium payments made on the alleged invalid insurance
policies.
We hold that the subject policies are valid even if the premiums
were paid on installments. The records clearly show that
petitioner and private respondent intended subject insurance
policies to be binding and effective notwithstanding the
staggered payment of the premiums. The initial insurance
contract entered into in 1982 was renewed in 1983, then in
1984. In those three (3) years, the insurer accepted all the
installment payments. Such acceptance of payments speaks
loudly of the insurer's intention to honor the policies it issued to
petitioner. Certainly, basic principles of equity and fairness
would not allow the insurer to continue collecting and accepting
the premiums, although paid on installments, and later deny
liability on the lame excuse that the premiums were not
prepared in full.
SOUTH SEA SURETY v. COURT OF APPEALS Sec. 306. . . . Any insurance company which delivers to an
insurance agent or insurance broker a policy or contract of
insurance shall be deemed to have authorized such agent or
broker to receive on its behalf payment of any premium which is
due on such policy of contract of insurance at the time of its
issuance or delivery or which becomes due thereon.
When therefore the insured logs were lost, the insured had
already paid the premium to an agent of the South Sea Surety and
Insurance Co., Inc., which is consequently liable to pay the
insurance proceeds under the policy it issued to the insured.
Alpha Insurance & Surety Co. v. Castor Contracts of insurance, like other contracts, are to be
construed according to the sense and meaning of the
terms which the parties themselves have used. If such
terms are clear and unambiguous, they must be taken
and understood in their plain, ordinary and popular
sense. Accordingly, in interpreting the exclusions in an
insurance contract, the terms used specifying the
excluded classes therein are to be given their meaning
as understood in common speech.
Adverse to petitioners claim, the words "loss" and
"damage" mean different things in common ordinary
usage. The word "loss" refers to the act or fact of losing,
or failure to keep possession, while the word "damage"
means deterioration or injury to property.
Therefore, petitioner cannot exclude the loss of
respondents vehicle under the insurance policy under
paragraph 4 of "Exceptions to Section III," since the
same refers only to "malicious damage," or more
specifically, "injury" to the motor vehicle caused by a
person under the insureds service. Paragraph 4 clearly
does not contemplate "loss of property."
Fortune Insurance & Surety Co., Inc. v. Ca An insurance contract is a contract of indemnity upon
the terms and conditions specified therein. It is settled
that the terms of the policy constitute the measure of
the insurer's liability. In the absence of statutory
prohibition to the contrary, insurance companies have
the same rights as individuals to limit their liability and
to impose whatever conditions they deem best upon
their obligations not inconsistent with public policy.
MMPSEU v. Mitsubishi Motors Phils. Corp. The collateral source rule is predicated on the theory
that a tortfeasor has no interest in, and therefore no
right to benefit from monies received by the injured
person from sources unconnected with the defendant.
(cannot apply insurer has no fault)