Insurance Constantino Vs Asia Life
Insurance Constantino Vs Asia Life
Insurance Constantino Vs Asia Life
FACTS:
Case 1:
The life of Arcadio Constantino was
insured with Asia Life Insurance
Company (Asia) for a term of 20 years
with Paz Lopez de Constantino as
beneficiary. The first premium covered
the period up to September 26, 1942.
After the first premium, no further
premiums were paid. The insured died on
September 22, 1944.
Asia Life Insurance Company, being an
American Corp., had to close its branch
office in Manila by reason of the Japanese
occupation, i.e. from January 2, 1942,
until the year 1945.
Case 2:
Spouses Tomas Ruiz and Agustina Peralta.
Their premium were initially annually but
subsequently changed to quarterly. The
last quarterly premium was delivered on
on November 18, 1941 and it covered the
period until January 31, 1942.
Upon the Japanese occupation, the insurer
and insured were not able to deal with
each other
Because the insured had borrowed on the
policy P234.00 in January, 1941, the cash
surrender value of the policy was
sufficient to maintain the policy in force
only up to September 7, 1942.
Tomas Ruiz died on February 16, 1945
with Agustina Peralta as beneficiary. Her
demand for payment was refused on the
ground of non-payment of the premiums.
Plaintiffs: As beneficiaries, they are
Facts:
Misamis Lumber Company insured its
Ford Falcon to Capital Insurance for P
14,000. One day, the cars crank
andflywheel broke when it passed over a
water hole in Aurora Boulevard. Misamis
sent it to be repaired at the cost of 302
pesos. However, Capital did not want to
pay the entire amount because the repair
limit in the contract stipulated up to 150
pesos only. Misamis filed suit.
The lower court ruled against the
insurance corporation because the
company did not show that the cost was
excessive. Also , the court ruled that
absolving the company of the excess
amount would make the contract one
sided.
Issue: Is the insurance company liable for
more than the amount in the repair limit?
Held: No. Insurance company only
ordered to pay 150 pesos.
Ratio:
Paragraph 4, subpar a. of the insurance
contract is clear and specific. It authorizes
up to 150 pesos only as a repair limit.
The lower court did not heed the express
stipulation in the agreement. The policy
specifically noted the mechanics for repair
in par. 2 and the limits of the liability in
par 4. The company didnt notify the
insurance provider before it did the
repairs. Also, even if the contract is
onerous, this doesnt justify its abrogation
VERENDIA VS CA
Facts:
> Fidelity and Surety Insurance
Company (Fidelity) issued Fire Insurance
Policy No. F-18876 effective between
June 23, 1980 and June 23, 1981
covering Rafael (Rex) Verendia's
residential in the amount of
P385,000.00. Designated as beneficiary
was the Monte de Piedad & Savings
Bank.
> Verendia also insured the same
building with two other companies,
namely, The Country Bankers Insurance
for P56,000.00 and The Development
Insurance for P400,000.00.
> While the three fire insurance policies
were in force, the insured property was
completely destroyed by fire.
> Fidelity appraised the damage
amounting to 385,000 when it was
accordingly informed of the loss. Despite
demands, Fidelity refused payment
under its policy, thus prompting
Verendia to file a complaint for the
recovery of 385,000
> Fidelity, averred that the policy was
avoided by reason of over-insurance,
that Verendia maliciously represented
that the building at the time of the fire
was leased under a contract executed
on June 25, 1980 to a certain Roberto
Garcia, when actually it was a Marcelo
Garcia who was the lessee.
Issue:
Whether or not Verendia can claim on
the insurance despite the
misrepresentation as to the lessee and
the overinsurance.
Held:
NOPE.
The contract of lease upon which
Verendia relies to support his claim for
insurance benefits, was entered into
between him and one Robert Garcia, a
couple of days after the effectivity of the
insurance policy. When the rented
residential building was razed to the
ground, it appears that Robert Garcia
INSURANCE CORP
Facts: Gulf Resorts is the owner of the
Plaza Resort situated at Agoo, La Union
and had its properties in said resort
insured originally with the American
Home Assurance Company (AHAC). In
the first 4 policies issued, the risks of
loss from earthquake shock was
extended only to petitioners two
swimming pools. Gulf Resorts agreed to
insure with Phil Charter the properties
covered by the AHAC policy provided
that the policy wording and rates in said
policy be copied in the policy to be
issued by Phil Charter. Phil Charter
issued Policy No. 31944 to Gulf Resorts
covering the period of March 14, 1990 to
March 14, 1991 for P10,700,600.00 for a
total premium of P45,159.92. the breakdown of premiums shows that Gulf
Resorts paid only P393.00 as premium
against earthquake shock (ES). In Policy
No. 31944 issued by defendant, the
shock endorsement provided that In
consideration of the payment by the
insured to the company of the sum
included additional premium the
Company agrees, notwithstanding what
is stated in the printed conditions of this
policy due to the contrary, that this
insurance covers loss or damage to
shock to any of the property insured by
this Policy occasioned by or through or
in consequence of earthquake (Exhs. "1D", "2-D", "3-A", "4-B", "5-A", "6-D" and
"7-C"). In Exhibit "7-C" the word
"included" above the underlined portion
was deleted. On July 16, 1990 an
earthquake struck Central Luzon and
Northern Luzon and plaintiffs properties
covered by Policy No. 31944 issued by
defendant, including the two swimming
pools in its Agoo Playa Resort were
damaged.
Petitioner advised respondent that it
would be making a claim under its
Insurance Policy 31944 for damages on
its properties. Respondent denied
petitioners claim on the ground that its
insurance policy only afforded
earthquake shock coverage to the two
swimming pools of the resort. The trial
court ruled in favor of respondent. In its
insurance contract.
HELD:
NO. Health Maintenance Organizations
are not engaged in the insurance
business. The SC said in June 12, 2008
decision that it is irrelevant that
petitioner is an HMO and not an insurer
because its agreements are treated as
insurance contracts and the DST is not a
tax on the business but an excise on the
privilege, opportunity or facility used in
the transaction of the business.
Petitioner, however, submits that it is of
critical importance to characterize the
business it is engaged in, that is, to
determine whether it is an HMO or an
insurance company, as this distinction is
indispensable in turn to the issue of
whether or not it is liable for DST on its
health care agreements. Petitioner is
admittedly an HMO. Under RA 7878 an
HMO is an entity that provides, offers
or arranges for coverage of designated
health services needed by plan
members for a fixed prepaid premium.
The payments do not vary with the
extent, frequency or type of services
provided. Section 2 (2) of PD 1460
enumerates what constitutes doing an
insurance business or transacting an
insurance businesswhich are making or
proposing to make, as insurer, any
insurance contract; making or proposing
to make, as surety, any contract of
suretyship as a vocation and not as
merely incidental to any other legitimate
business or activity of the surety; doing
any kind of business, including a
reinsurance business, specifically
recognized as constituting the doing of
an insurance business within the
meaning of this Code; doing or
proposing to do any business in
substance equivalent to any of the
foregoing in a manner designed to
evade the provisions of this Code.
Overall, petitioner appears to provide
insurance-type benefits to its members
(with respect to its curative medical
services), but these are incidental to the
principal activity of providing them
medical care. The insurance-like
FACTS:
In the contract of mortgage, the owner
P.D. Dunn had agreed, at his own expense,
to insure the mortgaged property for its
full value and to indorse the policies in
such manner as to authorize the Brewery
Company to receive the proceeds in case
of loss and to retain such part thereof as
might be necessary to satisfy the
remainder then due upon the mortgage
debt. Instead, however, of effecting the
insurance himself Dunn authorized and
requested the Brewery Company to
procure insurance on the property in the
amount of P15,000 at Dunn's expense.
San Miguel insured the property only as
mortgagee.
Dunn sold the propert to Henry Harding.
The insurance was not assigned by Dunn
to Harding.
When it was destroyed by fire, the two
companies settled with San Miguelto the
extent of the mortgage credit.
RTC: Absolved the 2 companies from the
difference. Henry Harding is not entitled
to the difference between the mortgage
credit and the face value of the policies.
Henry Harding appealed.
ISSUE:
HELD: affirmed
section 19 of the Insurance Act:
a change of interest in any part of a thing
insured unaccompanied by a
corresponding change of interest in the
insurance, suspends the insurance to an
equivalent extent, until the interest in the
thing and the interest in the insurance are
vested in the same person
section 55:
the mere transfer of a thing insured does
not transfer the policy, but suspends it
until the same person becomes the owner
of both the policy and the thing insured
Undoubtedly these policies of insurance
might have been so framed as to have
been "payable to the San Miguel Brewery,
mortgagee, as its interest may appear,
remainder to whomsoever, during the
continuance of the risk, may become the
owner of the interest insured." (Sec 54,
Act No. 2427.) Such a clause would have
proved an intention to insure the entire
interest in the property, not merely the
insurable interest of the San Miguel
Brewery, and would have shown exactly
to whom the money, in case of loss,
should be paid. But the policies are not so
written.
The blame for the situation thus created
rests, however, with the Brewery rather
than with the insurance companies, and
GREPALIFE VS CA
INSURANCE LAW: Parties in Insurance
Contract
FACTS:
Great Pacific Life Assurance Corporation
(Grepalife) executed a contract of group
life insurance with Development Bank of
the Philippines (DBP) wherein Grepalife
agreed to insure the lives of eligible