Pineda Vs Court of Appeals
Pineda Vs Court of Appeals
Pineda Vs Court of Appeals
LUZ PINEDA, MARILOU MONTENEGRO, VIRGINIA ALARCON, DINA LORENA AYO, CELIA
CALUMBAG and LUCIA LONTOK, petitioners,
vs.
HON. COURT OF APPEALS and THE INSULAR LIFE ASSURANCE COMPANY,
LIMITED, respondents.
This is an appeal by certiorari to review and set aside the Decision of the public respondent Court of
Appeals in CA-G.R. SP No. 229501 and its Resolution denying the petitioners' motion for
reconsideration.2 The challenged decision modified the decision of the Insurance Commission in IC
Case
No. RD-058. 3
The petitioners were the complainants in IC Case No. RD-058, an administrative complaint against
private respondent Insular Life Assurance Company, Ltd. (hereinafter Insular Life), which was filed
with the Insurance Commission on 20 September 1989. 4 They prayed therein that after due
proceedings, Insular Life "be ordered to pay the claimants their insurance claims" and that "proper
sanctions/penalties be imposed on" it "for its deliberate, feckless violation of its contractual
obligations to the complainants, and of the Insurance Code." 5 Insular Life's motion to dismiss the
complaint on the ground that "the claims of complainants are all respectively beyond the jurisdiction
of the Insurance Commission as provided in Section 416 of the Insurance Code,"6 having been
denied in the Order of 14 November 1989, 7 it filed its answer on 5 December 1989. 8 Thereafter,
hearings were conducted on various dates.
On 20 June 1990, the Commission rendered its decision9 in favor of the complainants, the dispositive
portion of which reads as follows:
a) Pay a fine of FIVE HUNDRED PESOS (P500.00) a day from the receipt of a copy
of this Decision until actual payment thereof;
b) Pay and settle the claims of DINA AYO and LUCIA LONTOK, for P50,000.00 and
P40,000.00, respectively;
d) Show cause within ten days why its other responsible officers who have handled
this case should not be subjected to disciplinary and other administrative sanctions
for deliberately releasing to Capt. Nuval the check intended for spouses ALARCON,
in the absence of any Special Power of Attorney for that matter, and for negligence
with respect to the release of the other five checks.
SO ORDERED. 10
In holding for the petitioners, the Insurance Commission made the following findings and
conclusions:
After taking into consideration the evidences [sic], testimonial and documentary for
the complainants and the respondent, the Commission finds that; First: The
respondent erred in appreciating that the powers of attorney executed by five (5) of
the several beneficiaries convey absolute authority to Capt. Nuval, to demand,
receive, receipt and take delivery of insurance proceeds from respondent Insular
Life. A cursory reading of the questioned powers of authority would disclosed [sic]
that they 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. On the contrary, the said powers of attorney are
couched in terms which could easily arouse suspicion of an ordinary
man. . . .
Third: Respondent Insular Life did not observe Section 180 of the Insurance Code,
when it issued or released two checks in the amount of P150,000.00 for the three
minor children (P50,000.00 each) of complainant, Dina Ayo and another check of
P40,000.00 for minor beneficiary Marissa Lontok, daughter of another complainant
Lucia Lontok, there being no showing of any court authorization presented or the
requisite bond posted.
Insular Life appealed the decision to the public respondent which docketed the case as CA-G.R. SP
No. 22950. The appeal urged the appellate court to reverse the decision because the Insurance
Commission (a) had no jurisdiction over the case considering that the claims exceeded
P100,000.00,
(b) erred in holding that the powers of attorney relied upon by Insular Life were insufficient to convey
absolute authority to Capt. Nuval to demand, receive and take delivery of the insurance proceeds
pertaining to the petitioners, (c) erred in not giving credit to the version of Insular Life that the power
of attorney supposed to have been executed in favor of the Alarcons was missing, and
(d) erred in holding that Insular Life was liable for violating Section 180 of the Insurance Code for
having released to the surviving mothers the insurance proceeds pertaining to the beneficiaries who
were still minors despite the failure of the former to obtain a court authorization or to post a bond.
On 10 October 1991, the public respondent rendered a decision, 12 the decretal portion of which
reads:
It appears that on 23 September 1983, Prime Marine Services, Inc. (PMSI, for
brevity), a crewing/manning outfit, procured Group PoIicy
No. G-004694 from respondent-appellant Insular Life Assurance Co., Ltd. to provide
life insurance coverage to its sea-based employees enrolled under the plan. On 17
February 1986, during the effectivity of the policy, six covered employees of the
PMSI perished at sea when their vessel, M/V Nemos, a Greek cargo vessel, sunk
somewhere in El Jadida, Morocco. They were survived by complainants-appellees,
the beneficiaries under the policy.
On the basis thereof, the public respondent held that the Insurance Commission had jurisdiction over
the case on the ground that although some of the claims exceed P100,000.00, the petitioners had
asked for administrative sanctions against Insular Life which are within the Commission's jurisdiction
to grant; hence, "there was merely a misjoinder of causes of action . . . and, like misjoinder of
parties, it is not a ground for the dismissal of the action as it does not affect the other reliefs prayed
for." 15 It also rejected Insular Life's claim that the Alarcons had submitted a special power of attorney
which they (Insular Life) later misplaced.
On the other hand, the public respondent ruled that the powers of attorney, Exhibits "1" to "5," relied
upon by Insular Life were sufficient to authorize Capt. Nuval to receive the proceeds of the insurance
pertaining to the beneficiaries. It stated:
When the officers of respondent-appellant read these written powers, they must have
assumed Capt. Nuval indeed had authority to collect the insurance proceeds in
behalf of the beneficiaries who duly affixed their signatures therein. The written
power is specific enough to define the authority of the agent to collect any sum of
money pertaining to the sinking of the fatal vessel. Respondent-appellant interpreted
this power to include the collection of insurance proceeds in behalf of the
beneficiaries concerned. We believe this is a reasonable interpretation even by an
officer of respondent-appellant unschooled in the law. Had respondent appellant,
consulted its legal department it would not have received a contrary view. There is
nothing in the law which mandates a specific or special power of attorney to be
executed to collect insurance proceeds. Such authority is not included in the
enumeration of Art. 1878 of the New Civil Code. Neither do we perceive collection of
insurance claims as an act of strict dominion as to require a special power of
attorney. Moreover, respondent-appellant had no reason to doubt Capt. Nuval. Not
only was he armed with a seemingly genuine authorization, he also appeared to be
the proper person to deal with respondent-appellant being the President and General
Manager of the PMSI, the policyholder with whom respondent-appellant always
dealt. The fact that there was a verbal agreement between complainants-appellees
and Capt. Nuval limiting the authority of the latter to claiming specified death benefits
cannot prejudice the insurance company which relied on the terms of the powers of
attorney which on their face do not disclose such limitation. Under the circumstances,
it appearing that complainants-appellees have failed to point to a positive provision of
law or stipulation in the policy requiring a specific power of attorney to be presented,
respondents-appellant's reliance on the written powers was in order and it cannot be
penalized for such an act. 16
Insofar as the minor children of Dina Ayo and Lucia Lontok were concerned, it ruled that the
requirement in Section 180 of the Insurance Code which provides in part that:
has been amended by the Family Code 17 which grants the father and mother joint legal
guardianship over the property of their unemancipated common child without the necessity of
a court appointment; however, when the market value of the property or the annual income
of the child exceeds P50,000.00, the parent concerned shall be required to put up a bond in
such amount as the court may determine.
Hence, this petition for review on certiorari which we gave due course after the private respondent
had filed the required comment thereon and the petitioners their reply to the comment.
We have carefully examined the specific powers of attorney, Exhibits "1" to "5," which were executed
by petitioners Luz Pineda, Lucia B. Lontok, Dina Ayo, Celia Calumag, and Marilyn Montenegro,
respectively, on 14 May 198618and uniformly granted to Capt. Rosendo Nuval the following powers:
To follow-up, ask, demand, collect and receipt for my benefit indemnities or sum of
money due me relative to the sinking of M.V. NEMOS in the vicinity of El Jadida,
Casablanca, Morocco on the evening of February 17, 1986; and
We agree with the Insurance Commission that 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. On the contrary, the
said powers of attorney are couched in terms which could easily arouse suspicion of an ordinary
man." 19 The holding of the public respondent to the contrary is principally premised on its opinion
that:
[t]here is nothing in the law which mandates a specific or special power of attorney to
be executed to collect insurance proceeds. Such authority is not included in the
enumeration of art. 1878 of the New Civil Code. Neither do we perceive collection of
insurance claims as an act of strict dominion as to require a special power of
attorney.
If this be so, then they could not have been meant to be a general power of attorney since
Exhibits "1" to "5" are special powers of attorney. The execution by the principals of special
powers of attorney, which clearly appeared to be in prepared forms and only had to be filled
up with their names, residences, dates of execution, dates of acknowledgment and others,
excludes any intent to grant a general power of attorney or to constitute a universal agency.
Being special powers of attorney, they must be strictly construed.
Certainly, it would be highly imprudent to read into the special powers of attorney in question the
power to collect and receive the insurance proceeds due the petitioners from Group Policy No. G-
004694. 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. Such
practice was testified to by Mr. Marciano Urbano, Insular Life's Assistant Manager of the Group
Administrative Department, thus:
ATTY. CAGUIOA:
Can you explain to us why in this case, the claim was filed by a
certain Capt. Noval [sic]?
WITNESS:
q What is the reason why policyholders are the ones who file the
claim and not the designated beneficiaries of the employees of the
policyholders?
On cross-examination, Urbano further elaborated that even payments, among other things, are
coursed through the policyholder:
WITNESS:
q And when you say claim payments should always be coursed thru
the policyholder, do you require a power of attorney to be presented
by the policyholder or not?
a Not necessarily.
q In other words, under a group insurance policy like the one in this
case, Insular Life could pay the claims to the policyholder himself
even without the presentation of any power of attorney from the
designated beneficiaries?
WITNESS:
a No. Sir.
ATTY. AMPIL:
q Why? Is this case, the present case different from the cases which
you answered that no power of attorney is necessary in claims
payments?
WITNESS:
q Will you now tell the Honorable Commission why you did not pay
Prime Marine and instead paid the beneficiaries, the designated
beneficiaries?
ATTY. AMPIL:
q Will you tell the Commission what circumstances led you to pay the
designated beneficiaries, the complainants in this case, instead of the
policyholder when as you answered a while ago, it is your practice in
group insurance that claims payments, etc., are coursed thru the
policyholder?
WITNESS:
q And so in this case, you gave the checks to the policyholder only
coursing them thru said policyholder?
a Yes, Sir. 21
This practice is usual in the group insurance business and is consistent with the jurisprudence
thereon in the State of California — from whose laws our Insurance Code has been mainly patterned
— which holds that the employer-policyholder is the agent of the insurer.
Group insurance is a comparatively new form of insurance. In the United States, the first modern
group insurance policies appear to have been issued in 1911 by the Equitable Life Assurance
Society. 22 Group insurance is essentially a single insurance contract that provides coverage for
many individuals. In its original and most common form, group insurance provides life or health
insurance coverage for the employees of one employer.
The coverage terms for group insurance are usually stated in a master agreement or policy that is
issued by the insurer to a representative of the group or to an administrator of the insurance
program, such as an employer. 23 The employer acts as a functionary in the collection and payment
of premiums and in performing related duties. Likewise falling within the ambit of administration of a
group policy is the disbursement of insurance payments by the employer to the employees. 24 Most
policies, such as the one in this case, require an employee to pay a portion of the premium, which
the employer deducts from wages while the remainder is paid by the employer. This is known as a
contributory plan as compared to a non-contributory plan where the premiums are solely paid by the
employer.
Although the employer may be the titular or named insured, the insurance is actually related to the
life and health of the employee. Indeed, the employee is in the position of a real party to the master
policy, and even in a non-contributory plan, the payment by the employer of the entire premium is a
part of the total compensation paid for the services of the employee. 25 Put differently, the labor of the
employees is the true source of the benefits, which are a form of additional compensation to them.
It has been stated that every problem concerning group insurance presented to a court should be
approached with the purpose of giving to it every legitimate opportunity of becoming a social agency
of real consequence considering that the primary aim is to provide the employer with a means of
procuring insurance protection for his employees and their families at the lowest possible cost, and
in so doing, the employer creates goodwill with his employees, enables the employees to carry a
larger amount of insurance than they could otherwise, and helps to attract and hold a permanent
class of employees. 26
In Elfstrom vs. New York Life Insurance Company, 27 the California Supreme Court explicitly ruled
that in group insurance policies, the employer is the agent of the insurer. Thus:
We are convinced that the employer is the agent of the insurer in performing the
duties of administering group insurance policies. It cannot be said that the employer
acts entirely for its own benefit or for the benefit of its employees in undertaking
administrative functions. While a reduced premium may result if the employer
relieves the insurer of these tasks, and this, of course, is advantageous to both the
employer and the employees, the insurer also enjoys significant advantages from the
arrangement. The reduction in the premium which results from employer-
administration permits the insurer to realize a larger volume of sales, and at the
same time the insurer's own administrative costs are markedly reduced.
The most persuasive rationale for adopting the view that the employer acts as the
agent of the insurer, however, is that the employee has no knowledge of or control
over the employer's actions in handling the policy or its administration. An agency
relationship is based upon consent by one person that another shall act in his behalf
and be subject to his control. It is clear from the evidence regarding procedural
techniques here that the insurer-employer relationship meets this agency test with
regard to the administration of the policy, whereas that between the employer and its
employees fails to reflect true agency. The insurer directs the performance of the
employer's administrative acts, and if these duties are not undertaken properly the
insurer is in a position to exercise more constricted control over the employer's
conduct.
In Neider vs. Continental Assurance Company, 28 which was cited in Elfstrom, it was held that:
[t]he employer owes to the employee the duty of good faith and due care in attending
to the policy, and that the employer should make clear to the employee anything
required of him to keep the policy in effect, and the time that the obligations are due.
In its position as administrator of the policy, we feel also that the employer should be
considered as the agent of the insurer, and any omission of duty to the employee in
its administration should be attributable to the insurer.
The ruling in Elfstrom was subsequently reiterated in the cases of Bass vs. John Hancock Mutual
Life Insurance Co. 29 and Metropolitan Life Insurance Co. vs. State Board of Equalization.30
In the light of the above disquisitions and after an examination of the facts of this case, we hold that
PMSI, through its President and General Manager, Capt. Nuval, acted as the agent of Insular Life.
The latter is thus bound by the misconduct of its agent.
Insular Life, however, likewise recognized Capt. Nuval as the attorney-in-fact of the petitioners.
Unfortunately, through its official, Mr. Urbano, it acted imprudently and negligently in the premises by
relying without question on the special power of attorney. In Strong vs. Repide, 31 this Court ruled that
it is among the established principles in the civil law of Europe as well as the common law of
American that third persons deal with agents at their peril and are bound to inquire as to the extent
of the power of the agent with whom they contract. And in Harry E. Keller Electric
Co. vs. Rodriguez, 32 this Court, quoting Mechem on Agency, 33 stated that:
The person dealing with an agent must also act with ordinary prudence and
reasonable diligence. Obviously, if he knows or has good reason to believe that the
agent is exceeding his authority, he cannot claim protection. So if the suggestions of
probable limitations be of such a clear and reasonable quality, or if the character
assumed by the agent is of such a suspicious or unreasonable nature, or if the
authority which he seeks to exercise is of such an unusual or improbable character,
as would suffice to put an ordinarily prudent man upon his guard, the party dealing
with him may not shut his eyes to the real state of the case, but should either refuse
to deal with the agent at all, or should ascertain from the principal the true condition
of affairs. (emphasis supplied)
Even granting for the sake of argument that the special powers of attorney were in due form, Insular
Life was grossly negligent in delivering the checks, drawn in favor of the petitioners, to a party who is
not the agent mentioned in the special power of attorney.
Nor can we agree with the opinion of the public respondent that since the shares of the minors in the
insurance proceeds are less than P50,000.00, then under Article 225 of the Family Code their
mothers could receive such shares without need of either court appointments as guardian or the
posting of a bond. It is of the view that said Article had repealed the third paragraph of Section 180
of the Insurance Code. 34 The pertinent portion of Article 225 of the Family Code reads as follows:
Art. 225. The father and the mother shall jointly exercise legal guardianship over the
property of their unemancipated common child without the necessity of a court
appointment. In case of disagreement, the father's decision shall prevail, unless there
is judicial order to the contrary.
Where the market value of the property or the annual income of the child exceeds
P50,000, the parent concerned shall be required to furnish a bond in such amount as
the court may determine, but not less than ten per centum (10%) of the value of the
property or annual income, to guarantee the performance of the obligations
prescribed for general guardians.
It is clear from the said Article that regardless of the value of the unemancipated common child's
property, the father and mother ipso jure become the legal guardian of the child's property. However,
if the market value of the property or the annual income of the child exceeds P50,000.00, a bond has
to be posted by the parents concerned to guarantee the performance of the obligations of a general
guardian.
It must, however, be noted that the second paragraph of Article 225 of the Family Code speaks of
the "market value of the property or the annual income of the child," which means, therefore, the
aggregate of the child's property or annual income; if this exceeds P50,000.00, a bond is required.
There is no evidence that the share of each of the minors in the proceeds of the group policy in
question is the minor's only property. Without such evidence, it would not be safe to conclude that,
indeed, that is his only property.
SO ORDERED.
# Footnotes
1 Annex "F" of Petition; Rollo, 57-64. Per Associate Justice Luis A. Javellana,
concurred in by Associate Justices Jorge S. Imperial and Serafin V. C. Guingona.
6 Id., 12.
7 Id., 15.
8 Id., 17-18.
13 Id., 64.
14 Rollo, 58-59.
15 Rollo, 60, citing Section 11, Rule 3 and Pacal vs. Ramos, 81 Phil. 30 [1948].
16 Rollo, 62.
26 Neider vs. Continental Assurance Co., 35 So. 2d 237 (La. Sup. Ct. 1948).
27 432 P. 2d 731 (Cal. Sup. Ct. 1976).
28 Supra.
30 Supra.