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Thelma Vda. de Canilang, Petitioner, vs. Hon. Court of Appeals and Great Pacific Life Assurance Corporation, Respondents. GR No. 92492 June 17, 1993

1. Jaime Canilang concealed material health information when applying for life insurance, failing to disclose that he had recently been diagnosed with sinus tachycardia and treated for acute bronchitis. 2. Information is considered material if it would influence the insurer's assessment of risk, as Jaime's heart condition and medical treatments were facts that Great Pacific should have been made aware of to properly evaluate his insurability. 3. Jaime's concealment of his medical issues and consultations was likely intentional rather than inadvertent, as he had visited his doctor just before applying and would have been aware of his heart condition, making his failure to disclose not credible.

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193 views2 pages

Thelma Vda. de Canilang, Petitioner, vs. Hon. Court of Appeals and Great Pacific Life Assurance Corporation, Respondents. GR No. 92492 June 17, 1993

1. Jaime Canilang concealed material health information when applying for life insurance, failing to disclose that he had recently been diagnosed with sinus tachycardia and treated for acute bronchitis. 2. Information is considered material if it would influence the insurer's assessment of risk, as Jaime's heart condition and medical treatments were facts that Great Pacific should have been made aware of to properly evaluate his insurability. 3. Jaime's concealment of his medical issues and consultations was likely intentional rather than inadvertent, as he had visited his doctor just before applying and would have been aware of his heart condition, making his failure to disclose not credible.

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THELMA VDA. DE CANILANG, petitioner, vs. HON.

COURT OF APPEALS and GREAT had thought that he was merely suffering from a minor ailment and
PACIFIC LIFE ASSURANCE CORPORATION, respondents. simple cold.
GR No. 92492 June 17, 1993  BP 874 was found to be inapplicable to the said case as ruled by the
Insurance Commission. Such law voids an insurance contract whether
DOCTRINE or not a concealment was intentionally made. This law did not apply
Materiality is to be determined not by the event, but solely by the probable and because it became effective only on June 1, 1985.
reasonable influence of the facts upon the party to whom the communication  CA reversed the Ins. Comm’s decision. It dismissed Thelma Canilang’s
is due, in forming his estimate of the disadvantages of the proposed contract, petition. CA found that the failure of Jaime Canialng to disclose
or in making his inquiries. previous medical consultation and treatment constituted material
information which should have been communicated to Great Pacific
FACTS to enable the latter to make proper inquiries. Hence, this petition for
 June 1982 – Jaime Canilang consulted Dr. Wilfredo B. Caludio and was review on certiorari.
diagnosed as suffering from “sinus tachycardia”.
 The doctor prescribed the ff. for him: Trazepam (tranquilizer) and Aptin ISSUE/S
(beta-blocker drug) W/N the concealment is material to the contract? YES.
 Aug. 1982 – Mr. Canilang consulted the same doctor and was
diagnosed to have “acute bronchitis.” Next day, he applied for a non- HELD/RATIO
medical insurance policy with respondent Great Pacific Life Assurance 1. Materiality of the information concealed.
Company naming his wife, Thelma Canilang, as his beneficiary. Under the Old Insurance Code, the information concealed must be
 The application had a medical declaration portion which was material to the contract. (Test of materiality)
executed and read as:
(1) I have not been confined in any hospital, sanitarium or infirmary, nor received Sec. 31. Materiality is to be determined not by the event, but
any medical or surgical advice/attention within the last five (5) years. solely by the probable and reasonable influence of the facts
(2) I have never been treated nor consulted a physician for a heart condition, high
upon the party to whom the communication is due, in forming
blood pressure, cancer, diabetes, lung, kidney, stomach disorder, or any other
physical impairment. his estimate of the disadvantages of the proposed contract, or
(3) I am, to the best of my knowledge, in good health. in making his inquiries.

EXCEPTIONS 2. Application of the materiality test: The information which Jaime


xxx
Canilang failed to disclose was material to the ability of Great Pacific
to estimate the probable risk he presented as a subject of life
I hereby declare that all the foregoing answers and statements are complete, true insurance.
and correct. I hereby agree that if there be any fraud or misrepresentation in the
above statements material to the risk, the INSURANCE COMPANY upon discovery Materiality relates rather to the ‘probable and reasonable influence of
within two (2) years from the effective date of insurance shall have the right to the fact upon the party to whom the communication should have
declare such insurance null and void. xxx
been made, in assessing the risk involved in making or omitting to make
further inquiries and in accepting the application for insurance; that
 As a result, Jaime was issued ordinary life insurance Policy No. 345163 ‘probable and reasonable influence of the facts” concealed must, of
with face value of P19,700 effective as of 9 August 1982. course, be determined objectively, by the judge ultimately.
 Year after, Jaime died of congestive heart failure, anemia and chronic
anemia. Thus, widow Thelma filed a claim with Great Pacific which the 3. Nature of the concealment, whether intentional or not.
latter denied on the ground that the insured had concealed material Before, a concealment, whether intentional or unintentional entitles the
information from it. [He failed to disclose that he had consulted Dr. injured party to rescind the contract. In 1978, the code intended to limit
Claudio who has found him to suffering from sinus trachydia] the kinds of concealment which generates the right of rescission on the
 Canilang then filed before the insurance commission against Great ground that the kinds of appear. This is not persuasive.
Pacific for the recovery of their insurance proceeds. During the hearing,
she testified that she was not aware that her late husband suffered
The net result of the phrase, “whether intentional or unintentional is
serious illnesses and that as far as she knew her husband died because
precisely to leave unqualified the term of “Concealment”. Thus,
of kidney failure. Insurance Commissioner ruled in favor of Canilang—
Section 27 of the Insurance Code of 1978 is properly read as referring
there was no intentional concealment on the part of the insured as he
to “any concealment” without regard to whether such concealment is
intentional or unintentional.

4. in the case at bar, the nature of the facts not conveyed to the insurer
was such that the failure to communicate must have been intentional
rather than merely inadvertent. For Jaime Canilang could not have
been unaware that his heart beat would at times rise to high and
alarming levels and that he had consulted a doctor twice in the two
(2) months before applying for non- medical insurance. Indeed, the
last medical consultation took place just the day before the insurance
application was filed. In all probability, Jaime Canilang went to visit his
doctor precisely because of the discomfort and concern brought
about by his experiencing “sinus tachycardia.”

5. We find it difficult to take seriously the argument that Great Pacific had
waived inquiry into the concealment by issuing the insurance policy
notwithstanding Canilang’s failure to set out answers to some of the
questions in the insurance application. Such failure precisely
constituted concealment on the part of Canilang. Petitioner’s
argument, if accepted, would obviously erase Section 27 from the
Insurance Code of 1978.

PETITION DENIED. CA AFFIRMED.

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