Second Division (G.R. No. 204736, November 28, 2016)
Second Division (G.R. No. 204736, November 28, 2016)
Second Division (G.R. No. 204736, November 28, 2016)
95
SECOND DIVISION
[ G.R. No. 204736, November 28, 2016 ]
MANULIFE PHILIPPINES, INC.,[1] PETITIONER, VS. HERMENEGILDA
YBAÑEZ, RESPONDENT.
DECISION
Assailed in this Petition for Review on Certiorari[2] are the April 26, 2012 Decision[3] of
the Court of Appeals (CA) in CA-G.R. CV No. 95561 and its December 10, 2012
Resolution[4] which affirmed the April 22, 2008 Decision[5] and the June 15, 2009 Order[6]
of the Regional Trial Court (RTC), Branch 57, Makati City in Civil Case No. 04-1119.
Factual Antecedents
Before the RTC of Makati City, Manulife Philippines, Inc. (Manulife) instituted a
Complaint[7] for Rescission of Insurance Contracts against Hermenegilda Ybañez
(Hermenegilda) and the BPI Family Savings Bank (BPI Family). This was docketed as
Civil Case No. 04-1119.
It is alleged in the Complaint that Insurance Policy Nos. 6066517-1[8] and 6300532-6[9]
(subject insurance policies) which Manulife issued on October 25, 2002 and on July 25,
2003, respectively, both in favor of Dr. Gumersindo Solidum Ybañez (insured), were
void due to concealment or misrepresentation of material facts in the latter's applications
for life insurance, particularly the forms entitled Non-Medical Evidence dated August 28,
2002 (NME),[10] Medical Evidence Exam dated September 10, 2002 (MEE),[11] and the
Declaration of Insurability in the Application for Life Insurance (DOI) dated July 9,
2003;[12] that Hermenegilda, wife of the said insured, was revocably designated as
beneficiary in the subject insurance policies; that on November 17, 2003, when one of the
subject insurance policies had been in force for only one year and three months, while the
other for only four months, the insured died; that on December 10, 2003, Hermenegilda,
now widow to the said insured, filed a Claimant's Statement-Death Claim[13] with respect
to the subject insurance policies; that the Death Certificate dated November 17, 2003 [14]
stated that the insured had "Hepatocellular CA., Crd Stage 4, secondary to Uric Acid
Nephropathy; SAM Nephropathy recurrent malignant pleural effusion; NASCVC"; that
Manulife conducted an investigation into the circumstances leading to the said insured's
death, in view of the aforementioned entries in the said insured's Death Certificate; that
Manulife thereafter concluded that the insured misrepresented or concealed material facts
at the time the subject insurance policies were applied for; and that for this reason
Manulife accordingly denied Hermenegilda's death claims and refunded the premiums
that the insured paid on the subject insurance policies.[15]
Manulife also set forth in said Complaint the details of the insured's supposed
misrepresentation/s or concealment/s, to wit:
2.6. On the basis of the authority granted by [Hermenegilda] in her Claimant's Statement
(Annex "H"), [Manulife] conducted an investigation [into] the Insured's medical records
and history, and discovered that the Insured concealed material facts which the law, good
faith, and fair dealing required him to reveal when he answered the [NME] (Annex "C"),
[the MEE] (Annex "D"), and [the DOI] (Annex "E"), as follows:
(1) Insured's confinement at the Cebu Doctors' Hospital [CDH] from 27 December 2000
to 31 December 2000, wherein he underwent total parotidectomy on 28 December 2000
due to the swelling of his right parotid gland and the presence of a tumor, and was found
to have had a history of being hypertensive, and his kidneys have become atretic or
shrunken. A copy of each of the Admission and Discharge Record and PGIS' Interns'
Progress Notes and Operative Record of the [CDH] is attached hereto and made an
integral part hereof as Annex "K", "K-1", and "K-2", respectively.
(2) Insured’s confinement at the CDH from 9 May 2002 to 14 May 2002, wherein he was
diagnosed to have acute pancreatitis, in addition to being hypertensive. A copy [of] each
of the Insured's Admission and Discharge Record and Doctor's History/Progress Notes is
attached hereto and made an integral part hereof as Annex "L" and "L-1", respectively.
(3) Insured's diagnosis for leptospirosis in 2000. A copy [of] each of the Insured's
Admission and Discharge Record and History Sheet is attached hereto and made an
integral part hereof as Annex "M" and "M-1", respectively.
xxxx
2.8. Due to the Insured's concealment of material facts at the time the subject insurance
policies were applied for and issued, [Manulife] exercised its right to rescind the subject
insurance contracts and denied the claims on those policies.
x x x x[16]
Manulife thus prayed that judgment be rendered finding its act of rescinding the subject
insurance policies proper; declaring these subject insurance policies null and void; and
discharging. it from any obligation whatsoever under these policies.[17]
xxxx
10. The four grounds for denial as enumerated in Annex "N" of the complaint are refuted
as follows:
1) [The insured's] hospital confinement on 27 December 2000 at [the CDH was] due to
right parotid swelling secondary to tumor [for which he] underwent Parotidectomy on 28
December 2000. (There is an obvious scar and disfigurement in the right side of [the
insured's] face, in front, and below his ear. This [ought to] have been easily noticed by
[Manulife's company] physician, Dr. [Winifredo] Lumapas.
2) [The insured's] history of Hypertension [has been] noted 03 years prior to [the
insured's] admission on 27 December 2000. (This is not something serious or fatal)
4) [The insured's] hospital confinement [at the CDH] on 09 May 2002 with findings of
Agute Pancreatitis (This is related to the gallstones of [the insured]. When the gallbladder
is diseased, distention is impossible and its pressure regulating function is lost - a fact that
may explain high incidence of pancreatitis in patient with cholecystic disease. [The
insured] had cholecystitis, so his acute pancreatitis is related to the cholecystitis and
chol[e]lithiasis (gallstones).
xxxx
11. [Manulife] accepted [the insured's] application, and now that a claim for the benefits
[is] made, [Manulife now] says that [the insured] misrepresented and concealed his past
illnesses[!] In the form filled up by [Dr. Winifredo F. Lumapas,] Manulife's [company]
physician, dated 9/10/02, [the insured] checked the column which says ''yes" (to] the
following questions:
13. x x x [Undoubtedly, Manulife] had the option to inquire further [into the insured's
physical condition, because the insured had given it authority to do so] based on the
authority given by [the insured. And how come that Manulife] was able to gather all
[these] information now and not before [the insured] was ensured? x x x
xxxx
16. Moreover, in the comments of [the said] Dr. Lumapas, (Annex "D" of the Complaint),
he said the physical condition of [the] then prospective insurance policy holder, [the
insured, was] "below average". x x x [Estoppel now bars Manulife from claiming the
contrary.]
17. [Especially] worth noting are the [following] comments of [the said Dr. Lumapas, on
the insured's answer to the questionnaires] - (Annex "D" of the Complaint), [to wit:]
"4. d. Have you had any electrocardiograms, when, why, result. "Yes"
= Result normal
16. Have you seen a doctor, or had treatment, operation or hospital care during the last 5
years? "Yes" admitted at [CDH,] Cebu City by Dr. Lamberto Garcia and Dr. Jorge Ang
for Chronic Calculous Chol[e]cystitis
= CBC, Hepatitis Panel done - all negative results except hepatitis antigen (+)
18. Do you. consume alcohol beverages? If so, how much? Yes, consumes 12 shots of
whisky during socials.
32. From your knowledge of this person would you consider his/ her health to be Average
[ ] Below average [/] Poor [ ]
(Underscoring ours)
18. It is interesting to note that the answers in the insurance agent's form for [the insured]
(Annex "C" of the Complaint) did not jibe with the answers [made by] Dr. Lumapas in
Annex "D" of the Complaint. This only boosts Hermenegilda's claim that x x x indeed, it
was the Manulife's agent herself, (Ms. Montesclaros) who checked all the items in the
said form to speed up the insurance application and its approval, [so she could] get her
commission as soon as possible.
19. In fine, at the time when both insurance policies in question were submitted for
approval to [Manulife, the latter had had all the forewarnings that should have put it on
guard or on notice that things were not what it wanted them to be, reason enough to bestir
it into exercising greater prudence and caution to further inquire into) the health or
medical history of [the insured]. In particular, Manulife ought to have noted the fact that
the insured was at that time already 65 years old, x x x that he had a previous operation,
and x x x that his health was "below average. x x x[18]
On November 25, 2005, BPI Family filed a Manifestation[19] praying that either it be
dropped from the case or that the case be dismissed with respect to it (BPI Family),
because it no longer had any interest in the subject insurance policies as asssignee
because the insureds obligation with it (BPI Family) had already been settled or paid.
Since no objection was interposed to this prayer by either Manulife or Hermenegilda, the
RTC granted this prayer in its Order of November 25, 2005.[20]
Then in the Second Order dated November 25, 2005,[21] the RTC considered the pre-trial
as terminated. Trial then ensued.
Manulife presented its sole witness in the person of Ms. Jessiebelle Victoriano
(Victoriano), the Senior Manager of its Claims and Settlements Department. [22] The oral
testimony of this witness chiefly involved identifying herself as the Senior Manager of
Manulife's Claims and Settlements Department and also identifying the following pieces
of evidence;[23] the subject insurance policies; NME, MEE, DOI; the Assignment of
Policy No. 6066517-1 to BPI Family as collateral, dated July 9, 2003; its Letter dated
July 10, 2003 re: assignment of said Policy; death claim filed by Hermenegilda on
December 10, 2003; the insured's Death Certificate; the Marriage Contract between the
insured and Hermenegilda; copies of CDH's Admission and Discharge Records of the
insured for December 2000 re: parotidectomy; copies of CDH's PGIS' Interns' Notes and
CDH Operative Record dated December 28, 2000 re: hypertension; copies of CDH's
Admission and Discharge Record of the insured for May 2002, and the Doctor's
History/Progress Notes re: acute pancreatitis and hypertension; copies of CDH's
Admission and Discharge Record of the insured for October 2003 re: leptospirosis; letters
dated March 24, 2004 to Hermenegilda and BPI Family; and BPI Checks deposited on
April 10, 2004 and May 14, 2004 to the bank accounts of BPI Family and Hermenegilda,
respectively, representing the premium refund.
In its Order of October 2, 2006,[24] the RTC admitted all these exhibits.
Like Manulife, Hermenegilda, in an1plication of her case, also called only one witness to
the witness stand: her counsel of record, Atty. Edgardo Mayol (Atty. Mayol), whose
testimony focused on his professional engagement with Hermenegilda and the monetary
expenses he incurred in attending to the hearings in this case.[25] Hermenegilda thereafter
filed her Formal Offer of Evidence[26] wherein she proffered the following: NME, MEE,
DOI, the insured's driver's license, her letter dated May 8, 2004 protesting the denial by
Manulife of her insurance claim, the contract of services between her and Atty. Mayol,
the official receipts for plane tickets, terminal fees, and boarding passes, attesting to Atty.
Mayol's plane travels to and from Cebu City to attend to this case. These were all
admitted by the RTC.[27]
[Hermenegilda's] claim for moral and exemplary damages is denied for lack of evidence.
SO ORDERED.[28]
The RTC found no merit at all in Manulife's Complaint for rescission of the subject
insurance policies because it utterly failed to prove that the insured had committed the
alleged misrepresentation/s or concealment/s. In fact, Victoriano, the one and only
witness that Manulife called to the witness stand, gave no firsthand, direct evidence at all
relative to the particulars of the alleged misrepresentation/s or concealment/s that the
insured allegedly practiced or committed against it. This witness did not testify at all in
respect to the circumstances under which these documentary exhibits were executed, nor
yet about what these documentary exhibits purported to embody. The RTC stressed that
the CDH medical records that might or could have established the insured's
misrepresentation/s or concealment/s were inadmissible for being hearsay, because
Manulife did not present the physician or doctor, or any responsible official of the CDH,
who could confirm the due execution and authenticity of its medical records; that if
anything, Manulife itself admitted in its Reply[29] that its very own company physician,
Dr. Winifredo Lumapas, had duly noted the insured's scar, even as the same company
physician also categorized in the MEE the insured's health as "below average"; and that
in short, it is evident that Manulife thus had had ample opportunity to verify and to
inquire further into the insured's medical history commencing from the date of the MEE
but opted not to do so; and that if things did not come up to its standards or expectations,
it was totally at liberty to reject the insured's applications altogether, or it could have
demanded a higher premium for the insurance coverage.
The RTC further ruled that Hermenegilda was entitled to attorney's fees in the sum of
P100,000.00 and actual expenses in the amount of P40,050.00, because she was
compelled to litigate to defend her interest against Manulife's patently unjustified act in
rejecting her clearly valid and lawful claim. The RTC also found merit in Hermenegilda's
claims relative to the expenses she paid her Cebu-based counsel.
In its Order of June 15, 2009,[30] the RTC denied tor lack of merit Manulife's motion for
reconsideration[31] and Hermenegilda's motion for partial reconsideration.[32]
From the RTC's Decision, Manulife filed a Notice of Appeal[33] which was given due
course by the RTC in its Order of June 11, 2010.[34]
In its appellate review, the CA virtually adopted en toto the findings of facts made by,
and the conclusions of law arrived at, by the RTC. Thus, the CA decreed:
WHEREFORE, the instant appeal is DENIED. TI1e assailed Decision dated April 22,
2008 and Order dated Jtn1e 15, 2009 of the Regional Trial Court of Makati, Branch 57,
are hereby AFFIRMED.
SO ORDERED.[35]
The CA, like the RTC, found Manulife's Complaint bereft of legal and factual bases. The
CA ruled that it is settled that misrepresentation or concealment in insurance is an
affirmative defense, which the insurer must establish by convincing evidence if it is to
avoid liability; and that in this case the one and only witness presented by Manulife
utterly failed to prove the basic elements of the alleged misrepresentation/s or
concealment/s of material facts imputed by Manulife against the now deceased insured.
The CA held that there is no basis for Manulife's claim that it is exempted from the duty
of proving the insured's supposed misrepresentation/s or concealment/s, as these had
allegedly been admitted already in Hermenegilda's Answer; that in the absence of
authentication by a competent witness, the purported CDH medical records of the insured
are deemed hearsay hence, inadmissible, and devoid of probative value; and that the
medical certificate, even if admitted in evidence as an exception to the hearsay rule, was
still without probative value because the physician or doctor or the hospital's official who
issued it, was not called to the witness stand to validate it or to attest to it.
Manulife moved for reconsideration[36] of the CA's Decision, but this was denied by the
CA in its Resolution of December 10, 2012;[37] hence, the present recourse.
Issue
Whether the CA committed any reversible error in affirming the RTC Decision
dismissing Manulife's Complaint for rescission of insurance contracts for failure to prove
concealment on the part of the insured.
Our Ruling
The present recourse essentially challenges anew the findings of fact by both the RTC
and the CA that the Complaint for rescission of the insurance policies in question will not
prosper because Manulife failed to prove concealment on the part of the insured. This is
not allowed. It is horn-book law that in appeal by certiorari to this Court under Rule 45
of the Revised Rules of Court, the findings of fact by the CA especially where such
findings of fact are affirmatory or confirmatory of the findings of fact of the RTC, as in
this case, are conclusive upon this Court. The reason is simple: this Court not being a trial
court, it does not embark upon the task of dissecting, analyzing, evaluating, calibrating or
weighing all over again the evidence, testimonial or documentary, that the parties
adduced during trial. Of course, there are exceptions to this rule, such as (1) when the
conclusion is grounded upon speculations, surmises or conjectures; (2) when the
inference is manifestly mistaken, absurd or impossible; (3) when there is a grave abuse of
discretion; (4) when the judgment is based on a misapprehension of facts; (5) when the
findings of fact are conflicting; (6) when there is no citation of specific evidence on
which the factual findings are based; (7) when the findings of absence of facts is
contradicted by the presence of evidence on record; (8) when the findings of the CA are
contrary to the findings of the RTC; (9) when the CA manifestly overlooked certain
relevant and undisputed facts that, if properly considered, would justify a different
conclusion; (10) when the findings of the CA are beyond the issues of the case; and, (11)
when the CA's findings are contrary to the admission of both parties.[38] We are satisfied
that none of these exceptions obtains in the Petition at bench. Thus, this Court must defer
to the findings of fact of the RTC - as affirmed or confirmed by the CA - that Manulife's
Complaint for rescission of the insurance policies in question was totally bereft of factual
and legal bases because it had utterly failed to prove that the insured had committed the
alleged misrepresentation/s or concealment/s of material facts imputed against him. The
RTC correctly held that the CDH's medical records that might have established the
insured's purported misrepresentation/s or concealment/s was inadmissible for being
hearsay, given the fact that Manulife failed to present the physician or any responsible
official of the CDH who could confirm or attest to the due execution and authenticity of
the alleged medical records. Manulife had utterly failed to prove by convincing evidence
that it had been beguiled, inveigled, or cajoled into selling the insurance to the insured
who purportedly with malice and deceit passed himself off as thoroughly sound and
healthy, and thus a fit and proper applicant for life insurance. Manulife's sole witness
gave no evidence at all relative to the particulars of the purported concealment or
misrepresentation allegedly perpetrated by the insured. In fact, Victoriano merely
perfunctorily identified the documentary exhibits adduced by Manulife; she never
testified in regard to the circumstances attending the execution of these documentary
exhibits much less in regard to its contents. Of course, the mere mechanical act of
identifying these documentary exhibits, without the testimonies of the actual participating
parties thereto, adds up to nothing. These documentary exhibits did not automatically
validate or explain themselves. "The fraudulent intent on the part of the insured must be
established to entitle the insurer to rescind the contract. Misrepresentation as a defense of
the insurer to avoid liability is an affirmative defense and the duty to establish such
defense by satisfactory and convincing evidence rests upon the insurer."[39] For failure of
Manulife to prove intent to defraud on the part of the insured, it cannot validly sue for
rescission of insurance contracts.
WHEREFORE, the Petition is DENIED. The assailed Decision of the Court of Appeals
dated April 26, 2012 in CA-G.R. CV No. 95561 and its December 10, 2012 Resolution,
are AFFIRMED.
SO ORDERED.
[1]
Also referred to as "Manufacturers Life Insurance Company (Philippines)" or "The
Manufacturers Life Insurance Co. (Phils.), Inc." in some parts of the records.
[2]
Rollo, pp. 14-56.
[3]
CA rollo, pp. 144-160; penned by Associate Justice Vicente S. E. Veloso and
concurred in by Associate Justices Mario V. Lopez and Angelita A. Gacutan.
[4]
CA rollo, p. 253.
[5]
Records, pp. 457-463; penned by Pairing Judge Reynaldo M. Laigo.
[6]
Id. at 547.
[7]
Id. at 7.
[8]
Id. at 273-275.
[9]
Id. at 276-282.
[10]
Id. at 283 and 284 (front and dorsal side).
[11]
Id. at 285; front and dorsal side.
[12]
Id. at 286 (front and dorsal side) and 287.
[13]
Id. at 290.
[14]
Id. at 291.
[15]
Id. at 303-310.
[16]
Id. at 4-5.
[17]
Id. at 6.
[18]
Id. at 109-114.
[19]
Id. at 241-243.
[20]
Id. at 246.
[21]
Id. at 247-248.
[22]
TSN, April 6, 2006 and June 22, 2006.
[23]
Records, pp. 266-311.
[24]
Id. at 314.
[25]
TSN, March 13, 2007 and June 7, 2007.
[26]
Records, pp. 348-368.
[27]
Id. at 404.
[28]
Id. at 463.
[29]
Id. at 157.
[30]
Id. at 547.
[31]
Id. at 477-490.
[32]
Id. at 493-494.
[33]
Id. at 548-550.
[34]
Id. at 553.
[35]
CA rollo, p. 160.
[36]
Id. at 165-199.
[37]
Id. at 254.
[38]
Samala v. Court of Appeals, 467 Phil. 563, 568 (2004).
[39]
Great Pacific Life Assurance Corporation v. Court of Appeals, 375 Phil. 142, 152
(1999).
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