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PAN MALAYAN INSURANCE CORP. v CAApril 3, 1990 FACTS: Canlubang Automotive Resources Corp. obtained from PanMalay an insurance for its MitsubishiColt Lancer . While the policy was still in effect, the insured car was hit by a pick-up owned by Erlinda Fabie butdriven by another person. The car suffered damages in the amount of P42K. Panmalay defrayed the cost of repair of the insured car. It then demanded reimbursement fromFabie and her driver of said amount, but to no avail. Panmalay filed a complaint for damages with the RTC of Makati against Fabie and the driver.Panmalay averred that the damages caused to the insured car was settled under the “own d a m a g e ” coverage of the insurance policy. Private respondents filed a motion to dismiss alleging that Panmalay had no cause of action sincet h e “won damage” clause of the po licy precluded subrogation under Art . 2207 of the C C . Indemnification under said article is on the assumption that there was no wrongdoer or no 3 rd party atfault. RTC dismissed Panmalay’s complaint. RTC held that payment by Panmalay under the “owndamage”
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PAN MALAYAN INSURANCE CORP. v CAApril 3, 1990FACTS: •Canlubang Automotive Resources Corp. obtained from PanMalay an insurance for its MitsubishiColt Lancer .•While the policy was still in effect, the insured car was hit by a pick-up owned by Erlinda Fabie butdriven by another person. The car suffered damages in the amount of P42K.•Panmalay defrayed the cost of repair of the insured car. It then demanded reimbursement fromFabie and her driver of said amount, but to no avail.•Panmalay f i led a compla in t for damages wi th the RTC of Makat i agains t Fabie and the dr iver .Panmalay averred tha t the damages caused to the insured car was se t t led under the “own damage”coverage of the insurance policy.•Private respondents filed a motion to dismiss alleging that Panmalay had no cause of action sincet h e   “ w o n   d a m a g e ”   c l a u s e   o f   t h e   p o l i c y   p r e c lu d e d   s u b r o g a t i o n   u n d e r   A r t .   2 2 0 7   o f   t h e   C C . Indemnification under said article is on the assumption that there was no wrongdoer or no 3rdpar ty a t fault.•RTC dismissed Panmalay’s compla in t . RTC held tha t payment by Panmalay under the “own damage” clause was an admission by the insurer that the damage was caused by the assured and/or its representatives.CA affirmed, albeit on a somewhat different ground. Applying the ejusdem generis rule, CA heldthat Section III-I of the pplicy, which was the basis for the settlement of the claim against insurance, didnot cover damage arising from collision or overturning due to the negligence of 3rdparties as one of theinsurable risks.•Both tribunals concluded that Panmalay could not now invoke Art 2207 and claim reimbursement.ISSUE:

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WON Panmalay was subrogated to the rights of Canlubang against the driver and his employer HELD:Yes•Article 2207 of the CC is founded on the well-settled principle of subrogation.If the insured property is destroyed or damages through the fault or negligence of a party other than theassured, then the insurer, upon payment to the assured, will be subrogated to the right of the assured torecover from the wrongdoer to the extent that the insurer has been obligated to pay.Payment by the insurer to the assured opera tes as an equi table ass ignment to the former of a l l theremedies which the latter may have against the 3rdparty whose negligence or wrongful act caused theloss.The r ight of subrogat ion i s not dependent upon any pr iv i ty of cont rac t or upon wri t ten ass ignment of  claim. It accrues simply upon payment of the insurance claim by the insurer.•There are exceptions to this rule:1.if the assured by his won act releases the wrongdoer or 3rdparty liable for the loss or damage, fromliability2 .where the insurer pays the assured the va lue of the los t goods wi thout not i fy ing the carr ie r who has in good faith settled the assured’[s claim for loss3 .where the insurer pays the assured for a loss which i s not a r i sk covered by the pol icy (voluntarypymt)None of the exceptions are availing in the present case.•AS TO LC RULING: When Panmalay u t i l ized the phrase “own damage”-- a pharase which, incidentally, is not found in the insurance policy—to define the basis for its settlement, it simply meantthat it had assumed to reimburse the costs for repairing the damage to the insured vehicle.I t i s in th is sense tha t the so-ca l led “own damage” coverage of pol icy i s d i f ferent f rom the “3rdpartyliability” coverage and from the “property damae” coverage.•AS TO CA RULING: CA’s ruling that the coverage of the insured risks under Section III-I of thepol icy does not inc lude damage to the insured

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vehic le ar i s ing f rom col l i s ion or over turning due to negligent acts of a 3rdparty, has no merit.N o t o n l y   i s   i t   a n   e r r o n e o u s i n t e r p r e t a t i o n o f   t h e p r o v i s i o n s   o f   t h e s e c t i o n , b u t   i t   a l s o   v i o l a t e s   a fundamental rule on the interpretation of property insurance contracts where interpretation should beliberally in favor of the assured and strictly against the insurer in cases of disagreement between theparties.The meaning advanced by Panmalay regarding the coverage of Section III-I of the policy is undeniablemore beneficial to Canlubang than that insisted upon by the CA.I n a n y c a s e , t h e v e r y p a r t i e s t o t h e p o l i c y , C a n l u b a n g a n d P a n m a l a y , w e r e n o t s h o w n t o b e i n disagreement regarding the meaning and coverage of Section III-I. Hence, it was improper for CA to

 assert its own interpretation of the contract that is contrary to the clear understanding and intention of the parties to it.•Thus , SC held tha t Panmalay, as subrogee , has no legal obs tac le f rom f i l ing the compla in t for  damages against the 3rdparties responsible for the damage to the car.Attorney’s fees and expenses of litigationArt . 2208. In the absence of s t ipula t ion , a t torney 's fees and expenses of l i t iga t ion , o ther than judic ia l costs, cannot be recovered, except:(1) When exemplary damages are awarded;(2) When the defendant's act or omission has compelled the plaintiff to litigate with third persons or toincur expenses to protect his interest;(3) In criminal cases of malicious prosecution against the plaintiff;(4) In case of a clearly unfounded civil action or proceeding against the plaintiff;(5) Where the defendant ac ted in gross and evident bad fa i th in refus ing to sa t i s fy the p la in t i f f ' s p la in ly valid, just and demandable claim;(6) In actions for legal support;(7) In actions for the recovery of wages of household helpers, laborers andskilled workers;(8) In actions for indemnity under workmen's compensation and employer's liability laws;(9) In a separate civil action to recover civil liability arising from a crime;(10) When at least double judicial costs are awarded;(11) In any other case where the court deems it just and equitable that attorney's fees and expenses of litigation should be recovered.In all cases, the attorney's fees and expenses of litigation must be reasonable

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NSURANCE LAW CASE DIGESTSI.GENERAL PROVISIONS (Section 1)A . Or i g i n o f I n su ra n c e B . L a w s   G o v e r n i n g   I n s u r an c e   i n   t h e Philippinesi . I n s u r a n c e C o d e o f 1 9 7 8 i i . C i v i l   C o d e   ( A r t i c l e s   7 3 9 ,   2 0 1 2 ,   20 1 1 , 2207)i i i . Sp ec i a l L a w s C.Insurance Contract (Section 2)i.Definitioni i . E l e m e n t s ii i .Characteristicsiv.Interpretation of Insurance ContractsSimeon del Rosario vs. The Equitable Insuranceand Casualty Co Inc. (1963)Facts:O n   F e b r u a r y   7 ,   1 9 5 7 ,   E q u i t a b l e   I n s u r a n c e   a n dCasualty Co., Inc., issued Personal Accident Policy No.7136 on the life of Francisco del Rosario, alias PaquitoBolero, son of Simeon, binding itself to pay the sum of P1,000.00 to P3,000.00, as indemnity for the death of the insured.The provisions of the insurance policy pertinent to thecase are as follows:Part I. Indemnity For DeathI f   the  insured sustains any bodi ly   injury which  iseffected solely through violent, external, visible anda c c i d e n t a l   m e a n s ,   a n d   w h i ch   s h a l l   r e s u l t , independently of all other causes and within sixty (60)days from the occurrence thereof, in the Death of theI n s u r e d ,   t h e   C o m p a n y   s h a l l   p a y   t h e   a m o u n t   s e topposite such injury:Section 1. Injury sustained other than those specifiedb e l o w   u n l e s s   e x c e p t e d   h e r e i n a f t e r .   .   .   .  .   .   .   . P1,000.00S e c t i o n   2 .   I n j u r y   s u s t a i n e d   b y   t h e   w re c k i n g   o r disablement of  a rai l road passenger car or  streetrailway car in or on which the Insured is travelling as afarepaying passenger. . . . . . . P1,500.00Part VI. ExceptionsT h i s   p o l i c y   s h a l l   n o t   c o v e r   d i s a p p e a r a n c e   o f   t h e Insured nor shall it cover Death, Disability, Hospitalfees, or Loss of Time, caused to the insured:. . . (h) By drowning except as a consequence of thewrecking or disablement in the Philippine waters of apassenger steam or motor vessel in which the Insuredis travelling as a farepaying passenger; . . . .A rider to the Policy contained the following:IV. DROWNINGIt is hereby declared and agreed that exemption clauseLetter (h) embodied in

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PART VI of the policy is herebywaived by the company, and to form a part of theprovision covered by the policy.A f i re broke out in the motor launch ISLAMA. As aconsequence of which, Francisco del Rosario and 33o t h e r s   w e r e   f o r c e d   t o   j u m p   o f f   t h e   l a u n c h .  T h i s resulted in the death of Francisco and his beneficiaryRemedios Jayme.Equitable insurance paid Simeon del Rosario, father of Francisco Php1000 pursuant to Sec.1 of Part 1 of thepolicy. On the day of receipt, Atty. Francisco wroteEquitable acknowledging the receipt of Simeon of theamount of Php1000 but informed the company that thea m o u n t   i s   i n c o r r e c t   a s   S i m e o n   w a s   e n t i t l e d  t o Php1,500, under Sec.2 Part 1 of the policy.E q u i t a b l e   r e f e r r e d   t h e   m a t t e r   t o   t h e   I n s u r a n ce Commissioner  who opined that the  l iabi l i ty  of   thecompany is only Php1000. Thus, Equitable refused topay. Subsequently, Atty. Francisco asked for Php3000from Equitable. The company refused to pay. Hence ac o m p l a i n t   f o r   t h e   r e c o v e r y   o f   t h e   b a l a n c e   w as instituted.Issue:How much should the indemnity be?Ruling:The CFI ruled that:On the face of the policy Exhibit "A" itself, death bydrowning  is  a ground for recovery apart   from thebodily injury because death by bodily injury is coveredby Part I  of the pol icy whi le  death by drowning isc o v e r e d   b y   P a r t   V I   t h e r e o f .   B u t   w h i l e   t h e   p o l i c ymentions specific amounts that may be recovered ford e a t h   f o r   b o d i l y   i n j u r y ,   y e t ,   t h e r e   i s   n o t   s p e c i f ic a m o u n t   m e n t i o n e d   i n   t h e   p o l i c y   f o r   d e a t h   t h ru drowning although the latter is, under Part VI of thepolicy, a ground for recovery thereunder. Since thed e f e n d a n t   h a s   b o u n d   it s e l f   t o   p a y   P 1 0 0 0 . 0 0   t o P3,000.00 as indemnity for the death of the insuredbut the policy does not positively state any definiteamount that may be recovered in case of death bydrowning, there is an ambiguity in this respect in

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thepolicy, which ambiguity must be interpreted in favor of the insured and strictly against the insurer so as toallow greater indemnity. Thus, del Rosario is entitled toPhp3000. Since Equitable has already paid Php1000, abalance of Php2000 remains to be paid.SC upheld the ruling of the CFI for it is supported bythe generally accepted principles of insurance, whiche n u n c i a t e   t h a t   w h e r e   t h e r e   i s   a n   a m b i g u i t y  w i t h respect to the terms and conditions of the policy, thesame wi l l  be resolved against  the one responsiblethereof.It should be recalled in this connection, that generally,the  insured,  has l i t t le,   i f  any,  part ic ipat ion  in thepreparation of the policy, together with the drafting of its terms and Conditions. The interpretation of obscurestipulations in a contract should not favor the partyEH 403⦿ 2010-2011 ⦿2011-2012 ⦿ Page 1who cause the obscurity (Art. 1377, N.C.C.), which, inthe case at bar, is the insurance company.. . . . And so it has been generally held that the "termsin an insurance policy, which are ambiguous, equivocalor uncertain . . . are to be construed strictly against,the insurer, and liberally in favor of the insured so ast o   e f f e c t   t h e   d o m i n a n t   p u r p o s e   o f   i n d e m n i t y   o r payment to the insured, especially where a forfeiture isinvolved," (29 Am. Jur. 181) and the reason for thisrule is that the "insured usually has no voice in theselection or arrangement of the words employed andthat the language of the contract is selected with greatcare and del iberat ion by expert  and  legal  advisersemployed by, and acting exclusively in the interest of,the

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insurance company" (44 C.J.S. 1174). Calanoc v.Court of Appeals, et al . , G.R. No. L-8151, Dec. 16,1955..   .   .   .   W h e r e   t w o   i n t e r p r e t a t i o n s ,   e q u a l l y   fa i r ,   o f   languages used in an insurance policy may be made,that which allows the greater indemnity will prevail.(L'Engel v. Scotish Union & Nat. F. Ins. Co., 48 Fla. 82,37 So. 462, 67 LRA 581 111 Am. St. Rep. 70, 5 Ann.Cas. 749).At any event, the policy under consideration, coversd e a t h   o r   d i s a b i l i t y   b y   a c c i d e n t a l   m e a n s ,   a n d t h e appellant insurance company agreed to pay P1,000.00to P3,000.00. is indemnity for death of the insured.FIELDMEN’S INSURANCE CO. vs. VDA. DESONGCOFACTS:F e d e r i c o   S o n g c o   o w n e d   a   p r i v a t e   j e e p n e y .   O nSeptember 15, 1960, he was induced by Fieldmen'si n s u r a n c e   a g e n t   B e n j a m i n   S a m b a t   t o   a p pl y   f o r   a Common Carrier's Liability Insurance Policy coveringhis motor vehicle. He was issued a Common CarriersA c c i d e n t   I n s u r a n c e   P o l i c y .   O n   t h e   n e x t   y e ar ,   h e renewed the policy by paying the annual premium.D u r i n g   t h e   e f f e c t i v i t y   o f   t h e   r e n e w e d   p o l ic y ,   t h e insured vehicle collided with another car while beingdriven by Rodolfo Songco, a duly licensed driver ands o n   o f   F e d e r i c o   ( t h e   v e h i c l e   o w n e r ) .   A s   a   r e s u lt , Federico Songco (father) and Rodolfo Songco (son)died, along with other passengers. A claim was f i led but was denied by the insurancecompany on the pretext that what was insured was aprivate vehicle and not a common carrier. During thetrial, it was declared by a witness that when insuranceagent Benjamin Sambat was inducing Songco to insurehis vehicle, the latter butted in saying, “Our vehicle isa pr ivate vehicle  and not  for passengers.”  But theagent replied: “Regardless of whether your vehicle wasan owner-type or  for  passengers,   i t  could st i l l  beinsured because our company  is  not owned by theGovernment. And the Government has nothing to dowith our company.” The Court of Appeals rendered a decision in favor of the claimants. It held that where inequitable conduct

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iss h o w n   b y   a n   i n s u r a n c e   f i r m ,   i t   i s   e s t o p p e d   f r o menforcing forfeitures in its favor, in order to forestallfraud or imposition on the insured. After Fieldmen'sInsurance Co. had led the insured Songco to believethat he could qualify under the common carrier liabilityinsurance policy, it could not, thereafter, be permittedto change its stand to the detriment of the heirs of theinsured. The failure to apply the Doctrine of Estoppel inthis case would result in a gross travesty of justice.ISSUE:Whether or not the insurance claim is proper?RULING:The fact that the insured owned a private vehicle, nota common carrier, was something which the companyknew all along. In fact, it exerted the utmost pressureon the insured, a man of scant education, to enter intothe contract of insurance. The Court of Appeals alsoheld that since some of the conditions contained in thep o l i c y   w e r e   i m p o s s i b l e   t o   c o m p l y   w i t h   u n d e r   t he existing conditions at the time, the insurer is estoppedfrom asserting breach of such conditions. The Supreme Court, in affirming the decision of theCourt of Appeals, took judicial notice of the fact thatnowadays, monopolies, cartels and concentration of capital, endowed with overwhelming economic power,manage to  impose upon part ies deal ing with themcunningly prepared agreementsthat the weakerparty may not change one whit, his participation in theagreement being reduced to the alternative of “take ito r   l e a v e   i t ”label led s ince Raymond Salei l les  ascontracts by adherence (contrats d'adhesion), incontrast to those entered into by parties bargaining onan equal footing, such contracts (i.e. insurance policies& international bills of lading) obviously call for greaterstrictness and vigilance on the part of courts of justicew i t h   a   v i e w   t o   p r o t e c t i n g   t h e   w e a k e r   p a r t y   f r

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o m abuses.Citing the case of Qua Chee Gan vs. Law Union & RockI n s u r a n c e ,   " T h e c o n t r a c t   o f i n s u r a n c e   i s   o n e   o f  perfect good faith(uberima fides) not for the insuredalone but equally so for the insurer; in fact, it is moreso for the latter, since its dominant bargaining positioncarries with it stricter responsibility." Landicho vs. GSIS[G.R. No. L-28866 March 17, 1972]FACTS:On June 1, 1964, the GSIS issued in favor of FlavianoLandicho,  a c ivi l  engineer of   the Bureau of  PublicWorks, stationed at Mamburao, Mindoro Occidental,optional additional life insurance policy No. OG-136107in the sum of P7,900. xxxEH 403⦿ 2010-2011 ⦿2011-2012 NSURANCE LAW CASE DIGESTSBefore the issuance of said policy, Landicho had filedan application, by filing and signing a printed form of the GSIS on the basis of which the policy was issued.Paragraph 7 of said application States:7. xxx I hereby agree as follows: xxxc .   T h a t   t h i s   a p p l i c a t i o n   s e r v e s   a s   a letter of  authority  to the Col lect ingOfficer of our Office thru the GSIS todeduct  from my salary the monthlyp r e m i u m   i n   t h e  a m o u n t   o f   P 3 3 . 3 6 , beginning the month of  May,  1964,and every month thereafter until noticeo f   i t s   d i s c o n t i n u a n c e   s h a l l   h a v e beenreceived from the System; .d. That the failure to deduct from mysalary the month premiums shall

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notmake the pol icy  lapse,  however,   thepremium account shall be consideredas indebtedness which, I bind myself topay the System; .e .   T h a t   m y   p o l i c y   s h a l l   b e   m a d e effective on the first day of the monthn e x t   f o l l o w i n g   t h e   m o n t h   t h e   f i r s t premium is  paid;  provided,  that  i t   isnot more ninety (90) days before ora f t e r   t h e   d a t e   o f   t h e   m e d i c a l e x a m in a t i o n ,   w a s   c o n d u c t e d   i f   required."While still an employee of the Bureau of Public Works,Mr. Landicho died in an airplane crash on June 29,1966. Mrs. Landicho, in her own behalf and that of herco-plaintiffs and minor children, Rafael J. and MariaL o u r d e s   E u g e n i a ,   f i l e d   w i t h   t h e   G S I S   a   c l a i m  f o r P15,800, as the double indemnity due under policy No.OG-136107. GSIS denied the claim, upon the groundt h a t   t h e   p o l i c y   h a d   n e v e r   b e e n   i n   f o r c e   b e c au s e , p u r s u a n t   t o   s u b d i v i s i o n   ( e )   o f   t h e   a b o v e -q u o t e d paragraph 7 of the application, the policy "shall be ...effective on the first day of the month next followingthe month the first premium is paid," and no premiumhad ever been paid on said policy. The Lower Courtdecided in favor of the petitioner. GSIS appealed to theSupreme Court.ISSUE:WON the insurance policy in question has ever been inforce, not a single premium having been paid thereon.RULING:Lower Court decision is sustained.(T)he language, of subdivisions (c), (d) and (e) is suchas to create an ambiguity that should be resolvedagainst the party responsible therefor — defendantGSIS, as the party who prepared and furnished theapplication form — and in favor of the party misledthereby, the insured employee.Indeed, our Civil Code provides:The interpretation of obscure words orstipulations in a contract shall not favorthe party who caused the obscurity.2

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 This is particularly true as regards insurance policies,in respect of which it is settled that the " "terms in aninsurance policy, which are ambiguous, equivocal, oruncertain ...are to be construed strict ly  and most  strongly against the insurer, and liberally in favor of the insured so as to effect the dominant purpose of indemnity or payment to the insured, especially wherea forfeiture is involved" (29 Am. Jur., 181), and thereason for this rule is the "insured usually has no voicein the selection or arrangement of the words employedand that the language of the contract is selected withg r e a t   c a r e   a n d   d e l i b e r a t i o n   b y   e x p e r t s   a n d   l e ga l advisers employed by, and acting exclusively in theinterest of, the insurance company." (44 C.J.S., p.1174.)3.The equitable and ethical considerations justifying theforegoing view are bolstered up by two (2) factors,namely:(a) The aforementioned subdivision (c) states "thatthis application serves as a letter of authority to theCollecting Officer of our Office" — the Bureau of PublicWorks — "thru theGSIS to deduct from my salary themonthly premium in the amount of P33.36." No suchdeduction was made — and, consequently, not eventhe f i rst  premium "paid" — because the col lect ingofficer of the Bureau of Public Works wasnot advisedby the GSIS to make it (the deduction) pursuant tosaid authority. Surely, this omission of the GSIS shouldnot inure to its benefit. .(b)The GSIS had impliedly induced the  insured tobelieve that Policy No. OG-136107was in force, heh a v i n g   b e e n   p a i d   b y   t h e   G S I S   t h e   d i v i d en d s corresponding to said policy 

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. Had the insured had thes l i g h t e s t   i n k l i n g   t h a t   t h e   l a t t e r   w a s   n o t ,   a s   y e t, effective for non-payment of the first premium, hewould have, in all probability, caused the same to beforthwith satisfied.WHEREFORE, the decision appealed from should be, itis hereby affirmed, with costs against the defendant-appellant, Government Service Insurance System. It isso ordered. . DELA CRUZ V. CAPITAL INS. & SURETY CO., INC.DEATH RESULTING FROM BOXING IS AN ACCIDENT –S I N C E   D E A T H   I S   N O T   A   N A T U R A L   O R   P R O B A B L E RESULT OF BOXING.Facts:Eduardo de la Cruz, employed as a mucker  in theItogon-Suyoc Mines, Inc. in Baguio, was the holder of an accident   insurance pol icy underwritten by theCapital Insurance & Surety Co., Inc., In connectionwith the celebration of the New Year, the Itogon-SuyocMines, Inc. sponsored a boxing contest for generalentertainment wherein the insured Eduardo de la Cruz,a non-professional boxer participated. In the course of h i s   b o u t   w i t h   a n o t h e r   p e r s o n ,   l i k e w i s e   a   n on - professional ,  of   the same height,  weight,  and size,EH 403⦿ 2010-2011 ⦿2011-2012 ⦿ Page 3

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NSURANCE LAW CASE DIGESTSwas filed by Masagana under the policies prior to 14July 1992.  On 14  July 1992,  Masagana f i led withUCPBGen its formal claim for indemnification of theinsured property razed by fire. On the same day, 14July 1992,  UCPBGen returned to Masagana the 5manager's checks that it tendered, and at the sametime rejected Masagana's claim for the reasons (a)that the policies had expired and were not renewed,and (b) that the fire occurred on 13 June 1992, beforeMasagana's tender of premium payment. On 21 July1992, Masagana filed with the Regional Trial Court,B r a n c h   5 8 ,   M a k a t i   C i t y ,   a   c i v i l   c o m p l a i n t   a ga i n s t UCPBGen for recovery of P18,645,000.00, representingthe face value of  the pol ic ies  covering Masagana's insured property razed by fire, and for attorney's fees.On 23 October 1992, after its motion to dismiss hadb e e n   d e n i e d ,   U C P B G e n   f i l e d   a n   a n s w e r   t o   th e complaint. It alleged that the complaint "fails to state acause of  act ion";   that UCPBGen was not  l iable toMasagana for insurance proceeds under the policiesbecause at the time of the loss of Masagana's propertydue to fire, the policies had long expired and were notr e n e w e d .   A f t e r   d u e   t r i a l ,   o n   1 0   M a r c h   1 9 9 3 ,   t he Regional  Tr ial  Court,  Branch 58, Makati ,   rendereddecision, (1) authorizing and allowing Masagana toc o n s i g n /d e p o s i t   w i t h   t h i s   C o u r t   t h e   s u m   o f   P225,753.95 (refused by UCPBGen) as full payment of the corresponding premiums for the replacement-renewal policies; (2) declaring Masagana to have fullyc o m p l i e d   w i t h   i t s   o b l i g a t i o n   t o   p a y   t h e   p r e m i um thereby rendering the replacement-renewal  pol icyeffective and binding for the duration 22 May 1992until 22 May 1993; and, ordering UCPBGen to deliverforthwith to Masagana the said replacement-renewalpolicies; (3) declaring two of the policies in force from22 August 1991 up to 23 August 1992 and 9 August1991 to 9

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August 1992, respectively; and (4) orderingU C P B G e n   t o   p a y   M a s a g a n a   t h e   s u m s   of :   ( a ) P18,645,000.00 representing the  latter 's  c laim for indemnity under three policies and/or its replacement-renewal policies; (b) 25% of the total amount due asand for attorney's fees; (c) P25,000.00 as necessarylitigation expenses; and, (d) the costs of suit. In duetime, UCPBGen appealed to the Court of Appeals. On 7September 1998, the Court of Appeals promulgated itsdecision affirming that of the Regional Trial Court withthe modification that item 3 of the dispositive portionwas deleted,  and the award of  attorney's   fees wasreduced to 10% of the total amount due. The Court of A p p e a l s   h e l d   t h a t   f o l l o w i n g   p r e v i o u s   p r a c t i se , Masagana was allowed a 60 to 90 day credit term forthe renewal of its policies, and that the acceptance of t h e   l a t e   p r e m i u m   p a y m e n t   s u g g e s te d   a n understanding that payment could be made  later.UCPBGen appealed. Issue:Whether the fire insurance policies issued by UCPBGento the Masagana covering the period 22 May 1991 to22 May 1992, had expired on the latter date or hadb e e n   e x t e n d e d   o r   r e n e w e d   b y   a n   i m p l i e d   c r e d it arrangement though actual payment of premium wastendered on a latter date after the occurrence of therisk (fire) insured against.Held: The answer is easily found in the Insurance Code. No,an insurance policy, other than life, issued originally oro n   r e n e w a l ,   i s   n o t   v a l i d   a n d   b i n d i n g   u n t i l   a c t u a lp a y m e n t   o f   t h e   p r e m i u m .   A n y   a g r e e m e n t   t o   t h e contrary is void. The parties may not agree expresslyor impliedly on the extension of credit or time to paythe premium and consider the policy binding beforeactual payment. The case of Malayan Insurance Co.,Inc. vs. Cruz-Arnaldo is not applicable. In that case,payment of the premium was in fact actually made on2 4   D e c e m b e r   1 9 8 1 ,   a n d   t h e   f i r e   o c c u r r e d   o n   1 8 January 1982. Here, the payment of the premium forrenewal of

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the policies was tendered on 13 July 1992,a month after the fire occurred on 13 June 1992. Theassured did not even give the insurer a notice of losswithin a reasonable time after occurrence of the fire.Hence, the Supreme Court reversed and set aside thedecision of the Court of Appeals in CA-GR CV 42321. Inlieu thereof, the Court rendered judgment dismissingMasagana's complaint and UCPBGen's counterclaimsthereto filed with the Regional Trial Court, Branch 58,Makati City, in Civil Case 92-2023, without costs.PHILIPPINE PHOENIX SURETY & INSURANCE,INC.vs.WOODWORKS, INC. [G.R. No. L-22684 August 31, 1967]FACTS:That on April 1, 1960, plaintiff issued to defendant FirePolicy No. 9652 for the amount of P300,000.00. Thepremiums of said policy amounted to P6, 051.95. Thedefendant paid P3,000.00 on September 22, 1960 andthe plaintiff made several demands on defendant topay the amount of P3,522.09.Appellee Philippine Phoenix Surety & Insurance Co.,Inc. commenced this action in the Municipal Court of Manila to recover from appellant Woodworks, Inc. thesum of P3,522.09, representing the unpaid balance of the premiums on a f i re  insurance pol icy issued byappellee in favor of appellant for a term of one yearfrom April 1, 1960 to April 1, 1961. From an adversedecision of said court, Woodworks, Inc. appealed tothe Court of First Instance of Manila.Appeal upon a question of law taken by Woodworks,Inc. from the judgment of the Court of First Instanceof Manila "ordering the defendant, Woodworks, Inc. top a y   t o   t h e   p l a i n t i f f ,   P h i l i p p i n e   P h o e n i x   S u r e t y   &  Insurance, Inc., the sum of P3,522.09 with interestthereon at the legal rate of 6% per annum from thedate of the filing of the complaint until fully paid, andcosts of the suit." Hence, this petition.Issue:EH 403⦿ 

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2010-2011 ⦿2011-2012 ⦿INSURANCE LAW CASE DIGESTSWhether or not the non-payment of premium does notcancel the policy in a perfected contract of insuranceWhether or  not a part ial  payment of  the premiummade the policy effective during the whole period of the policyRuling:The petition is lack of merit.T h e r e   i s ,   c o n s e q u e n t l y ,   n o   d o u b t   a t   a l l   t h a t ,  a s between the insurer and the insured, there was notonly a perfected contract of insurance but a partiallyperformed one as far as the payment of the agreedpremium was concerned. Thereafter the obligation of the insurer to pay the insured the amount for whichthe policy was issued in case the conditions thereforhad been complied with, arose and became bindingupon it, while the obligation of the insured to pay theremainder of   the total  amount of   the premium duebecame demandable.The court did not agree with appellant's theory thatnon-payment by it of the premium due, produced thecancellation of the contract of insurance. Such theorywould place exclusively   in the hands of  one of  thecontracting parties the right to decide whether thecontract should stand or not. Rather the correct viewwould seem to be this: as the contract had becomeperfected, the parties could demand from each otherthe performance of  whatever obl igat ions they hadassumed. In the case of the insurer, it is obvious thati t   h a d   t h e   r i g h t   t o   d e m a n d   f r o m   t h e   i n s u r e d   t he completion of the payment of the premium due or suef o r   t h e   r e s c i s s i o n   o f   t h e   c o n t r a c t .   A s   i t   c h o s e   to d e m a n d   s p e c i f i c   p e r f o r m a n c e   o f   t h e   i n s u r e d 's obl igat ion to pay

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the balance of  the premium, thelatter's duty to pay is indeed indubitable.The appealed decision being in accordance with lawand the evidence, the same is affirmed.Digested by: Gestopa, GevinaMakati Tuscany Condominium Corp. vs. Court of AppealsFacts:Sometime in early 1982, private respondent AmericanHome Assurance Co. (AHAC), represented by AmericanInternational Underwriters (Phils.), Inc., issued in favorof petitioner Makati Tuscany Condominium Corporation(TUSCANY) Insurance Policy on the latter's buildingand premises, for a period beginning March 1982 ande n d i n g   M a r c h   1 9 8 3 ,   w i t h   a   t o t a l   p r e m i um   o f   P466,103.05. The premium was paid on installments,all of which were accepted by private respondent.I n   F e b r u a r y   1 9 8 3 ,   p r i v a t e   r e s p o n d e n t   i s su e d   t o petitioner another Insurance Policy, which replacedand renewed the previous policy, for a term covering 1March 1983 to 1 March 1984.  The premium in thea m o u n t   o f   P 4 6 6 , 1 0 3 . 0 5   w a s   a g a i n   pa i d   o n installments. All payments were likewise accepted byprivate respondent.In January 1984, the policy was again renewed andprivate respondent  issued to pet it ioner   InsurancePolicy for the period March 1984 to March 1985. Onthis renewed policy, petitioner made two installmentpayments,  both accepted by pr ivate respondent.Thereafter, petitioner refused to pay the balance of thepremium.Consequently,  AHAC f i led an act ion to recover theunpaid balance of P314,103.05 for Insurance policy. Inits answer with counterclaim, Tuscany admitted thei s s u a n c e   o f   I n s u r a n c e   P o l i c y .   I t   e x p l a i ne d   t h a t   i t discontinued the payment of premiums because thepolicy did not contain a credit clause in its favor andthe receipts for the installment payments covering thepolicy for 1984-85, as well as the two (2) previousp o l i c i e s ,   s t a t e d   t h e   f o l l o w i n g   r e s e r v a t i o n s:   ( 2 ) Acceptance of this payment shall not waive any of thecompany rights to deny liability on any claim under

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thep o l i c y   a r i s i n g   b e f o r e   s u c h   p a y m e n t s   o r   a f t e r   t he expiration of the credit clause of the policy; and (3)Subject to no loss prior to premium payment. If therebe any loss such  is  not covered.  Tuscany furtherclaimed that the policy was never binding and valid,and no risk attached to the policy. It then pleaded ac o u n t e r c l a i m   f o r   P 1 5 2 , 0 0 0 . 0 0   f o r   t h e   p r e m i u m s al r e a d y   p a i d   f o r   1 9 8 4 - 8 5 ,   a n d   i n   i t s   a n s w e r  w i t h a m e n d e d   c o u n t e r c l a i m ,   s o u g h t   t h e   r e f un d   o f   P924,206.10 representing the premium payments for1982-85.Issue:Whether payment by installment of the premiums dueon an  insurance pol icy  inval idates the contract  of   insurance.Ruling:No. The subject policies are valid even if the premiumswere paid on installments. The records clearly showthat Tuscany and AHAC intended subject insurancepolicies to be binding and effective notwithstanding thes t a g g e r e d   p a y m e n t   o f   t h e   p r e m i u m s .   T h e   i n i t i al insurance contract entered into in 1982 was renewedin 1983, then in 1984. In those 3 years, the insurera c c e p t e d   a l l   t h e   i n s t a l l m e n t   p a y m e n ts .   S u c h acceptance of payments speaks loudly of the insurer'sintention to honor the policies it issued to Tuscany.Certainly, basic principles of equity and fairness wouldn o t   a l l o w   t h e   i n s u r e r   t o   c o n t i n u e   c o l l e c t i n g   an d a c c e p t i n g   t h e   p r e m i u m s ,   a l t h o u g h   p a id   o n i n s t a l l m e n t s ,   a n d   l a t e r   d e n y   l i a b i l i t y   o n   t h e  l a m e excuse that the premiums were not prepaid in full.T h u s ,   w h i l e   t h e   i m p o r t   o f   S e c t i o n   7 7   is   t h a t prepayment of  premiums  is  str ict ly  required as acondition to the validity of the contract, the Court wasn o t   p r e p a r e d   t o   r u l e   t h a t   t h e   r e q u e s t   t o   ma k e installment payments duly approved by the insurer,would prevent the entire contract of

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insurance fromgoing into effect despite payment and acceptance of EH 403⦿ 2010-2011 ⦿2011-2012 ⦿INSURANCE LAW CASE DIGESTSthe initial premium or first installment. Section 78 of the  Insurance Code  in effect  al lows waiver  by theinsurer of the condition of prepayment by making anacknowledgment in the insurance policy of receipt of premium as conclusive evidence of payment so far ast o   m a k e   t h e   p o l i c y   b i n d i n g   d e s p i t e   t h e   f a c t   t h a tp r e m i u m   i s   a c t u a l l y   u n p a i d .   S e c t i o n   7 7   m e r e l y precludes the parties from stipulating that the policy isval id even  i f  premiums are not paid,  but does note x p r e s s l y   p r o h i b i t   a n   a g r e e me n t   g r a n t i n g   c r e d i t extension, and such an agreement is not contrary tomorals, good customs, public order or public policy. Sois an understanding to allow insured to pay premiumsin installments not so proscribed. At the very least,both parties should be deemed in estoppel to questionthe arrangement they have voluntarily accepted. Itappearing from the peculiar circumstances that thep a r t i e s   a c t u a l l y   i n t en d e d   t o   m a k e   t h e   t h r e e   ( 3 ) insurance contracts  val id,  effect ive and binding,Tuscany may not be allowed to renege on its obligationto pay the balance of the premium after the expirationo f   t h e   w h o l e   t e r m   o f   t h e   t h i r d   p o l i c y   (A H - C P P - 9210651) in March 1985. Moreover, where the risk isentire and the contract is indivisible, the insured is notentitled to a refund of the premiums paid if the

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insurerw a s   e x p o s e d   t o   t h e   r i s k   i n s u r e d   f o r   a n y   p e r io d , however brief or momentary.Digested by: Roxanne A. HuyoTibay v. CAFacts:On 22 January 1987 private respondent Fortune Lifeand General Insurance Co., Inc. (FORTUNE) issued FireInsurance Pol icy No.  136171  in  favor of  Violeta R.Tibay and/or  Nicolas Roraldo on their   two-storeyresidential  bui lding  located at 5855 Zobel  Street,Makati City, together with all their personal effectstherein. The insurance was for P600,000.00 coveringthe period from 23 January 1987 to 23 January 1988.O n   2 3   J a n u a r y   1 9 8 7 ,   o f   t h e   t o t a l   p r e m iu m   o f   P2,983.50, petitioner Violeta Tibay only paid P600.00thus leaving a considerable balance unpaid.On 8 March 1987 the insured building was completelydestroyed by fire. On 10 March 1987 Violeta Tibay paidthe balance of the premium. On the same day, shef i l e d   w i t h   F O R T U N E   a   c l a i m   o n   t h e   f i r e   i n s u r a nc e pol icy.  Her c laim was accordingly referred to i tsadjuster, Goodwill Adjustment Services, Inc. (GASI).Petitioner forthwith complied and signed a non-waiveragreement. In a letter dated 11 June 1987, FORTUNEdenied the claim of  Violeta for violat ion of  Pol icyCondition No. 2 and of Sec. 77 of the Insurance Code.E f f o r t s   t o   s e t t l e   t h e   c a s e   b e f o r e   t h e   I n s u ra n c e Commission proved futile.On 19 July 1990 the trial court ruled for petitionersand adjudged FORTUNE liable. On 24 March 1995 theCourt of Appeals reversed the court a quo by declaringFORTUNE not to be liable to plaintiff-appellees thereinbut ordering defendant-appel lant  to return to theformer the premium of P2,983.50 plus 12% interestfrom 10 March 1987 until full payment. Hence thispetition for review…Issue: W O N   a   f i r e   i n s u r a n c e   p o l i c y   i s   v a l i d ,   b i n d i n g   a n denforceable upon mere partial payment of premiumRuling:The SC finds no merit in the petition; hence, it affirmsthe Court of Appeals.Insurance is a contract whereby one undertakes for

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aconsiderat ion to  indemnify  another against   loss,d a ma g e   o r   l i a b i l i t y   a r i s i n g   f r o m   a n   u n k n o w n   o r contingent event. The consideration is the premium,which must be paid at the time and in the way andmanner specified in the policy, and if not so paid, thepolicy will lapse and be forfeited by its own terms.The pertinent provisions in the Policy on premium read–THIS POLICY OF INSURANCE WITNESSETH, THAT onlyafter payment to the Company  in accordance withPolicy Condition No. 2 of the total premiums by thei n s u r e d   a s   s t i p u l a t e d   a b o v e   f o r   t h e   pe r i o d aforementioned for insuring against Loss or Damageby Fire or Lightning as herein appears, the Propertyherein described x x x2.This policy including any renewal thereof and/or any endorsement thereon is not in force until the premium has been fully paid toa n d   d u l y   r e c e i p t e d   b y   t h e   C o m p a n y   i n   t h e manner provided herein.Any supplementary agreement seeking toamend this  condit ion prepared by agent,  broker orCompany official, shall be deemed invalid and of noeffect.xxx xxxxxxE x c e p t   o n l y   i n   t h o s e   s p e c i f i c   c a se s   w h e r e corresponding rules and regulations which are or mayhereafter be in force provide for the payment of thestipulated premiums in periodic installments at fixedp e r c e n t a g e ,   i t   i s   h e r e b y   d e c l a r e d ,   a g r e e d  a n d warranted that t h i s   p o l i c y   s h a l l   b e   d e e m e d   effective, valid and binding upon the Company only when the premiums therefor have actually been paid  in  ful l  and duly acknowledged in ar e c e i p t   s i g n e d   b y   a n y   a u t h o r i z e d   o f f i c i a l   o r   representat ive/agent  of   the Company  in suchmanner as provided herein.Clearly the Policy provides for payment of premium infull. Accordingly, where the premium has only

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beenpartially paid and the balance paid only after the perilinsured against has occurred, the insurance contractdid not take effect and the insured cannot collect at allon the policy. This is fully supported by Sec. 77 of theInsurance Code which provides –EH 403⦿ 2010-2011 ⦿2011-2012