FINMAN GENERAL ASSURANCE

CORPORATION vs. THE HONORABLE

COURT OF APPEALS
FINMAN GENERAL ASSURANCE CORPORATION vs. THE HONORABLE COURT OF
APPEALS 213 SCRA 493, September 2, 1992 NOCON, J.:

FACTS:
On October 22, 1986, deceased, Carlie Surposa was insured with petitioner Finman General
Assurance Corporation with his parents, spouses Julia and Carlos Surposa, and brothers
Christopher, Charles, Chester and Clifton, all surnamed, Surposa, as beneficiaries. While said
insurance policy was in full force and effect, the insured, Carlie Surposa, died on October 18,
1988 as a result of a stab wound inflicted by one of the three (3) unidentified men. Private
respondent and the other beneficiaries of said insurance policy filed a written notice of claim with
the petitioner insurance company which denied said claim contending that murder and assault
are not within the scope of the coverage of the insurance policy. Private respondent filed a
complaint with the Insurance Commission which rendered a favorable response for the
respondent. The appellate court ruled likewise. Petitioner filed this petition alleging grave abuse
of discretion on the part of the appellate court in applying the principle of "expresso unius
exclusio alterius" in a personal accident insurance policy, since death resulting from murder
and/or assault are impliedly excluded in said insurance policy considering that the cause of death
of the insured was not accidental but rather a deliberate and intentional act of the assailant.
Therefore, said death was committed with deliberate intent which, by the very nature of a
personal accident insurance policy, cannot be indemnified.
ISSUE: Whether or not the insurer is liable for the payment of the insurance premiums
HELD:
Yes, the insurer is still liable. Contracts of insurance are to be construed liberally in favor of the
insured and strictly against the insurer. Thus ambiguity in the words of an insurance contract
should be interpreted in favor of its beneficiary. The terms "accident" and "accidental" as used in
insurance contracts have not acquired any technical meaning, and are construed by the courts in
their ordinary and common acceptation. Thus, the terms have been taken to mean that which
happen by chance or fortuitously, without intention and design, and which is unexpected,
unusual, and unforeseen. Where the death or injury is not the natural or probable result of the
insured's voluntary act, or if something unforeseen occurs in the doing of the act which produces
the injury, the resulting death is within the protection of the policies insuring against death or
injury from accident. In the case at bar, it cannot be pretended that Carlie Surposa died in the
course of an assault or murder as a result of his voluntary act considering the very nature of
these crimes. Neither can it be said that where was a capricious desire on the part of the
accused to expose his life to danger considering that he was just going home after attending a
festival. Furthermore, the personal accident insurance policy involved herein specifically
enumerated only ten (10) circumstances wherein no liability attaches to petitioner insurance
company for any injury, disability or loss suffered by the insured as a result of any of the
stimulated causes. The principle of " expresso unius exclusio alterius" the mention of one
thing implies the exclusion of another thing is therefore applicable in the instant case since
murder and assault, not having been expressly included in the enumeration of the circumstances
that would negate liability in said insurance policy cannot be considered by implication to
discharge the petitioner insurance company from liability for, any injury, disability or loss suffered
by the insured. Thus, the failure of the petitioner insurance company to include death resulting
from murder or assault among the prohibited risks leads inevitably to the conclusion that it did not
intend to limit or exempt itself from liability for such death.

ANDREW PALERMO, plaintiff-appellee, vs.

PYRAMID INSURANCE CO., INC.,
defendant- appellant.
G.R. No. L-36480 May 31, 1988 ANDREW PALERMO, plaintiff-appellee, vs. PYRAMID
INSURANCE CO., INC., defendant- appellant.
FACTS:
On March 7, 1969, the insured, appellee Andrew Palermo, filed a complaint in the Court of First
Instance of Negros Occidental against Pyramid Insurance Co., Inc., for payment of his claim
under a Private Car Comprehensive Policy MV-1251 issued by the defendant (Exh. A). In its
answer, the appellant Pyramid Insurance Co., Inc., alleged that it disallowed the claim because
at the time of the accident, the insured was driving his car with an expired driver's license. After
the trial, the court a quo rendered judgment on October 29, 1969 ordering the defendant "to pay
the plaintiff the sum of P20,000.00, value of the insurance of the motor vehicle in question and to
pay the costs." On November 26, 1969, the plaintiff filed a "Motion for Immediate Execution
Pending Appeal." It was opposed by the defendant, but was granted by the trial court on
December 15, 1969.
ISSUE: WON plaintiff was not authorized to drive the insured motor vehicle because his driver's
license had expired.
RULING:
There is no merit in the appellant's allegation that the plaintiff was not authorized to drive the
insured motor vehicle because his driver's license had expired. The driver of the insured motor
vehicle at the time of the accident was, the insured himself, hence an "authorized driver" under
the policy. While the Motor Vehicle Law prohibits a person from operating a motor vehicle on the
highway without a license or with an expired license, an infraction of the Motor Vehicle Law on
the part of the insured, is not a bar to recovery under the insurance contract. It however renders
him subject to the penal sanctions of the Motor Vehicle Law. The requirement that the driver be
"permitted in accordance with the licensing or other laws or regulations to drive the Motor Vehicle
and is not disqualified from driving such motor vehicle by order of a Court of Law or by reason of
any enactment or regulation in that behalf," applies only when the driver" is driving on the
insured's order or with his permission." It does not apply when the person driving is the insured
himself.

Geagonia v CA G.R. No. 114427

Geagonia v CA G.R. No. 114427 February 6, 1995
Facts:
Geagonia, owner of a store, obtained from Country Bankers fire insurance policy for
P100,000.00. The 1 year policy and covered thestock trading of dry goods. The policy noted the
requirement that "3. The insured shall give notice to the Company of any insurance or insurances
already effected, or which may subsequently be effected, covering any of the property or
properties consisting of stocks in trade, goods in process and/or inventories only hereby insured,
and unless notice be given and the particulars of such insurance or insurances be stated therein
or endorsed in this policy pursuant to Section 50 of the Insurance Code, by or on behalf of the
Company before the occurrence of any loss or damage, all benefits under this policy shall be
deemed forfeited, provided however, that this condition shall not apply when the total insurance
or insurances in force at the time of the loss or damage is not more than P200,000.00." The
petitioners stocks were destroyed by fire. He then filed a claim which was subsequently denied
because the petitioners stocks were covered by two other fire insurance policies for Php 200,000
issued by PFIC. The basis of the private respondent's denial was the petitioner's alleged violation
of Condition 3 of the policy. Geagonia then filed a complaint against the private respondent in the
Insurance Commission for the recovery of P100,000.00 under fire insurance policy and
damages. He claimed that he knew the existence of the other two policies. But, he said that he
had no knowledge of the provision in the private respondent's policy requiring him to inform it of
the prior policies and this requirement was not mentioned to him by the private respondent's
agent. The Insurance Commission found that the petitioner did not violate Condition 3 as he had
no knowledge of the existence of the two fire insurance policies obtained from the PFIC; that it
was Cebu Tesing Textiles w/c procured the PFIC policies w/o informing him or securing his
consent; and that Cebu Tesing Textile, as his creditor, had insurable interest on the stocks. The
Insurance Commission then ordered the respondent company to pay complainant the sum of
P100,000.00 with interest and attorneys fees. CA reversed the decision of the Insurance
Commission because it found that the petitioner knew of the existence of the two other policies
issued by the PFIC.
Issues:
1. WON the petitioner had not disclosed the two insurance policies when he obtained the fire
insurance and thereby violated Condition 3 of the policy.
2. WON he is prohibited from recovering
Held: Yes. No. Petition Granted
Ratio:
1. The court agreed with the CA that the petitioner knew of the prior policies issued by the PFIC.
His letter of 18 January 1991 to the private respondent conclusively proves this knowledge. His
testimony to the contrary before the Insurance Commissioner and which the latter relied upon
cannot prevail over a written admission made ante litem motam. It was, indeed, incredible that he
did not know about the prior policies since these policies were not new or original.
2. Stated differently, provisions, conditions or exceptions in policies which tend to work a
forfeiture of insurance policies should be construed most strictly against those for whose benefits
they are inserted, and most favorably toward those against whom they are intended to operate.
With these principles in mind, Condition 3 of the subject policy is not totally free from ambiguity
and must be meticulously analyzed. Such analysis leads us to conclude that (a) the prohibition
applies only to double insurance, and (b) the nullity of the policy shall only be to the extent
exceeding P200,000.00 of the total policies obtained. Furthermore, by stating within Condition 3
itself that such condition shall not apply if the total insurance in force at the time of loss does not
exceed P200,000.00, the private respondent was amenable to assume a co-insurer's liability up
to a loss not exceeding P200,000.00. What it had in mind was to discourage over-insurance.
Indeed, the rationale behind the incorporation of "other insurance" clause in fire policies is to
prevent over-insurance and thus avert the perpetration of fraud. When a property owner obtains
insurance policies from two or more insurers in a total amount that exceeds the property's value,
the insured may have an inducement to destroy the property for the purpose of collecting the
insurance. The public as well as the insurer is interested in preventing a situation in which a fire
would be profitable to the insured.