Professional Documents
Culture Documents
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5
Requisites of negotiability.
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2 Par. 2 ICP.
2 Par. 4 ICP.
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375 ICP.
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Aleatory.
2. Discussion of characteristics.
a) Insurance as a risk distributing device.
(1) Insurance, as a device, distributes the risk of
economic loss among as many as possible to
those who are subject to the same kind of risk.
This is because in paying a pre-determined
amount to insure a dened risk, each member
compensates the loss suffered by any
contributor. This is known as the principle of risk
distribution.
b) Contract of adhesion or ne print rule.
(1) Insurance is a contract of adhesion since its
terms is not a result of mutual negotiations but
PJG
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2010 NCC.
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104
ICP.
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Personal contract.
(1) As the law presumes that consideration is given
to the personal qualications of the insured in
approving the insurance application.
to 14 ICP.
12
51f ICP.
13
2 ICP.
14
77 ICP.
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16
17
PJG
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18
19
20
2008 April 9.
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21
PJG
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52 ICP
23
24
PJG
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49 ICP.
26
232 ICP.
27
233-237 ICP.
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28
Black's Law.
29
50 ICP.
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Case law:
(1) A rider containing an automatic increase
clause, which increases the coverage
subject to the attainment of a certain age
of the insured is not a separate contract.
It is part of the original contract in a
nature of a conditional obligation.31
50 ICP.
31
32
64 ICP.
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33
65 ICP.
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e) Kinds of policies.
(1) Property insurance are classied into:
(a) Open policy.
i)
34
35
60 ICP.
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36
61 ICP.
37
62 ICP.
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39
PJG
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40
41
181 ICP.
42
43
44
234 ICP.
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4. Microinsurance.
a) It is a nancial product or service which meets the
protection of the poor where:
(1) The aggregate of its premium and charges do
not exceed 7.5% of daily minimum wage of nonagricultural workers in Manila;
(2) But the guaranteed benet is not more than
1,000 times of the current daily minimum wage
in Manila.
F. Parties to insurance contract. (Chapter 2 in Aquino.)
1. Insurer.
a) Insurer, generally.
(1) The person who undertakes to indemnify
another.
b) Who may be insurers.
(1) Insurers may be partnerships, associations or
corporations who are duly authorized by the
insurance commission to engage in insurance
business.45
45
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192 ICP.
47
193 ICP.
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Certicate of authority.
(1) No insurance company can transact business in
the Philippines until it obtains a certicate of
authority. It is issued by the insurance
commissioner and expires on the last day of
December, 3 years after issuance and
renewable every three years thereafter.
2. Insured.
a) Insured, generally.
48
197 ICP.
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49
7 ICP.
50
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3 ICP.
52
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Generally revokable.
(1) The designation of a beneciary is revokable
unless the right to revoke is expressly waived in
the policy.53
53
11 ICP.
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54
64 FC.
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55
56
182 ICP.
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(perhaps
57
182 ICP.
58
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PJG
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59
PJG
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60
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61
PJG
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PJG
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63
15 ICP.
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64
65
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67
8 and 9 ICP.
PJG
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68
Geagonia v CA / Supra.
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69
8 and 17 ICP.
70
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71
PJ: I surmise that this is the general rule as it is more rational to retain the interest on the part
of the mortgagor.
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72
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73
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74
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75
14 ICP.
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76
20 ICP.
77
20 ICP.
78
21 ICP.
79
22 ICP.
80
23 ICP.
81
24 ICP.
82
57 ICP.
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1306 NCC.
84
3 ICP.
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a) Marine insurance.
(1) If the loss of the vessel in the past may not have
been known by ordinary means of
communication, as the loss here transpired in
the past.
(2) Query: why in the fuck would an applicant insure
a ship he cannot communicate to? That's funny.
Unless it is an "as you like it" insurance contract.
I.
85
77 ICP.
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86
77 ICP.
87
78 ICP.
88
89
90
77 ICP.
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91
78 ICP.
92
306 ICP.
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(2) T h e i n s u r e r i s b o u n d b y i t s a g e n t ' s
acknowledgement of receipt of payment or
premium.93
3. Effect of payment of the premium by a postdated
check.
a) Check dated subsequent to loss.
(1) Payment of premium via postdated check, that
has a stated maturity subsequent to the loss is
insufcient to put the insurance into effect.
b) Check dated prior to loss.
(1) A check or note, accepted by the insurer, dated
prior to the loss, assuming it is sufciently
funded, is sufcient. It is still binding
notwithstanding that the check is not cashed
upon loss as encashment retroacts to the date of
the instrument.94
4. When insured entitled to return of premium.
a) Thing insured was never exposed to the risk
insured against95;
93
94
95
80 ICP.
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b) Contract is voidable:
(1) because of fraud or misrepresentation of the
insurer,
(2) because of existence facts which the insured is
ignorant without his fault
c) Insurer never incurred liability96;
d) Insurance is for a denite period and the insured
surrenders his policy before termination;
e) Over-insurance97;
f)
g) A n n u l m e n t o f c o n t r a c t b e c a u s e o f
misrepresentation of the insurer or his agent, or
because of facts where the insured is ignorant
without his fault98.
5. Suretyship.
a) Premium in suretyship, rule.
(1) Premium is also necessary in order for the
contract of suretyship or bond to be binding.
96
82 ICP.
97
83 ICP.
98
82 ICP.
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b) Exception.
(1) When the obligee accepted the bond, it is
binding even if the premium has not been paid
subject to the right of the insurer to recover the
premium from its principal.99
6. Non-default options insurance in life insurance.
a) Default, generally.
(1) When an insured defaults, he forfeits the
benets of the insurance contract.
b) Hence, to prevent the lapse of life insurance policy,
the insured may avail the following:
(1) Grace period;
(2) Automatic policy loan from the policy's cash
surrender value;
(3) Application of dividend;
(4) Reinstatement clause.
c) Reinstatement of a lapsed policy of life insurance.
(1) Policy holders in life insurance shall have the
policy reinstated at anytime within 3 years from
the date of default of premium payment.100
99
100
233[j] ICP.
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(a) Unless;
i)
proof of insurability,
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(a) Concealment;
(b) Representation;
(c) Warranty;
(d) Condition; and
(e) Exception.
(2) General discussion of the devices.
(a) Concealment, generally.
i)
101
26 ICP.
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3. Concealment.
a) Test of materiality.
102
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104
105
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Applied:
(1) Where an applicant who is not a doctor is
asked regarding the medical history of his
wife, when asked about history of highblood, heart trouble, diabetes, ulcer, liver
disease and asthma; who categorically
answered no; the policy was not avoided.
b) Effects of concealment.
(1) Concealment vitiates the contract and entitles
the insurer to rescind, even if the death or loss is
due to a cause not related to the concealed
matter.106
c) Cause of loss.
(1) The matter concealed need not be the cause of
loss.
(2) It is sufcient that non-disclosure misled the
insurer in forming his estimates of the risks of
the proposed insurance policy or in making
inquiries.107
(a) Applied:
106
27 ICP.
107
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108
27 ICP.
109
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111
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Application.
(1) Insurer cannot be liable where the
insured signed in blank answered
negatively on questioning about suffering
any lung ailment and died from a
concealed tuberculosis, where the agent
and examiner colluded. As he asked the
agent to write for him, in turn, an agency
is created in his favor and are party to the
concealment.
f)
Case law.
(1) Florendo v Philam.
(a) SC ruled that even if the agent is aware that
the insured has a pacemaker, there is still
concealment since the duty not to conceal is
imposed on the insured.
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112
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113
48 ICP.
114
36 ICP.
115
39 ICP.
PJG
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31 and 46 ICP.
117
45 ICP.
PJG
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118
67 ICP.
119
74 to 76 ICP.
PJG
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73 ICP.
121
75 ICP.
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122
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64[f] ICP.
124
125
Ibid.
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126
PJG
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127
128
48 ICP.
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129
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131
95 ICP.
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(a) Same:
i)
Person insured;
132
96 ICP.
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133
97 ICP.
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(1) Treaty.
(a) A prior agreement where the reinsure accepts
the reinsurance ceded by the reinsured/
original insurer.
i)
134
100 ICP.
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95 ICP.
136
97 ICP.
PJG
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PJG
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88
400k from X.
137
97 ICP.
PJG
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138
139
96 ICP.
PJG
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X-200k
ii) Y-100k
iii) Z-300k
(c) PJ - i cannot stress the importance of knowing
simple fractions here.
N. Loss and claims settlement. (Chapter 7 and 8 of
Aquino)
1. Preliminaries.
a) Loss is the damage sustained by the insured.
(1) In property insurance, this consists of cash value
depending on extent of loss.
(2) In life insurance, it occurs upon death.
(3) In health insurance, it occurs upon injury or
disability.
b) Kinds of causes.
PJG
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PJG
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140
86 ICP.
141
88 ICP.
142
87 ICP.
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143
89 ICP.
144
90 ICP.
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(a) T h i s i s h i g h l y d e p e n d e n t o n t h e
circumstances, as the law do not demand the
impossible, it contemplates a reasonable time
decided in favor of the insured.
(b) In the same manner, substantial compliance is
sufcient.
(c) Notice is waived in case the policy is null and
void.
(d) All defects not raised by the insurer in the
notice and proof is considered waived.
(e) Effect of delay:
i)
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91 ICP.
146
147
PJG
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96
coverage of policy.
PJG
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97
249 ICP.
149
250 ICP.
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98
Moral damages;
150
Legal interest is pegged @6% by BSP. So it is immaterial that the claim itself do not arise
from a loan or forebearance of money.
151
63 and 97 ICP.
152
63 ICP.
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153
Sundiang.
154
PJG
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156
2207 NCC.
PJG
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158
PJG
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160
101 ICP.
PJG
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161
115 ICP.
162
163
122 ICP.
164
102 ICP.
PJG
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165
103 ICP.
166
107 ICP.
167
108 ICP.
PJG
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168
PJG
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169
170
PJG
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171
108 ICP.
172
35 ICP.
173
110 ICP.
PJG
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of 146
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174
138 ICP.
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of 146
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175
116 ICP.
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Time policy.
(1) As the specied time operates as
requirement that the ship be seaworthy
during every voyage.178
176
177
118 ICP.
178
117[a] ICP.
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ii) Transshipment.
(1) The commencement of each voyage, as
per custom dictates, in each transshipment, the ship must be seaworthy.179
(a) Routes: terms of policy, description of
voyage, established custom.
iii) Portions of voyage contemplated.
(1) Whenever contemplated that there will be
different portions of the voyage, the ship
must be seaworthy in each portion.180
iv) Unreasonable delay in repair.
(1) As an unreasonable delay in repairing
defects exonerates the insurer from
liability arising therefrom. Though, the
ship be seaworthy on the onset of the
voyage.181
c) Applicability of implied warranty of seaworthiness
to cargo owners.
179
117[b] ICP.
180
119[b] ICP.
181
120 ICP.
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182
PJG
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183
125 ICP.
184
126 ICP.
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132 ICP.
186
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c) Abandonment.
(1) Act of the insured which after a constructive total
loss, he declares relinquishment to the insurer of
his interest in the thing insured.187
(a) Requisites of a valid abandonment.
i)
187
140 ICP.
188
140 ICP.
189
141 ICP.
190
142 ICP.
191
143 ICP.
192
144 ICP.
193
145 ICP.
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146 ICP.
195
169 ICP.
196
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197
170 ICP.
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ii) Altered;
(1) Alteration is without consent of the
insurer;
(2) Alteration is within the control of the
insured;
(3) Such alteration increases risk.
(2) Examples of material alteration:198
(a) Conversion of residential to factory;
(b) Transfer of machineries without consent as it
changes the nature of the thing insured.
4. Friendly re versus hostile re.
a) Friendly re.
(1) Fire that burns where it is supposed to or in a
controlled manner.
198
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b) Hostile re.
(1) Fire that burns and escapes where it is not
supposed to, or
(2) May be friendly re which went out of control or
became too strong.
S. Casualty insurance. (Chapter 14 in Aquino.)
1. Casualty insurance.
a) Insurance covering loss or liability arising from
accident, mishap but excluding other types of
insurance such as re or marine.199
2. Intentional versus accidental insurance.
a) Intentional.
(1) Intentional injuries are usually excepted since it
implies consciousness and volition over the act.
To invoke this exception, it is the intention of the
person inicting the injury which is necessary.
This is because intentional acts of a third person
relieves the insurer from liability.200
b) Accidental.
199
176 ICP.
200
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202
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203
389 ICP.
PJG
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204
389 ICP.
PJG
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of 146
PJG
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of 146
206
391 ICP.
207
391 ICP.
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208
397 ICP.
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b) Prescriptive period.
(1) The action must be led in court or insurance
commission within one (1) year from the denial
of the claim.209
c) If there is an agreement.
(1) The insurance company shall ascertain the truth
and extent of the claim and pay within ve (5)
working days after reaching an agreement.210
d) If no agreement is reached.
(1) The insurance company shall only pay the "nofault" indemnity without prejudice to the claimant
from making further claims. In this case, the
claimant cannot be required or compelled by the
insurance company to execute a quitclaim or a
document releasing the insurer from liability
under the insurance policy or surety bond
issued.211
6. Liability of insurer.
a) May a third person sue the insurer directly?
209
397 ICP.
210
398 ICP.
211
398 ICP.
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(1) Depends:212
(a) Policy provides for indemnity against liability:
i)
53 ICP.
213
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214
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216
PJG
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217
218
219
PJG
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220
PJG
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221
222
223
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177 ICP.
225
181 ICP.
PJG
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227
183 ICP.
PJG
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of 146
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238(b) ICP.
229
437 ICP.
PJG
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230
439 ICP.
231
PJG
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232
254 ICP.
PJG
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256 ICP.
234
255 ICP.
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Actuary.
g) Rate organization.
h) Self-regulatory organization.
IV. Part 03 - Business Organizations.
A. Basic types of organizations.
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235
1440 NCC.
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BP 68.
237
AN 2137.
238
239
PD115.
240
AN3952.
241
1484 NCC.
242
PJG
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243
244
RA8293.