Notes On Insurance Code Sec.1 31 Reference Sec. Hernando Perez For Fair Use Only
Notes On Insurance Code Sec.1 31 Reference Sec. Hernando Perez For Fair Use Only
INSURANCE LAW
SEC. 1 – THIS DECREE SHALL BE KNOWN AS insurance company upon the advice of its legal
‘THE INSURANCE CODE’. advisers.
Reference: The Insurance Code and Financial Rehabilitation and Insolvency Act by Hernando B. Perez
Made by: Juan Paolo R. Datinguinoo, UB College of Law Page 1 of 12
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Reference: The Insurance Code and Financial Rehabilitation and Insolvency Act by Hernando B. Perez
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When the surety is only incidental, it is not an insurance Q: What are the nature of Insurance Contracts?
contract since it lacks the requirement that the
assumption of loss should be part of a general scheme A: GEN’L RULE: Insurance contracts shall be deemed
to distribute actual losses among a large group of contracts of indemnity which means that the right to
persons bearing somewhat similar risks. recover shall be commensurate to the amount of loss
incurred upon the happening of the loss.
Q: What are the tests to determine whether a
contract is an insurance contract? EXCEPTIONS:
1. Life Insurance – The amount of the insurance
A: The following tests may be used to determine whether may be for ANY value as there can be no
a contract is an insurance contract: (A-N-A) monetary value for the life of a person.
2. Accident Insurance where the result is death
1. Nature of the promise
2. Act required to be performed
3. Exact nature of the agreement in light of the Sec. 3. Any contingent or unknown event,
occurrence, contingency or circumstances under whether past or future, which may damnify a
which the performance becomes a requisite. person having an insurable interest, or
create a liability against him, may be insured
Case #9
White Gold Marine Services vs. Pioneer Insurance against, subject to the provisions of this
and Surety Corp. chapter.
- A contract may be deemed an insurance contract not The consent of the husband is not
on how it is called but on the nature of the obligations of necessary for the validity of an insurance
the parties involved with regard to the loss or occurrence policy taken out by a married woman on her
insured against. life or that of her children.
Q: What are the characteristics of an insurance
contract? (A-I-P-EC) Any minor of the age of eighteen years or
more, may, notwithstanding such minority,
A: contract for life, health and accident
insurance, with any insurance company duly
1. It is aleatory and not wagering. authorized to do business in the Philippines,
- Both parties bind each other to give or to do provided the insurance is taken on his own
something in consideration of the other shall life and the beneficiary appointed is the
give or do upon the occurrence of the risk minor's estate or the minor's father, mother,
insured against. husband, wife, child, brother or sister.
2. It is a contract of indemnity.
- The right to recover shall be commensurate
to the amount of loss incurred upon the The married woman or the minor herein
happening of the loss. allowed to take out an insurance policy may
3. It is a personal contract. exercise all the rights and privileges of an
- An insurer contracts with reference to the owner under a policy.
character of the insured for integrity and
prudence.
Reference: The Insurance Code and Financial Rehabilitation and Insolvency Act by Hernando B. Perez
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All rights, title and interest in the policy of an insurer requires the assumption of risks and
insurance taken out by an original owner on accordinglu, the insurer is still responsible even if the
the life or health of a minor shall event could not be foreseen, or though foreseen, is
automatically vest in the minor upon the inevitable.
death of the original owner, unless
otherwise provided for in the policy.
Q: Does a married person need the consent of the
other spouse in obtaining a CI?
Q: What risks may be insured against in a contract
of insurance?
A: GEN’L RULE: Events covered in an IC are future W/ CONSENT – Valid and enforceable
events. W/O CONSENT – Voidable (At the option of the
insured and not by the insurer, hence, the insurer cannot
raise the incapacity of the minor as a defense)
EXCEPTIONS: Past events may be covered by the Q: What happens to the interest in a CI taken upon the
insurance if two requisites are present: life of another upon the death of the policy holder?
Reference: The Insurance Code and Financial Rehabilitation and Insolvency Act by Hernando B. Perez
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Reference: The Insurance Code and Financial Rehabilitation and Insolvency Act by Hernando B. Perez
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Q: What is a “mortgage redemption” Insurance and A. Insurance secured by the Mortgagor, loss
what are its effects? payable to mortgagee
In case the mortgagor-insured dies, the 2. In case of death by the mortgagor, his heirs
proceeds of the insurance will be applied to the assumes right to the CI.
payment of the mortgage debt to the mortgagee,
thereby relieving the heirs of the mortgagor of the 3. BUT the mortgagee has a lien on the amount
burden of paying the debt. to be recovered by virtue of the debt of the
mortgagor.
EXCEPTION:
Case #11
1. If the mortgagee has decided to foreclose on
Great Pacific Life Assurance Corp. vs. CA the mortgage, then his interest/lien on the
amount recoverable by the mortgagor shall be
extinguished. (The foreclosure shall be the
one to settle the debt)
- Where the mortgagor pays the insurance premium
under group life policy, making the loss payable to the
mortgagee, the insurance is still on the interest of the
mortgagor who continues to be a party to the contract. B. Insurance secured by the mortgagee for
Such kind ogf policy insurance upon life or health MAY the extent of his credit W/O reference to the
PASS by transfer, will or succession to any person right of the mortgagor
whether he has an insurable interest or not, and such
person may recover whatever the insured might have
recovered.
1. The mortgagee may collect from the insurer
upon the occurrence of the loss to the extent
of his credit.
Q: What are the rules that govern insurance on
mortgaged properties? 2. The mortgagor may not collect from the
insurer the balance of the insurance proceeds
after payment to the mortgagee his benefits up
to the extent of his credit. (EXCEPTION:
A: The rules applicable depend on who insured the When permitted by the policy to do so)
mortgaged property:
3. The insurer becomes subrogated to the rights
of the mortgagee and may go after the
mortgagor for the collection of the amount it
paid to the mortgagee.
Reference: The Insurance Code and Financial Rehabilitation and Insolvency Act by Hernando B. Perez
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Sec. 10. Every person has an insurable A: Sec 10, par B states that every person has insurable
interest in the life and health: interest in the life and health of any person on whom he
depends wholly or in part for education or support, or in
(a) Of himself, of his spouse and of his
whom he has a pecuniary interest. These persons are
children; the persons who are required by law to support each
(b) Of any person on whom he depends other:
wholly or in part for education or 1. The spouse;
support, or in whom he has a 2. Legitimate ascendants and descendants;
pecuniary interest; 3. Parents and acknowledged natural children and
the legitimate of illegitimate descendants of the
(c) Of any person under a legal latter;
obligation to him for the payment of 4. Parents and natural children by legal fiction and
money, or respecting property or the legitimate and the illegitimate descendants
services, of which death or illness of the latter;
might delay or prevent the 5. Parents and illegitimate children who are not
performance; and natural; and
6. Brothers and sisters.
(d) Of any person upon whose life any
estate or interest vested in him Q: What are the limits in Sec 10, par C (insurable
depends. interest in debtor’s life)?
Reference: The Insurance Code and Financial Rehabilitation and Insolvency Act by Hernando B. Perez
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SEC. 11. The insured shall have the right to 2. Irrevocable – the beneficiary may not be
change the beneficiary he designated in the changed without his consent. Also, no other
policy, unless he has expressly waived this beneficiary may be added in the policy without
right in said policy. Notwithstanding the his permission.
Note: WHERE CONSENT IN BEHALF OF
foregoing, in the event the insured does not
MINORS MAY BE MADE:
change the beneficiary during his lifetime, the - When a minor was designated as
designation shall be deemed irrevocable. beneficiary and the interest of the minor in
the policy DOES NOT EXCEED P500,000,
Q: What is a beneficiary? his consent to the change of beneficiary may
be given by (IN EXACT ORDER):
A: A beneficiary is the person for whose benefit the o Judicial guardian
policy is issued and to whom the loss is payable. o Father
o Mother
Q: What are the rules applicable to naming a o Grandparent
beneficiary in a LI and a property insurance? o Eldest brother or sister (at least
18yo)
Life Insurance Property Insurance o Any relative of the minor who has
Beneficiary may be any Beneficiary must have
actual custody of the minor
one at the election of the insurable interest in the
- When the amount EXCEEDS P500,000, the
insured. Beneficiary may property both at the time of
adult should be court appointed first.
or may not have insurable effectivity of the policy
interest in the life insured. AND the occurrence of the
loss.
Case #12
PhilAm Life Insurance Co. vs. Pineda
Q: Who are not allowed to be beneficiaries in a life
insurance? - It is only with consent of all the beneficiaries that any
change or amendment in the policy concerning
A: Persons not allowed to receive donations are also not irrevocable beneficiaries may be made.
allowed to receive benefits in a contract of insurance. - Consent given by minors shall not be deemed effective
They are the following: as they cannot validly give their consent to the change of
1. Those made BETWEEN persons who are guilty beneficiaries.
of adultery or concubinage at the time of the
donation; Q: What rules shall apply when the beneficiary
Note: predeceases the insured?
a. Not including adulterous children
b. Conviction not required; may be proven by A: It depends on what kind of beneficiary:
preponderant evidence 1. REVOCABLE – the right to the proceeds of the
2. Those made BETWEEN persons found guilty of policy becomes payable to the estate of the
the same criminal offense, in consideration insured.
thereof; and 2. IRREVOCABLE – the beneficiary having vested
3. Those made to a public officer or his wife, right thereon, the legal representatives of the
descendants and ascendants, by reason of his beneficiary shall be entitled to the proceeds of
office. the insurance and not the estate of the insured.
Q: What are the kinds of beneficiaries?
“SEC. 12. The interest of a beneficiary in a life
A: There are two: insurance policy shall be forfeited when the
1. Revocable – the beneficiary may be changed beneficiary is the principal, accomplice, or
EXCEPTION: accessory in willfully bringing about the death of the
a. When stated in the policy that the right to insured. In such a case, the share forfeited shall
change beneficiary is waived pass on to the other beneficiaries, unless otherwise
b. When the insured did not change the disqualified. In the absence of other beneficiaries,
beneficiary during his lifetime, the the proceeds shall be paid in accordance with the
beneficiary shall be deemed irrevocable
Reference: The Insurance Code and Financial Rehabilitation and Insolvency Act by Hernando B. Perez
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policy contract. If the policy contract is silent, the SEC. 16. A mere contingent or expectant interest in
proceeds shall be paid to the estate of the insured. any thing, not founded on an actual right to the
thing, nor upon any valid contract for it, is not
Q: How shall forfeiture operate in case the beneficiary is insurable.
proven to be a principal, accomplice or accessory in the
killing of the insured?
Q: Distinguish insurable interest in LI and Property
A: The following rules on forfeiture shall apply: Insurance.
1. It shall pass on to other beneficiaries if there are
any, or unless disqualified as well. A:
2. If not, the proceeds shall be paid in accordance Life Insurance Property Insurance
to the stipulation in the policy. Not based on pecuniary Based on pecuniary
3. If the policy is silent, then it shall be paid to the interest as it may be (monetary) interest
estate of the insured. consanguinity or affinity
Interest must exist at the Interest must exist BOTH
Note:
time of the effectivity of the at the effectivity of the
Where the killing is unintentional or not
policy policy and the occurrence
felonious, the beneficiary will not be denied recovery
of the loss
by reason of his causing the death of the insured.
Insurable interest has no Insurable interest is limited
limit on the amount of to the actual value of the
insurable interest UNLESS damage the insured may
SEC. 13. Every interest in property, whether real or it is an insurance taken by suffer
personal, or any relation thereto, or liability in the creditor on the life of its
respect thereof, of such nature that a contemplated debtor
peril might directly damnify the insured, is an Beneficiary may not have Beneficiary needs to have
insurable interest. insurable interest on the insurable interest on the
life or health insured property insured
EXCEPT party is
prohibited to receive
donations
SEC. 14. An insurable interest in property may
consist in:
SEC. 17. The measure of an insurable interest in
(a) An existing interest; property is the extent to which the insured might be
damnified by loss or injury thereof.
(b) An inchoate interest founded on an
existing interest; or
(c) An expectancy, coupled with an existing SEC. 18. No contract or policy of insurance on
interest in that out of which the expectancy property shall be enforceable except for the benefit
arises. of some person having an insurable interest in the
property insured.
Reference: The Insurance Code and Financial Rehabilitation and Insolvency Act by Hernando B. Perez
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SEC. 20. Except in the cases specified in the next Change of interest in the thing insured
four sections, and in the cases of life, accident, and accompanied by change of interest in the policy shall
health insurance, a change of interest in any part of SUSPEND the policy to an equivalent extent UNLESS
a thing insured unaccompanied by a corresponding the interest in the thing and the interest in the policy
becomes vested to one person only. (Reason: Insurance
change of interest in the insurance, suspends the
policy is a PERSONAL contract.)
insurance to an equivalent extent, until the interest
in the thing and the interest in the insurance are Q: What happens when an insurance policy is
vested in the same person. suspended?
Reference: The Insurance Code and Financial Rehabilitation and Insolvency Act by Hernando B. Perez
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insured without corresponding transfer of the A: GEN’L RULE: Bad faith must exist at the time of the
insurance? after the application for insurance but before the
effectivity of the policy.
A: These are the following:
1. When there is a prohibition against alienation of
property without the consent of the insurer
(Policy not suspended but AVOIDED) EXCEPTIONS:
2. In case of life, accident or health insurance;
3. A change of interest in the thing insured AFTER
the occurrence of the loss; 1. Where the policy provides if the application is
4. A change of interest in one or more distinct approved and policy is issued, it shall be in force
things separately insured; from the date of application;
5. A change of interest by will or succession;
6. A transfer of interest by one of several partners, 2. Where the change occurs after the
joint owners or owners in common; and consummation of the insurance orally although
7. When the policy is so framed that it will inure to the formal policy has not been issued yet.
the benefit of the owner of the property.
Case #14
A: Concealment presupposes knowledge of the fact
concealed on the part of the party charged with Great Pacific Life Assurance Co. vs CA
concealment. Such party alleging concealment must
prove that such concealment is done with knowledge or
bad faith.
- The contract of insurance is one of perfect good faith,
absolute and perfect candor or openness and honesty. A
party guilty of concealment entitles the other for
Q: When must knowledge or bad faith exist to rescission.
constitute concealment?
Reference: The Insurance Code and Financial Rehabilitation and Insolvency Act by Hernando B. Perez
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all facts within his knowledge which are SEC. 30. Neither party to a contract of
material to the contract and as to which he insurance is bound to communicate information
makes no warranty, and which the other has not of the matters following, except in answer to the
the means of ascertaining. inquiries of the other:
Q: What facts should be communicated to the other (b) Those which, in the exercise of
party under Sec. 28? ordinary care, the other ought to know,
and of which the former has no reason to
suppose him ignorant;
A: The facts must have the following requisites: (c) Those of which the other waives
communication;
1. Must be within the party’s knowledge;
(d) Those which prove or tend to prove
2. Must be material to the contract; the existence of a risk excluded by a
warranty, and which are not otherwise
3. The other party has not the means of material; and
ascertaining such fact;
(e) Those which relate to a risk excepted
4. The party makes no warranties of such fact.
from the policy and which are not
otherwise material.
SEC. 29. An intentional and fraudulent
omission, on the part of one insured, to
communicate information of matters proving or
tending to prove the falsity of a warranty,
entitles the insurer to rescind.
SEC. 31. Materiality is to be determined not by
the event, but solely by the probable and
Q: What are the rules regarding warranties?
reasonable influence of the facts upon the party
to whom the communication is due, in forming
his estimate of the disadvantages of the
proposed contract, or in making his inquiries.
A: GEN’L RULE: Matters covered by a warranty need
not be revealed.
Reference: The Insurance Code and Financial Rehabilitation and Insolvency Act by Hernando B. Perez
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