Académique Documents
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Presented by:
Kent Wilson Andales
Marc Angelo Bantug
Rafael Andrei La Madrid
Rolan Jeff Lancion
Mark Gabriel Maranga
Sec 95. A double insurance exists where the same person is insured by
several insurers separately in respect to the same subject and interest.
Definition
In insurance contracts, the terms additional insurance, other insurance and
double insurance are used interchangeably, although there is a technical
difference in their meanings.
There is co-insurance by two (2) or more insurers hence it is also known as coinsurance.
Requisites: (PISIR)
(a) The person insured is the same
(b) Two (2) or more insurers insuring separately
(c) There is identity of subject matter
(d) There is identity of interest insured
(e) There is identity of risk or peril insured against.
Examples:
Juan insures his house against fire with ABC Insurance and XYZ Insurance
Company. There is double insurance because all the requisites are present.
The subject matter insured is the house of Juan. The interest insured is Juans
interest in the house.
Don Pepot mortgages his house to Jay. Insurance taken by Don Pepot and
another taken by Jay on the same house. In this example, there is no double
insurance because it is not on the same insurable interest.
No double insurance if the mortgagor and the mortgagee separately insures
the mortgaged property. The two (2) insurance policies do not involve the
same interest.
Mr. Pedro owns a house and he insures it with Any Insurance Corp against fire
for P500, 000 and with Matulungin Insurance Company against flood for P600,
000. There is no double insurance because although the same person and
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subject are involved in both insurance policies, the peril insured against are
different.
Double Insurance in Life Insurance
There can be double insurance in life insurance but there can never be overinsurance. The life of a person can be insured for any amount and it would still be
inadequate because of the intrinsic value of life.
Over Insurance by Double Insurance
There is over-insurance if the insured takes out an insurance over the property
insured in an amount which is in excess of the value of his insurable interest.
Instances:
(a) Over-insurance may exist even if there is only one insurer and one policy.
Example:
Mr. Green owns a house valued at P1,000,000, there is over-insurance if he
insures it with XYZ Corp. for P10,000,000.
(b) Over-insurance may likewise exist if there is double insurance.
Example:
Mr. Bryant owns a condominium unit valued at P800,000 and he insures it
with Lakers Insurance Company against fire for P500,000 and with Clippers
Corp against fire for P500,000.
(c) There can be under insurance even if there is double-insurance.
Example:
Mr. Irving owns a condominium unit valued at P500,000 and he insures it with
Cavaliers Corp against fire for P200,000 and Nuggets Life Insurance Comp.
against fire for P100,000.
The taking of another insurance without over-insurance is not a ground to rescind
the policy under Sec. 64 (f).
Double insurance vs over insurance
Double insurance
There may be no over insurance
as when the sum total of the
amounts of the policies issued
does not exceed the insurable
interest of the insured.
Always several insurers
Over insurance
The amount of the insurance is
beyond the value of the insureds
insurable interest.
*Double insurance and over insurance may exist at the same time or neither may
exist at all.
Examples:
Jojos insurable interest in a house is P1,000,000 and he insured it with Jolly
Insurance company for P10,000,000, in this case there is over insurance but not
double insurance.
Jojo insured his house with Jolly Insurance company for P 500,000 and Happy
Insurance Company for P500,000, in this case there is double insurance and not
over insurance.
If Jojo procures only one policy for the amount of P1,000,000 from Joy Insurance
Company, there is neither double insurance.
Binding effects of stipulation against double insurance.
Legal Basis:
Sec 75. A policy which contains no stipulation against additional insurance is not
invalidated by the procuring of such insurance.
Invariably, policies of fire insurance contain a stipulation or condition that they shall
be avoided if additional insurance is procured on the property without the insurers
consent.
A. Additional insurance obtained by the insured
The provision known as additional or other insurance clause and is
intended to prevent an increase in the moral hazard. This is valid and
reasonable and in the absence of consent, waiver or estoppel on the
part of the insurer, a breach thereof will prevent a recovery on the
policy.
In order to constitute a violation, the other insurance must be upon the
same subject matter, same interest and risk.
B. Additional insurance obtained by a third person
Good faith or bad faith of the insured is usually immaterial.
Insurance obtained by a third person without the knowledge or consent
of the insured will not affect his rights under the policy in the absence
of ratification.
No General Prohibition against double insurance
The implication of the rules on double-insurance under the Insurance Code is that
double-insurance is not prohibited.
Exception:
Discovery of other insurance coverage the makes the total insurance in excess of
the value of the property insured.
Two conditions that should be present: (a) another insurance coverage is discovered
(b) the total insurance is in excess of the value of the property insured.
There is a great temptation upon dishonest person, whose property is insured up to
its full value or above it, to bring about its destruction and the same considerations
undoubtedly tend to lessen the care that may be exercised by the honest in
preventing loss.
Other Insurance clause
Taking of another insurance policy over the same property may also be prohibited.
Alternative forms
(1) A condition that states that procurement of additional insurance without the
consent of the insurer renders the policy ipso facto.
(2) A provision that requires the insured to disclose the existence of any other
insurance on the property. Otherwise, the contract may be avoided for
material concealment.
(3) A warranty that there is no other existing insurance over the same property.
Purpose
To prevent over-insurance and thus avert the perpetration of fraud.
Validity
The law authorizes insurance companies to terminate the contract at any time, by
giving notice and refunding a ratable proportion of the premium.
An additional insurance unless consented to or unless a waiver was shown, ipso
facto avoided the contract and the fact that the company had not after notice of
such insurance, cancelled the policy, did not justify the legal conclusion that it had
elected to allow it to continue in force.
Sec 96. Where the insured in a policy other than life is over insured by
double insurance:
"(a) The insured, unless the policy otherwise provides, may claim
payment from the insurers in such order as he may select, up to the
amount for which the insurers are severally liable under their
respective contracts;
"(b) Where the policy under which the insured claims is a valued
policy, any sum received by him under any other policy shall be
deducted from the value of the policy without regard to the actual
value of the subject matter insured;
"(c) Where the policy under which the insured claims is an unvalued
policy, any sum received by him under any policy shall be deducted
against the full insurable value, for any sum received by him under
any policy;
"(d) Where the insured receives any sum in excess of the valuation
in the case of valued policies, or of the insurable value in the case of
unvalued policies, he must hold such sum in trust for the insurers,
according to their right of contribution among themselves;
"(e) Each insurer is bound, as between himself and the other
insurers, to contribute ratably to the loss in proportion to the
amount for which he is liable under his contract.
since the property is relied upon as security thereof, and in insuring he is not
insuring the property but his interest or lien thereon. His insurable interest is prima
facie the value mortgaged and extends only to the amount of the debt, not
exceeding the value of the mortgaged property. 20 Thus, separate insurances
covering different insurable interests may be obtained by the mortgagor and the
mortgagee.
A mortgagor may, however, take out insurance for the benefit of the mortgagee,
which is the usual practice. The mortgagee may be made the beneficial payee in
several ways. He may become the assignee of the policy with the consent of the
insurer; or the mere pledgee without such consent; or the original policy may
contain a mortgage clause; or a rider making the policy payable to the mortgagee
"as his interest may appear" may be attached; or a "standard mortgage clause,"
containing a collateral independent contract between the mortgagee and insurer,
may be attached; or the policy, though by its terms payable absolutely to the
mortgagor, may have been procured by a mortgagor under a contract duty to insure
for the mortgagee's benefit, in which case the mortgagee acquires an equitable lien
upon the proceeds. 21
In the policy obtained by the mortgagor with loss payable clause in favor of the
mortgagee as his interest may appear, the mortgagee is only a beneficiary under
the contract, and recognized as such by the insurer but not made a party to the
contract himself. Hence, any act of the mortgagor which defeats his right will also
defeat the right of the mortgagee. 22 This kind of policy covers only such interest as
the mortgagee has at the issuing of the policy. 23
On the other hand, a mortgagee may also procure a policy as a contracting party in
accordance with the terms of an agreement by which the mortgagor is to pay the
premiums upon such insurance. 24 It has been noted, however, that although the
mortgagee is himself the insured, as where he applies for a policy, fully informs the
authorized agent of his interest, pays the premiums, and obtains on the assurance
that it insures him, the policy is in fact in the form used to insure a mortgagor with
loss payable clause. 25
XXX With these principles in mind, we are of the opinion that Condition 3 of the
subject policy is not totally free from ambiguity and must, perforce, 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.
The first conclusion is supported by the portion of the condition referring to other
insurance "covering any of the property or properties consisting of stocks in trade,
goods in process and/or inventories only hereby insured," and the portion regarding
the insured's declaration on the subheading CO-INSURANCE that the co-insurer is
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cannot recover. Courts are notpermitted to make contracts for the parties. The
functions and duty of thecourts consist simply in enforcing and carrying out the
contracts actuallymade.W h i l e i t i s t r u e , a s a g e n e r a l r u l e , t h a t
c o n t r a c t s o f i n s u r a n c e a r e construed most favorably to the insured, yet
contracts of insurance, likeother contracts, are to be construed according to the
sense and meaningof the terms which the parties themselves have used. If such
terms areclear and unambiguous they must be taken and understood in their
plain,ordinary and popular sense.The annotation then, must be deemed to be a
warranty that the propertywas not insured by any other policy. Violation thereof
entitles the insurer to rescind. The materiality of non-disclosure of other insurance
policies isnot open to doubt.The insurance contract may be rather onerous, but that
in itself does not justify the abrogation of its express terms, terms which the insured
accepted or adhered to and which is the law between the contracting
parties.
General Insurance & Surety Corp vs. Ng Hua
FACTS:
ISSUE:
Whether or not General Insurance can refuse to pay the proceeds?
HELD:
Yes, General Insurance can validly refuse to pay the proceeds.The terms of the
policy which required the insured to declare other insurances must be deemed a
warranty binding on both the insurer and insured. Ng Huas violation of the
statement entitles General Insurance the right to rescind the contract of insurance
as such misrepresentation is considered fatal.
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FACTS:
In 1923, Mr. Sta. Ana built a house in Pasig, in which he took a P3,000-fire
insurance policy in Phoenix Assurance Company for a period of one year
or until 1 October 1926.
In Nov. 1925, Sta. Ana mortgaged said house to the plaintiff Rafael Garcia
for P5,000, for a period of 2 years, whereby the policies issued by the Phoenix
Assurance Company and the Guardian Assurance Company were
endorsed to mortgagee, Rafael Garcia.
In Dec. 1925, Sta. Ana reinsured said house with the defendant companies,
the Globe and Rutgers Fire Insurance Company of New York and
Commercial Assurance Company, Limited of London.
In Sept. 1926, took out another insurance policy on the house for P6,000 in
the Filipinas Compania de Seguros.
At around 3AM of 1 Oct. 1926, 12 hours before the expiration of policies
issued by Phoenix Assurance and Guardian Assurance, a fire broke out in the
insured house.
Sta. Ana demanded for payment of policies in each of the companies, but
assurance companies refused payment on the following grounds: (a) claim
was fraudulent being in excess of the real value of the property; (b) none of
said companies had been informed of the existence of the other policies; and
(c) the fire was intentional.
ISSUE:
Whether or not the plaintiff (Ulpiano Sta. Ana) can claim the net proceeds from the
insurance companies?
HELD:
No, the plaintiff cannot claim net proceeds. Without deciding whether the notice of
other insurance companies upon the same property must be given in writing, or
whether a verbal notice is sufficient to render an insurance valid which requires
such notice, whether oral or written, SC held that in the absolute absence of such
notice when it is one of the conditions specified in the fire insurance policy, the
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policy is null and void. Since the policy is null and void, plaintiff cannot recover from
the defendants insurance companies.
Facts:
Oliva Yap was the owner of a store in a two-storey building where she sold shopping
bags and footwear. Chua Soon Poon, her son-in-law, was in charge of the store.
Yap took out a Fire Insurance from Pioneer Insurance with a value of P25,000.00
covering her stocks, office furniture, fixtures and fittings.
Among the conditions in the policy executed by the parties are the following:
unless such notice be given and the particulars of such insurance or insurances be
stated in, or endorsed on this Policy by or on behalf of the Company before the
occurrence of any loss or damage, all benefits under this Policy shall be forfeited
Any false declaration or breach or this condition will render this policy null and void.
Another insurance policy for P20,000.00 issued by Great American covering the
same properties. The endorsement recognized co-insurance by Northwest for the
same value. Oliva Yap took out another fire insurance policy for P20,000.00 covering
the same properties from the Federal Insurance Company, Inc., which was procured
without notice to and the written consent of Pioneer.
A fire broke out in the building, and the store was burned. Yap filed an insurance
claim, but the same was denied for a breach. Oliva Yap filed a case for payment of
the face value of her fire insurance policy. The insurance company refused to pay
because she never informed Pioneer of another insurer. The trial court decided in
favor of Yap. Tshe CA affirmed.
Issue:
Whether or not Oliva Yap should be absolved from liability on the Pioneeer policy on
account of any violation of the co-insurance clause?
Held:
No, There was a violation. The insurance policy for P20,000.00 issued by the Great
American, ceased to be recognized by them as a co-insurance policy. Other
insurance without the consent of Pioneer would avoid the contract. The obvious
purpose of the aforesaid requirement in the policy is to prevent over-insurance and
thus avert the perpetration of fraud. The public, as well as the insurer, is interested
in preventing the situation in which a fire would be profitable to the insured. Double
insurance is not prohibited by law but it may be prohibited by other insurance
clause which is intended to prevent a moral hazard. It is valid and reasonable, a
breach thereof will prevent a recovery from the policy.
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