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Insurance Law

Course Syllabus
Atty. Philip John L. Pojas

GRADING SYSTEM:

Recitation - 20%
Prelims - 20%
Midterms - 20%
Finals - 40%

PART ONE
Insurance Law in General

I. Introduction

A. History
B. Laws governing insurance
C. Rules of construction

Alpha v. Castor, G.R. No. 198174, September 2, 2013


Gulf Resorts vs. PCIC, G.R. No. 156167. May 16, 2005

D. Regulation of the insurance business


E. Statute of Limitations
F. Basic Framework

II. General concepts

A. Contract of Insurance – 2(1)

Philamcare v. CA, March 18, 2002


Philippine Health Care v. CIR, June 12, 2008
Philippine Health Care v. CIR, September 18, 2009

B. Insurance business – 2(2)

White Gold Marine v. Pioneer, July 28, 2005

C. What may be insured against – 3, 84; 1174 Civil Code

Guingon v. del Monte, 20 SCRA 1043


Bonifacio v. Mora, 20 SCRA 261

D. Insurance for or against drawing of lottery – 4, 25

Uy v. Palomar, 27 SCRA 287


E. Bancassurance

F. Microinsurance

III. Kinds of Insurance

A. Life Insurance

1. Kinds – 179-183, 187 9th paragraph; 2021 Civil Code

a. Ordinary life

CIR v. Manila Bankers, March 16, 2011

b. Limited Payment life


c. Term Insurance
d. Endowment
e. Life Annuity
f. Accident

Sun Insurance v. CA, 211 SCRA 554


Dela Cruz v. Capital, 17 SCRA 559
Finman v. CA, 213 SCRA 493
Gallardo v. Morales, 107 Phil 903

2. Classes

a. Individual
b. Group

Pineda v. CA, 223 SCRA 754


CIR v. Manila Bankers, March 16, 2011

c. Industrial – 229

B. Non-life Insurance

1. Types

a. fire – 167
b. casualty – 174
c. marine – 99
d. compulsory motor vehicle – 373
e. suretyship - 175
PART TWO
Life Insurance

I. What may be insured against, contingencies – 3, 87, 180, 180-A


Sec. 3, Rule 131 Rules of Court

Gallardo v. Morales, 107 Phil 903


Calanoc v. CA, 98 Phil 79
Biagtan v. Insular, 44 SCRA 58
Dela Cruz v. Capital, 17 SCRA 559
Sun Insurance v. CA, 211 SCRA 554

II. Insurable interest – 10, 19 2nd part, 25, 181 in relation to 11

A. In one’s own life


B. In one’s spouse and children
C. Based on dependence for education and support – 195,
Family Code
D. Based on pecuniary interest

El Oriente v. Posadas, 56 Phil 147

E. Based on legal obligation

III. The Life Insurance Policy – 49-52, 56, 226-231

Jarque v. Smith, 56 Phil 758


Fortune v.CA, 244 SCRA 308
De Lim v. Sunlife, 41 Phil 263
Badger v. New York Life, 7 Phil 381
Enriquez v. Sunlife, 41 Phil 269
Lucero de Sindayen v. Insular, 62 Phil 9
Pineda v. CA, 226 SCRA 754
Great Pacific v. CA, 89 SCRA 543
Tang v. CA, 90 SCRA 236

IV. Premiums – 77, 78, 227(a), 228(a), 230(a)

Aleja v. GSIS, 13 SCRA 212


Areola v. CA, 236 SCRA 643
Constantino v. Asia Life, 87 Phil 248
Ocampo v. Government Insurance, 78 Phil 216
Insular Life v. Suva, 62 Phil 346

V. Parties to the Contract – 3


A. Insurer – 6, 184-187
B. Insured – 7

1. In general

Filipinas v. Huenefeld, 89 Phil 54

2. Rights

a. Right to borrow on policy – 227(g)


b. Right to dividends if participating policy – 226(a),
230(e), 195, 227(j), 230(j)
c. Right to reinstatement

Andres v. Crownlife, 102 Phil 919


Lalican v. Insular, August 25, 2009

d. Right to transfer/bequeath – 181- 182

Sunlife v. Ingersoll, 41 Phil 331


Grepalife v. CA, October 13, 1999

C. Cestui que vie

D. Beneficiary – 2012 Civil Code, 11-12

SSS v. Davac, 17 SCRA 863


Insular v. Ebrado, 80 SCRA 181
In re: Chanliongco, 79 SCRA 364
Gercio v. Sunlife, 48 Phil 53

VI. Measure of indemnity – 183, 10©

VII. Special rights of insured in case of default

A. Cash Surrender Value – 227(f), 227(g)

Manufacturer's Life v. Meer, 89 Phil 351

B. Extended Insurance – 227(j)


C. Paid Up Insurance
D. Automatic Premium Loan
PART THREE
Non-Life Insurance

I. What may be insured against – 3, 84-87

Heirs of Coscolluela v. Rico, 179 SCRA 511


Prats v. Phoenix, 52 Phil 807
East v. Globe, 57 Phil 576
Paris v. Phoenix, 49 Phil 753

II. Insurable interest – 13-18, 19 1st paragraph, 20-25, 58, Sec. 6 Act
No. 3893

Lampano v. Jose, 30 Phil 357


Traders v. Golangco, 95 Phil 826
Filipino v. CA, 179 SCRA 638
Cha v. CA, 277 SCRA 690
Garcia v. Hongkong, 45 Phil 122
Lim Cuan Sy v. Northern, 55 Phil 248
Chucuhe v. Insurance Commission, 158 SCRA 366
San Miguel v. Law Union, 40 Phil 674
RCBC v. CA, 289 SCRA 292

III. The Insurance Policy – 49-51; 56-58, 66

1. In general

Ang Giok v. Springfield, 56 Phil 375


Phil. Phoenix v. Woodworks, 92 SCRA 419
Gonzales v. Yeh Ting, 55 Phil 386
Del Rosario v. Equitable, 8 SCRA 343
Pacific Timber v. CA, 112 SCRA 199

2. Kinds of non-life insurance policy – 59-62

Harding v. Commercial, 38 Phil 464


Development v. IAC, 143 SCRA 62

IV. Premium – 77, 79, 81-82, 177

Phil Phoenix v. Woodworks, 92 SCRA 419


Arce v. Capital, 117 SCRA 63
Capital v. Plastic Era, 65 SCRA 134
Velasco v. Apostol, 173 SCRA 228
Valenzuela v. CA, 191 SCRA 1
Phil. Phoenix v. Woodworks, 20 SCRA 1271
Phil. Pryce v. CA, 230 SCRA 164
Reparations v. Universal, 83 SCRA 764
Makati v. CA, 215 SCRA 462
Tibay v. CA, 257 SCRA 126
Malayan v. Arnaldo, 154 SCRA 672
UCPB v. Masagana, April 4, 2001

V. Parties to the contract – 6-8

A. Insurer – 6, 184-187

B. Insured – 7

VI. Double insurance v. Reinsurance – 93-98

Equitable v. Rural, 4 SCRA 343


Pioneer v. Yap, 61 SCRA 426
Geagonia v. CA, 241 SCRA 152
Pioneer v. CA, 175 SCRA 668
Gibson v. Revilla, 92 SCRA 219
Artex v. Wellington, 51 SCRA 352

VII. Discussion on different kinds of non-life insurance

A. Marine insurance – 99; 100-106; 156

Malayan v. CA, 270 SCRA 242


Cathay v. CA, 151 SCRA 710
Choa v. CA, 183 SCRA 223
Filipino v. CA, 179 SCRA 638
Caltex v. Sulpicio, 315 SCRA 709
Mayer v. CA, 274 SCRA 432

B. Fire insurance – 167, 171-172

Del Castillo v. Metropolitan, 85 Phil 678


Filipinas v. Tan, 85 Phil 379

C. Casualty insurance – 174

Fortune v. CA, 244 SCRA 308

1. Suretyship – 177-178
Machette v. Hospicio, 43 Phil 297
Phil. Pryce v. CA, 230 SCRA 164

2. Compulsory Motor Vehicle Liability – 373, 378

Tanco v. Phil. Guarantee, 15 SCRA 313

PART FOUR
Payment of Proceeds and Filing of Claims

I. In life insurance - 242, 180

1. In general
2. Death as the suspensive condition

Fernandez v. National, 105 Phil 59

3. Proof of death v. Notice of death

Londres v. National, 94 Phil 627

4. Facility of payment clause – 228(f); 321© in rel. to 230(m)

II. In non-life insurance – 243-244, 88-91

A. In general

1. Loss – 84-87

2. Notice and proof of loss – 88-92

Finman v. CA, July 12, 2001

3. Payment of proceeds

Mla. Mahogany v. CA, 154 SCRA 650


Yu v. Fieldmens, 14 SCRA 491
Le Bog v. Hanover, 1 SCRA 599
Chuy v. Philam, 95 Phil 282
RCBC v. CA, 289 SCRA 292
Zenith v. CA, 185 SCRA 398

4. Right of subrogation

American Federal v. American, August 18, 2004


B. In marine insurance

1. Loss – 127-137

Phil. Manufacturer v. Insurance, 42 Phil 378


Pan Malayan v. CA, 201 SCRA 382
Jarque v. Smith, 56 Phil 758

2. Measure of Indemnity – 156-166

3. Abandonment – 138-155

Oriental v. CA, 200 SCRA 459

C. In compulsory motor vehicle liability insurance – 384 and 385


paragraph 2 in relation to 378; Insurancer Memorandum 4-
2006

GSIS v. CA, 308 SCRA 559


Tiu v. Arriesgado, Sept. 1, 2004

III. Litigation to satisfy claims; procedure – 63; 244; 416

Eagle Star v. Chia, 96 Phil 696


Traveller's v. CA, 272 SCRA 536
Filipino v. Alejandro, 145 SCRA 42
ACCFA v. Alpha, 24 SCRA 151
Vda de Gabriel v. CA, 264 SCRA 137
Country Bankers v. Traveller's, 176 SCRA 523

II. Unfair settlement practices – 241

PART FIVE
Grounds for Rescission

I. Concealment – 26,27,29

A. In general

Great Pacific Life v. CA, 89 SCRA 543


Musngi v. West Coast, 61 Phil 864
Sunlife v. CA, 245 SCRA 268
Grepalife v. CA, October 13, 1999
Philamcare v. CA, March 18, 2002

1. What must be communicated – 28, 29


2. What need not be communicated – 30, 32, 34, 35
3. Waiver of right to information of material facts -33

Ng Gan Zee v. Asian, 122 SCRA 461

4. Test of materiality - 31

Vda de Canilang v. CA, 223 SCRA 443

B. In marine insurance – 107-110

C. In life insurance - Incontestability clause – 48 2nd paragraph,


227(b), 228(b), 230(b)

Tan v. CA, 174 SCRA 403


Florendo v. Philam, G.R. No. 186983, February 22, 2012

II. Misrepresentation

A. In general – 36-43

Eguaras v. Great Eastern, 33 Phil 263


Argente v. West Coast, 51 Phil 725
Saturnino v. Philam, 7 SCRA 316

1. as a ground to rescind – 45, 48 1st paragraph


2. test of falsity – 44
3. materiality – 46

B. In life insurance

1. Incontestability clause – 48 2nd paragraph, 227(b),


228(b), 230(b)

2. Misrepresentations as to age – 227(d)

C. In marine insurance- 107, 111-112

III. Breach of warranty – 74-75

A. Warranty – 67-69

Prudential v. Trans-Asia, June 20, 2006


Union v. Philippine Guaranty, 47 SCRA 271

1. Express – 70, 72-73, 76


2. Implied – 113-126
B. In fire insurance – 168-170

Bachrach v. British, 17 Phil 555

IV. Other grounds for rescission in non-life insurance - 64-65

Saura v. Phil. International, 8 SCRA 143


Malayan v. Arnaldo, 154 SCRA 672
Paulino v. Capital, 105 Phil 1315

V. When right to rescission must be exercised – 48; 380

Tan Chay v. West Coast, 51 Phil 80


Argente v. West Coast, 51 Phil 725

PART VI
Special Laws

I. RA 9302, RA 9576

Phil. Deposit Insurance v. CA, April 30, 2003