By: Johanna Samson

WHAT IS

 is

insurance covering loss or

liability arising from accident or
mishap, excluding certain types
of loss which by law or custom are
considered as falling exclusively
within the scope of other types of
insurance such as marine, fire,
suretyship, and life.

WHAT ARE THE RISKS OR

LOSSES COVERED?
Casualty

= Accident
Presumed to include any loss or damage
when an accident is the cause of the
loss.
A casualty insurance policy excludes
losses arising from accident which are
within the coverage of other types of
insurance.

DOES
CASUALTY
INSURANCE
INCLUDES?

EMPLOYERS LIABILITY
INSURANCE

MOTOR VEHICLE LIABILITY

INSURANCE

PLATE GLASS
INSURANCE

BURGLARY AND THEFT

INSURANCE

PERSONAL ACCIDENT AND

HEALTH INSURANCE WRITTEN BY
NON-LIFE INSURANCE COMPANIES

LOSS CAUSED BY FIRE THAT IS

INSURED BY FIRE INSURANCE

LOSS TO VESSEL INSURED

BY MARINE INSURANCE

WHAT GOVERNS CASUALTY

INSURANCE?
Governed

by the general provisions

applicable to all types of insurance.
The rights and obligations of the parties
must be determined by the terms of
their contract, taking into consideration
its purpose and always in accordance
with the general purpose of insurance.

2 GENERAL DIVISIONS
Insurance against
perils which may
affect the person
and/or property of
the insured:
- Personal accident
- Robbery or theft
- Damage to or loss of
motor vehicle
- Insolvency of debtors
- Defalcation of
employees

Insurance against
perils which may give
rise to liability on the
part of the insured:
(third-party liability)
- Workmens
compensation
- Motor vehicle liability
- Professional liability
- Products liability

WHAT IS

 Third-party

liability insurance is
a form of liability

essentially
insurance.
A contract of indemnity for the
benefit of the insured and those in
privity with him, or those to whom
the law upon the grounds of public
policy extends the indemnity
against liability.

Liability
Insurance (Thirdparty liability)

Person and/or
property of the
insured

1. INSURABLE
INTEREST

To be found in the
interest the insured
has in the safety of
persons
who
may
maintain, or in the
freedom from damage
of property which may
become the basis of
suits against him in
case of their injury or
destruction.

Insured has interest

on his own life (Sec.
10) and on his
property (Sec. 13).

2. WHEN
PAYABLE?

When the liability of

the insured to the
injured third party
attaches,
regardless
of actual loss at that
time.

Action against the

insurer lies only
when there is an
actual loss
sustained by the
insured.

3. RIGHT OF
INJURED PERSON
TO SUE INSURER
OF PARTY AT
FAULT

Third persons to whom

the insured is liable,
can sue directly the
insurer
upon
occurrence
of
the
injury or event upon
which
the
liability
depends.

Third persons cannot

proceed against the
insurer. Third persons
recourse is limited to
the insured alone.

4. BASIS OF
INSURERS
LIABILITY

Based on the contract Based on the contract.

(insurance
policy).
While that of the
insured is based on
tort in accordance with
the provisions of the
Civil Code.

5. EXTENT OF
INSURERS
LIABILITY

Up to the extent of the Up to the extent of the

insurance policy and insurance policy.
that required by law.

ACCIDENT AND HEALTH

INSURANCE

ACCIDENT INSURANCE: Reimburses the

insured for pecuniary loss suffered as a result
of injuries sustained in an accident.
The insureds beneficiary has the burden of
proof in demonstrating that the cause of
death is due to the covered peril.
HEALTH INSURANCE: Reimburses the
insured for pecuniary loss arising out of
disease-related illness.

RULE AS TO DEATH OR INJURY

RESULTING FROM ACCIDENTAL
OR ACCIDENTAL MEANS
GENERAL

RULE: Death or injury does

not result from accident or accidental
means within the terms of an accident
policy if it is the natural result of the
insureds voluntary act, unaccompanied
by anything unforeseen except death or
injury.

WHAT IS THE EXCEPTION?

Where

the death or injury is not the

natural or probable result of the
insureds 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 insurance policy.

SUICIDE AND WILLFUL

EXPOSURE TO NEEDLESS PERIL

SUICIDE: Imports a positive act of ending

such life.
EXPOSURE TO NEEDLESS PERIL: A
reckless risking of it that is almost suicidal in
intent.
Both signify a disregard for ones life.
Voluntary exposure to a known danger
is held to negate the accidental character of
whatever followed from the known danger.

ACCIDENT VS. INTENTIONAL

WHAT IS ACCIDENT?

ACCIDENT in its commonly accepted

meaning or on its ordinary sense, has been
defined as: A fortuitous circumstance,
event, or happening, an event happening
without any human agency, or if
happening wholly or partly through human
agency, an event which under the
circumstance is unusual and unexpected
by the person to whom it happens.

According to Blacks Law Dictionary:

accident as an unintended and unforeseen
injurious occurrence, something that does
not occur in the usual course of events or
that could not be reasonably anticipated, an
unforeseen and injurious occurrence not
attributable to mistake, negligence, neglect
or misconduct.

According to Philippine Law Dictionary:

that which happens by chance or
fortuitously, without intention and design,
and which is unexpected, unusual and
unforeseen.

WHAT IS INTENTIONAL?
Injuries

that are inflicted by the

insured or any other person.
Implies the exercise of the
reasoning
faculties,
consciousness, and volition.

WHAT IS THE EFFECT OF NO

ACTION CLAUSE IN POLICY OF
LIABILITY INSURANCE?
The

no action clause expressly

disallows suing the insurer as a codefendant of the insured in a suit
to determine the latters liability to
the third person.

WHICH PROCEDURE TO FOLLOW?

THE INSURANCE POLICY OR THE
RULES OF COURT?
It

was held that no action clause

in the policy CANNOT PREVAIL
over the Rules of Court provisions
aimed at avoiding multiplicity of
suits.