NOTES IN INSURANCE CODE (b) Of any person on whom he depends wholly or in part for education or
support, or in whom he has a pecuniary interest;
GENERAL PRINCIPLES AND INSURABLE INTEREST
Q: What is a contract of insurance?
A: A "contract of insurance" is an agreement whereby one undertakes for a
consideration to indemnify another against loss, damage or liability arising from
an unknown or contingent event.
Q: What are the elements of contract of insurance?
A: The ff are the elements of contract of insurance (IRRAP)
The insured has Insurable interest
The insured is subject to a risk of loss by the happening of the designated peril
The insurer assumes the risk
Such assumption of risk is part of the general scheme to distribute actual losses
among a large group of persons bearing a similar risk
The insured pays a premium
Q: When is a contract of suretyship be deemed an insurance contract?
A: A contract of suretyship shall be deemed to be an insurance contract, within
the meaning of this Code, only if made by a surety who or which, as such, is
doing an insurance business as hereinafter provided.
Q: What is an Insurable interest?
A: Insurable interest, as provided under the Insurance Code, either means
a.Insurable interest over the person or b. insurable interest over the property.
Insurable interest over the person is provided under sec. 10, which enumerates
that Every person has an insurable interest in the life and health:
(a) Of himself, of his spouse and of his children;
(c) Of any person under a legal obligation to him for the payment of money,
or respecting property or services, of which death or illness might delay or
prevent the performance; and
(d) Of any person upon whose life any estate or interest vested in him depends.
On the other hand, insurable interest over the property is explained under sec
14, which provides that An insurable interest in property may consist in:
(a) An existing interest;
(b) An inchoate interest founded on an existing interest; or
(c) An expectancy, coupled with an existing interest in that out of which the
expectancy arises.
Q: What is an existing interest? Give an example.
A: Existing interest means an interest of present and certain value, may be
readily liquidated and demandable.
For example, a due and demandable loan agreement with 10% interest. Here,
the interest is certain, the amount is determinable and both happen at present
moment (since the loan is already due and demandable)
Q: What is an expectancy interest?
A: An expectancy interest is an interest certain to happen in the future but is
uncertain in amount.
For example, a farmer will sell his crops with 1% interest profit. Here, the interest
is an expectancy because there is a certain interest, but the total amount is
uncertain as it still depends on the number of crops that will be harvested by
the farmer.
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Q: What is an inchoate interest
A: An inchoate interest is sure to happen in the future AND also certain in
amount.
For example, a stock trader buys stocks in an Initial Public Offering of a soon to
be constructed hospital in Malolos for 10 pesos per stock with 2% interest rate.
Here, the inchoate interest is both FUTURE and CERTAIN in amount.
Q: Differentiate expectancy interest from inchoate interest
A: As to certainty, expectancy interest is uncertain in amount but inchoate
interest is certain
As to relationship with existing interest, expectancy interest must be coupled
with existing interest, while inchoate interest need not. (halimbawa, para
magakaroon ka ng expectancy interest sa profit on future crops, dapat muna
may tanim ka.
Q: Determine if the ff is Existing interest, Expectancy interest or Inchoate interest
Interest in contract of sale
Interest in contract to sell
Interest in future inheritance of a compulsory heir
Interest in future crops with liquiated and projected value
A:
Existing
eXpectancy
Inchoate
Inchoate
Q: May a member of the MILF or its breakaway group, the Abu Sayyaf, be
insured with a company licensed to do business under the Insurance Code of
the Philippines? Explain. (2000 Bar)
A: A member of the MILF or the Abu Sayyaf may be insured with a company
licensed to do business under the Insurance Code of the Philippines. What is
prohibited to be insured is a public enemy. A public enemy is a citizen or
national of a country with which the Philippines is at war. Such member of the
MILF or the Abu Sayyaf is not a citizen or national of another country, but of the
Philippines.
Q: Manpower Company obtained a group life insurance policy for its
employees from Phoenix Insurance Company. The master policy issued by
Phoenix on June 1, 1986 contained a provision that eligible employees for
insurance coverage were all full time employees of Manpower regularly
working at least 30 hours per week. The policy had also an incontestable
clause. Beforehand, Phoenix sent enrollment cards to Manpower for distribution
to its eligible employees. X filled out the card which contained a printed clause:
“I request the insurance for which I may become eligible under said Group
Policy.” The cards were then sent to Phoenix and X was among the employees
of Manpower who was issued a certificate of coverage by Phoenix
On July 3, 1988, X was killed on the occasion of a robbery in their house. While
processing the claim of X’s beneficiary, Phoenix found out that X was not an
eligible employee as defined in the group policy since he has not been
employed 30 hours a week by Manpower. Phoenix refused to pay. May X’s
beneficiary invoke the incontestability clause against Phoenix? Reasons. (1989
Bar)
A: The beneficiary of X may validly invoke the incontestability clause. If the
incontestability clause can apply even to cases of intentional concealment
and misrepresentation, there would be no cogent reason for denying such
application where the insured had not been guilty thereof. When X filled out
the card containing the printed clause “I request the insurance for which I may
become eligible under said Group Policy”, it behooved the insurer to look into
the qualifications of X whether he can thus be covered or not by the group life
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insurance policy. In issuing the certificate of coverage to X, Phoenix may, in
fact, be said to have waived the 30-hour per week requirement
Q: The policy of insurance upon his life, with a face value of P100,000, was
assigned by Jose, a married man with 2 legitimate children, to his nephew, Y
as security for a loan of P50,000. He did not give the insurer any written notice
of such assignment despite the explicit provision to that effect in the policy.
Jose died. Upon the claim on the policy by the assignee, the insurer refused to
pay on the ground that it was not notified of the assignment. Upon the other
hand, the heirs of Jose contended that Y is not entitled to any amount under
the policy because the assignment without due notice to the insurer was void.
Resolve the issues. (1991 Bar)
A: A life insurance is assignable. A provision, however, in the policy stating that
written notice of such an assignment should be given to the insurer is valid. The
failure of the notice of assignment would thus preclude the assignee from
claiming rights under the policy. The failure of notice did not, however, avoid
the policy; hence, upon the death of Jose, the proceeds would, in the absence
of a designated beneficiary, go to the estate of the insured. The estate, in turn,
would be liable for the loan of P50,000 owing in favor of Y.
Q: On July 14, 1985, X, a homosexual, took an insurance policy on the life of his
boyfriend, Y. In the insurance application, X misrepresented that Y was in
perfect health although he knew all the time that Y was afflicted with AIDS. On
October 18, 1987, Y died in a motor accident. Shortly thereafter, X filed his
insurance claim. Should the insurer pay? Reasons. (1987 Bar)
A: The insurer is not obliged to pay. Friendship alone is not the insurable interest
contemplated in life insurance. Insurable interest in the life of others (other than
one’s own life, spouses or children) is merely to the extent of the pecuniary
interest in that life. Assuming that such pecuniary interest exist, an insurer would
be liable despite concealment or misrepresentation if the insurance had been
in effect for more than 2 years (incontestability clause).
Q: Carlo and Bianca met in the La Boracay festivities. Immediately, they fell in
love with each other and got married soon after. They have been cohabiting
blissfully as husband and wife, but they did not have any offspring. As the years
passed by, Carlo decided to take out an insurance on Bianca’s life for P1M with
him (Carlo) as sole beneficiary, given that he did not have a steady source of
income and he always depended on Bianca both emotionally and financially.
During the term of the insurance, Bianca died of what appeared to be a
mysterious cause so that Carlo immediately requested for an autopsy to be
conducted. It was established that Bianca died of a natural cause. More than
that, it was also established that Bianca was a transgender all along—a fact
unknown to Carlo. Can Carlo claim the insurance benefit? (2014 Bar)
A:Yes. Carlo can claim the insurance benefit. If a person insures the life or health
of another person with himself as beneficiary, all his rights, title and interests in
the policy shall automatically vest in the person insured. Carlo, as the husband
of Bianca, has an insurable interest in the life of the latter. Also, every person
has an insurable interest in the life and health of any person on whom he
depends wholly or in part for support. The insurable interest in the life of the
person insured must exist when the insurance takes effect but need not exist
when the loss occurs. Thus, the subsequent knowledge of Carlo, upon the
death of Bianca, that the latter is a transgender does not destroy his insurable
interest on the life of the insured.
Q: On February 3, 1987, while Jose Palacio was in the hospital preparatory to a
heart surgery, he called his only son, Boy Palacio, and showed the latter a will
naming the son as sole heir to all the father’s estate including the family
mansion in Forbes Park. The following day, Boy Palacio took out a fire insurance
policy on the Forbes Park mansion. One week later, the father died. After his
father’s death, Boy Palacio moved his wife and children to the family mansion
which he inherited. On March 30, 1987, a fire occurred razing the mansion to
the ground. Boy Palacio then proceeded to collect on the fire insurance he
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took earlier on the house.Should the insurance company pay? Reasons. (1987
Bar)
A: In property insurance, insurable interest must exist both at the time of the
taking of the insurance and at the time the risk insured against occurs. The
insurable interest must be an existing interest. The fact alone that Boy Palacio
was the expected sole heir of his father’s estate does not give the prospective
heir any existing interest prior to the death of the decedent.
Q: Novette entered into a contract for the purchase of certain office supplies.
The goods were shipped. While in transit, the goods were insured by Novette.
Does she have an insurable interest over the goods even before delivery of the
same to her? Explain. (2015 Bar)
A:Yes, Novette has an insurable interest in the goods. The contract of sale was
already perfected and Novette acquired interest thereon although the goods
have yet to be delivered.
REPRESENTATION (SEC. 36 TO SEC 48)
Q: What is representation
A: Representation is a collateral statement of material facts NOT inserted in
policy of such facts and circumstances relative to proposed contract
communicated to underwriter to eliminate risk
Q: Is representation a part of the insurance contract?
A: As a general rule, no.
ETR: If the representation is incorporated in te insurance contract, it will serve as
a waver
Q: When is representation made?
A: as a general rule, representation is made at the time or before the perfection
of insurance contract
ETR: 1. In case of valid modification of contract under s. 47
2. In case of representation as to future under s. 39
Q: What is representation as to future under s. 39? Give an example.
A: A representation as to future means either a belief/ expectation or
promissory representation
A representation as to future belief or expectation is rooted on good faith and
cannot be the subject of rescission. For example, Maria, after entering a
perfected insurance contract answered that she has no Tuberculosis. However,
after working in a cigarette factory, she started experiencing difficulty in
breathing. Believing in good faith that she may have a lung problem leading
to TB, she communicated to the Insurer company her situation as to FUTURE
BELIEF that she may be diagnosed to TB. In this case, the insurer CANNOT
rescind the insurance contract because a representation as to future belief is
valid under sec 39.
On the other hand, promissory representation is rooted on bad faith. Here,
rescission is a proper remedy. For example, in marine insurance, XYZ ship
deviated from the route of Luzon-Visayas-Singapore and took instead the route
of Luzon-Mindanao-Singapore. Here, the promised route of L-V-S was not
fulfilled. Even if XYZ ship communicated the change of route to insurer
company, the insurer company may rescind the insurance contract in case an
accident happened in the route not agreed upon by the insurance contract
Q: Is representation same as warranty?
A: No. Representation is only collateral information which is commonly not
written in the contract of insurance, while warranty is always part of the
insurance contract
Q: What is the effect of representation?
A: It qualifies an implied warranty
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Q: What is the duty of the insurer in accepting representation?
A: Insurer has the duty to exercise reasonable prudence and care. Any false
representation will NOT automatically invalidate the insurance contract as the
insurer is expected to exercise reasonable care,, except in cases of INTENDED
misrepresentation/ deception
A: How do you determine the materiality of misrepresentation?
A: used the ff factors:
WON the misrepresentation was material to the risk insured against
WON misrepresentation would have influenced the insurer in determining the
insurance policy
Q: What is incontestability clause?
A: A clause that precludes the insurer from raising misrepresentation and
concealment defenses . Usually, incurance contract provides fro contestability
period.
Premium (SEC 77 TO SEC 82)
Q: When is an insurer entitled to premium?
A: n insurer is entitled to payment of the premium as soon as the thing insured
is exposed to the peril insured against
Q: Maria insured her house against fire for 1 year. Duing the year, there was no
fire. Can there be a refund for premium paid?
A: No,there can be no refund. The comsideration on the part of the insurer is
the premium paid by the insured and the comsideration on the part of the
insured is the protection, promise orundertaking on part of the insurer to
ineminity in case of loss.
Q: What is cash and carry basis?
A: Cash and carry basis means no payment no premium policy. It assures the
prompt payment before issuance of premium
Q: Are there any exceptions to cash and carry basis?
A: Yes. The ff are the exceptions to cash and cary basis rule:
A. In the case of a life or an industrial life policy whenever the grace period
provision applies.(sec 77)
B. when there n acknowledgment in a policy or contract of insurance or
the receipt of premium is conclusive evidence of its payment, so far as
to make the policy binding, notwithstanding any stipulation therein that
it shall not be binding until the premium is actually paid. (sec 78)
C. when parties agreed to paymet of premium by installment (Makati
Tuscany vs CA)
D. when estoppel bars the insurer from nvoking sec 77
E. in case of contract of suretyship or bonding, where the oblige has
accepted the bond (sec 177)
Q: is payment by installment of premium valid?
A: yes, provided the insurer so agrees
Q: what is the effect of acknowledgement of receipt of premium?
A: It serves as conclusive evidence of the policy.
Q: when is return of portion of premium valid?
A: the return of portion of the premium is valid in the ff instances:
when the insurance is made for definite period and the insured surrender his
policy
when there is an over insurance by several insurers
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Q: when is return of premium not allowed?
A: the return of premium is not allowed in the ff:
a. if a peril insured against has existed, and the insurer has been liable for
any period, however short, the insured is not entitled to return of
premiums, so far as that particular risk is concerned. (sec 80)
b. Where the insurance is made for a definite period of time and the
insured surrenders his policy, to such portion of the premium as
corresponds with the unexpired time, at a pro rata rate, unless a short
period rate has been agreed upon and appears on the face of the
policy, after deducting from the whole premium any claim for loss or
damage under the policy which has previously accrued; Provided, That
no holder of a life insurance policy may avail himself of the privileges of
this paragraph without sufficient cause as otherwise provided by law.
(sec 79, b)
c. A person insured is entitled to return of the premium when the contract
is voidable, on account of fraud or misrepresentation of the insurer, or
of his agent, or on account of facts, the existence of which the insured
was ignorant without his fault; or when by any default of the insured
other than actual fraud, the insurer never incurred any liability under the
policy. (sec 81)
Q: Will an insurance policy be binding even if premium is unpaid? What if
partially paid? (2015 Bar)
A: As a general rule, the insurance policy is not valid and binding, unless the
premium thereof has been paid. This is the cash-and-carry rule under the
Insurance Code. Premium is the consideration for the undertaking of the insurer
to indemnify the insured against a specified peril. There are exceptions,
however, one of them is, when there is an agreement allowing the insured to
pay the premium in installments and partial
payment has beenmade at the time of the loss (Makati Tuscany Condominium
Corporation v. Court of Appeals, G.R. No. 95546, November 6, 1992)
Q: Stable Insurance Co. (SIC) and St. Peter Manufacturing Co. (SPMC) have had
a long-standing insurance relationship with each other; SPMC secures the
comprehensive fire insurance on its plant and facilities from SIC. The standing
business practice between them has been to renewal of the policy is to allow
SPMC a credit period of 90 days from the within which to pay the premium.
Soon after the new policy was issued and before premium payments could be
made, a fire gutted the covered plant and facilities to the ground. The day after
the fire, SPMC issued a manager's check to SIC for the fire insurance premium,
for which it was issued a receipt; a week later SPMC issued its notice of loss.
SIC responded by issuing its own manager's check for the amount of the
premiums SPMC had paid, and denied SPMC's claim on the ground that under
the "cash and carry" principle governing fire insurance, no coverage existed at
the time the fire occurred because the insurance premium had not been paid.
Is SPMC entitled to recover for the loss from SIC? (2003, 2013 Bar)
A: St. Peter Manufacturing Company is entitled to recover for the loss from
Stable Insurance Company. Stable Insurance Company granted a credit term
to pay the premiums. This is not against the law, because the standing business
practice of allowing St. Peter Manufacturing Company to pay the premiums
after 60 or 90 days, was relied upon in good faith by SPMC. Stable Insurance
Company is in estoppel (UCPB General Insurance Company, Inc. v. Masagana
Telemart, Inc., 356 SCRA 307, 2001).
Q: The Peninsula Insurance Company offered to insure Francis' brand new car
against all risks in the sum of P1 Million for 1 year. The policy was issued with the
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premium fixed at P60,000.00 payable in 6 months. Francis only paid the first two
months installments. Despite demands, he failed to pay the subsequent
installments. Five months after the issuance of the policy, the vehicle was
carnapped. Francis filed with the insurance company a claim for its value.
However, the company denied his claim on the ground that he failed to pay
the premium resulting in the cancellation of the policy. Can Francis recover
from the Peninsula Insurance Company?
A:Yes. As a general rule, no policy is binding unless the premiums thereof have
been paid. However, one of the exceptions is when there is an agreement
allowing the insured to pay the premium in installments and partial payment
has been made at the time of loss. In the case at hand Francis already paid
two installments at the time of the loss and as such may recover on the policy
(Makati Tuscany Condominium Corp. v. CA, G.R. No. 95546, Nov. 6, 1992).
Furthermore, the contention of the insurer that the failure to pay premium
resulted in the cancellation of the policy is not tenable since no policy of
insurance shall be cancelled except upon notice thereof to the insured (Sec.
64, Insurance Code).
b. Would your answer in a) be the same if it as found that the proximate cause
of the fire was an explosion and that fire was but the immediate cause of the
loss and there is no excepted peril under the policy?
c. If the fire was found to have been caused by Alfredo’s own negligence, can
he still recover on the policy? (2007 Bar)
A:
a. Yes, Alfredo may recover on the policy. It is valid to stipulate that the insured
will be granted credit term for the payment of premium. Payment by means of
a check which was accepted by the insurer, bearing a date prior to the loss,
would be sufficient. The subsequent effects of encashment retroact to the date
of the check.
b. Yes, recovery under the insurance contract is allowed if the cause of the loss
was either the proximate or the immediate cause as long as an excepted peril,
if any, was not the proximate cause of the loss.
c. Yes, mere negligence on the part of the insured will not prevent recovery
under the insurance policy. The law merely prevents recovery when the cause
of loss is the willful act of the insured, alone or in connivance with others.

Q: What is a mutual insurance company or association? (2006 Bar)

A: A mutual insurance company is a cooperative enterprise where the
members are both the insurer and the insured. In it, themembers all contribute,
by a system of premiums or assessments, to the creation of a fund from which
all losses and liabilities are paid, and where the profits are divided among
themselves, in proportion of their interest.

Q: Alfredo took out a policy to insure his commercial building against fire. The
broker for the insurance company agreed to give a 15-day credit within which
to pay the insurance premium. Upon delivery of the policy on May 15, 2006,
Alfredo issued a postdated check payable on May 30, 2006. On May 28, 2006,
a fire broke out and destroyed the building owned by Alfredo.
a. May Alfredo recover on the insurance policy?

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