Ibarra
any kind whatsoever of the person who effected the insurance in favor
of the formers."
xxx
2.
3.
B.
Article 1321 The person making the offer may fix the time, place, and
manner of acceptance, all of which must be complied
with.
Article 1322 An offer made through an agent is accepted from the
time acceptance is communicated to him.
Article 1323 An offer becomes ineffective upon the death, civil
interdiction, insanity, or insolvency of either party before
acceptance is conveyed.
Article 1324 When the offerer has allowed the offeree a certain period
to accept, the offer may be withdrawn at any time before
acceptance by communicating such withdrawal, except
when the option is founded upon a consideration, as
something paid or promised.
Article 1325 Unless it appears otherwise, business advertisements of
things for sale are not definite offers, but mere invitations
to make an offer.
Article 1326 Advertisements for bidders are simply invitations to make
proposals, and the advertiser is not bound to accept the
highest or lowest bidder, unless the contrary appears.
As a contract
(a) Requisites of a valid contract (Article 1318, NCC)
Article 1318 There is no contract unless the following requisites concur:
(1) Consent of the contracting parties;
(2) Object certain which is the subject matter of the contract;
(3) Cause of the obligation which is established.
Insurable Interest
Concept
It may be stated generally, however, to be such an interest,
arising from the relation of the party obtaining the insurance,
either as creditor of or surety for the assured, or from ties of
blood or marriage to him, as will justify a reasonable
expectation of advantage or benefit from the continuance of
his life. It is not necessary that the expectation of advantage
or benefit should always be capable of pecuniary estimation;
for a parent has an insurable interest in the life of his child,
and a child in the life of his parent, a husband in the life of his
wife, and a wife in the life of her husband. The natural
affection in cases of this kind is considered as powerful as
operating more efficaciously to protect the life of the insured
than any other consideration.
of the
III. CHARACTERISTICS
(a) Aleatory Contract
Element of risk. An aleatory contract is one which is dependent on the
occurrence of an uncertain event or one which is certain to happen but the time
is unknown.
Co, Anne Lorraine Pongos |
(b) Onerous
This is valuable consideration.
Individual Life
ii.
Group Life
iii.
Industrial Life
It is that form of life insurance under which the premiums are payable
either monthly or oftener, if the face amount of insurance provided in
any policy is not more than five hundred times that of the current
statutory minimum daily wage in the City of Manila, and if the words
industrial policy are printed upon the policy as part of the descriptive
matter.
(c) Bilateral
A bilateral contract is a reciprocal arrangement between two parties where each
promises to perform an act in exchange for the other party's act. Each party is
an obligor (a person who is bound to another) to its own promise, and an
obligee (a person to whom another is obligated or bound) on the other party's
promise.
There are two or more contracting parties.
It is a formal Contract.
Marine
(d) Form
Type of Insurance
i.
Fire
As used in the Insurance Code, the term fire insurance shall include
insurance against loss by: (1) fire, (2) lightning, (3) windstorm, (4)
tornado, (5) earthquake, and (6) other allied risks, when such risks are
covered by extension to fire insurance policies or under separate
policies. Thus, fire insurance covers not only damage or loss by fire but
also allied risks if they are covered by extensions and separate
policies.
Co, Anne Lorraine Pongos |
iii.
Casualty
Section 176 Casualty insurance 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 fire or marine. It includes, but is not limited to,
employers liability insurance, motor vehicle liability
insurance, plate glass insurance, burglary and theft
insurance, personal accident and health insurance as
written by non-life insurance companies, and other
substantially similar kinds of insurance.
Thus, casualty insurance includes the following
(1) Burglary and theft insurance.
(2) Personal accident and health insurance as written by non-life
insurance companies.
(3) Plate glass insurance.
(4) Employers liability insurance.
(5) Motor vehicle liability insurance.
(6) Other substantially similar kinds of insurance.
The
INSURANCE
There are two parties, the insurer
and the insured.
The insurer expects loss to occur
and in some cases, like life
insurance, the loss is a certainty.
The insurer does not have the
right of reimbursement from the
insured.
Insurance covers losses that are
beyond the control of the insured.
V. APPLICABLE LAW
(a) New Insurance Code (Republic Act No. 10607)
(c) Suretyship
For regulatory purposes, a contract of suretyship shall be deemed to be an
insurance contract within the meaning of the Insurance Code when made
by a surety who or which, as such, is doing an insurance business.
The contract of suretyship under the New Civil Code is simply defined as an
agreement whereby one binds himself solidarily with the principal debtor.
By suretyship, a person known as surety binds himself solidarily to the
creditor to fulfill the obligation of the principal debtor. On the other hand,
Sections 177 and 178 of the Insurance Code provides:
Section 177 A contract of suretyship is an agreement whereby a party
called the surety guarantees the performance by another
party called the principal or obligor of an obligation or
undertaking in favor of a third party called the obligee. It
includes official recognizances, stipulations, bonds or
undertakings issued by any company by virtue of and under
the provisions of Act No. 536, as amended by Act No. 2206.
Section 178 The liability of the surety or sureties shall be joint and
several with the obligor and shall be limited to the amount
of the bond. It is determined strictly by the terms of the
The primary law that governs insurance contracts is the Insurance Code of the
Philippines that was originally enacted as Presidential Decree (PD) No. 602. PD
No. 602 was previously amended by PD Nos. 1141, 1280, 1455, 1460, 1814 and
1918, and BP Blg. 874. The previous edition of this work was based on PD No.
1460 as amended, otherwise known as Insurance Code of 1978
The most recent amendment is RA No. 10607 dated August 15, 2013. RA 10607
was published in a newspaper of general circulation on September 5, 2013. This
law re-enacted PD No. 602 as amended and introduced new concepts and
provisions. For example, the law now includes a provision on microinsurance,
bancassurance, trust operations of insurance companies, and self-regulatory
organizations. The new law strengthened the regulatory provisions of the Code.
These include but are not limited to: (1) increase of the paid-up capital and net
worth requirements for insurers, (2) new requirements for unimpaired capital or
assets and reserved, (3) new provisions on financing report framework, (4)
adoption of corporate governance rules, (5) changes in the provisions on margin
of solvency, (6) changes in the provisions on investments, (7) fixing the term of
the Insurance Commissioner to six years, and (8) changes in the jurisdiction of
the Insurance Commission over insurance claims. Other changes merely
expressly adopted prevailing jurisprudence.
(b) Civil Code Provisions on contracts and Article 2011 and other related articles
The New Civil Code provisions govern suppletorily. For instance, the rules on
perfection of contracts under the Title IV of the New Civil Code on obligations
and contracts can be applied in the absence of provisions of the Insurance
Code. Article 2011 of the New Civil Code provides that the contract of insurance
is governed by special laws and matters not expressly provided for in such
special laws shall be regulated by the said Code. The New Civil Code likewise
provides for grounds for disqualification of beneficiaries under Article 2012
thereof.
Right of Subrogation. The New Civil Code specifically deals with the right of the
insurer to subrogation. Article 2207 of the New Civil Code provides that if the
plaintiffs property has been insured, and he has received indemnity from the
insurance company for the injury or loss arising out of the wrong or breach of
contract complained of, the insurance company shall be subrogated to the
rights of the insured against the wrongdoer or the person who has violated the
contract. If the amount paid by the insurance company does not fully cover the
injury or loss, the aggrieved party shall be entitled to recover the deficiency
from the person causing the loss or injury.
Whenever used in this Code, the following terms shall have the
respective meanings hereinafter set forth or indicated, unless the
context otherwise requires:
Section 3
All rights, title and interest in the policy of insurance taken out by
an original owner on the life or health of the person insured shall
automatically vest in the latter upon the death of the original
owner, unless otherwise provided for in the policy.
10
Section 190 For purposes of this Code, the term insurer or insurance
company shall include all partnerships, associations, cooperatives
or corporations, including government-owned or -controlled
corporations or entities, engaged as principals in the insurance
business, excepting mutual benefit associations. Unless the
context otherwise requires, the term shall also include professional
reinsurers defined in Section 288. Domestic company shall include
companies formed, organized or existing under the laws of the
Philippines. Foreign company when used without limitation shall
Co, Anne Lorraine Pongos |
i.
11
ii.
12
Section 188
Section 190
For
purposes
of
this
Code,
the
term insurer or insurance company shall include all
partnerships,
associations,
cooperatives
or
corporations, including government-owned or
-controlled corporations or entities, engaged as
principals in the insurance business, excepting
mutual benefit associations. Unless the context
otherwise requires, the term shall also include
Co, Anne Lorraine Pongos |
professional
reinsurers
defined
in
Section
288. Domestic company shall include companies
formed, organized or existing under the laws of the
Philippines. Foreign company when used without
limitation
shall
include
companies
formed,
organized, or existing under any laws other than
those of the Philippines.
iii.
Mutual Benefit Association. Although excluded from the term insurer
under Section 184 of the Insurance Code, likewise within the regulatory
powers of the Insurance Commission are mutual benefit associations.
They must first secure a license from the Insurance Commission before
they can transact business.
Section 184
14
i.
Article 92
Article 109
Common Law Spouses, Unions Without Marriage Can common-lawspouses and partners be insured by the other partner? (Article 1409, NCC)
Article 1409 The following contracts are inexistent and void from the
beginning:
(1) Those whose cause, object or purpose is contrary to law,
morals, good customs, public order or public policy;
(2) Those which are absolutely simulated or fictitious;
(3) Those whose cause or object did not exist at the time of
the transaction;
(4) Those whose object is outside the commerce of men;
(5) Those which contemplate an impossible service;
(6) Those where the intention of the parties relative to the
principal object of the contract cannot be ascertained;
(7) Those expressly prohibited or declared void by law.
These contracts cannot be ratified. Neither can the right to set up the
defense of illegality be waived.
Who owns the insurance policy taken by one spouse? (Arts. 91, 92, 96 &
109, Family Code)
Article 91
15
ii.
iii.
Section 53
Effect of use of conjugal funds. If the funds of the conjugal partnership of gains
are used to pay for the premium, the proceeds of the policy constitute
community property if the policy was made payable to the deceaseds estate.
One-half of said proceeds belongs to the estate and the other half to the
surviving spouse.
All rights, title and interest in the policy of insurance taken out
by an original owner on the life or health of the person insured
shall automatically vest in the latter upon the death of the
original owner, unless otherwise provided for in the policy.
i.
(c) Beneficiary
Beneficiary is a party to whom the insurance proceeds will inure when the
contingency covered by the insurance happens. It may be the insured himself or
a third party.
The beneficiary may be a third person. Unless he is the insured himself, the
beneficiary is not one of the contracting parties. However, a third party
beneficiary named in the policy has the right to file an action against the insurer
in case of loss. No other party can recover the proceeds other than the
beneficiary.
Section 53, Insurance Code
16
ii.
iii.
Grounds for disqualification. See Article 739, NCC. Thus in the cases
mentioned in Article 739, NCC, although the insurance contract itself is
valid, the designation of beneficiary is void because they are disqualified as
beneficiaries.
Co, Anne Lorraine Pongos |
iv.
v.
The amount of the policy represents the premium to be paid, and the
right to it arises the moment the contract is perfected, for at the
moment the power of disposing of it may be exercised, and if death
occurs payment may be demanded. It is therefore something acquired
for a valuable consideration during the marriage, though the period of
its fulfillment, depend upon the death of one of the spouses, which
terminates the partnership. So considered, the question may be said to
be decided by Articles 1396 and 1401: if the premiums are paid with
the exclusive property of husband or wife, the policy belongs to the
owner; if with conjugal property, or if the money cannot be proved as
coming from one or the other of the spouses, the policy is community
property.
vi.
Section 54
(d) Insurance Agent Section 54, Insurance Code in relation to Section 309,
Insurance Code. See also the general provisions of Agency in the Civil Code.
The insurance policy may be obtained by a person through his agent or trustee.
Section 309 Any person who for compensation solicits or obtains insurance on
behalf of any insurance company or transmits for a person other
than himself an application for a policy or contract of insurance to
or from such company or offers or assumes to act in the
negotiating of such insurance shall be an insurance agent within
the intent of this section and shall thereby become liable to all the
duties, requirements, liabilities and penalties to which an
insurance agent is subject.
Article 1869 Agency may be express, or implied from the acts of the
principal, from his silence or lack of action, or his failure to
repudiate the agency, knowing that another person is acting
on his behalf without authority.
Section 307 No insurance company doing business in the Philippines, nor any
agent thereof, shall pay any commission or other compensation to
any person for services in obtaining insurance, unless such person
shall have first procured from the Commissioner a license to act as
an insurance agent of such company or as an insurance broker as
hereinafter provided.
No person shall act as an insurance agent or as an insurance
broker in the solicitation or procurement of applications for
insurance, or receive for services in obtaining insurance, any
commission or other compensation from any insurance company
doing business in the Philippines, or any agent thereof, without
first procuring a license so to act from the Commissioner, which
must be renewed every three (3) years thereafter. Such license
shall be issued by the Commissioner only upon the written
application of the person desiring it, such application if for a
license to act as insurance agent, being approved or endorsed by
the company such person desires to represent, and shall be upon
a form prescribed by the Commissioner giving such information as
he may require, and upon payment of the corresponding fee
hereinafter prescribed. The Commissioner shall satisfy himself as
to the competence and trustworthiness of the applicant and shall
have the right to refuse to issue or renew and to suspend or
revoke any such license in his discretion. The license shall expire
after the thirty-first day of December of the third year following
the date of issuance unless it is renewed.
Licenses may be renewed in the case of the company represented
by such agents, and in the case of insurance brokers, upon the
application of the said brokers, themselves.
Section 308 The provisions of Sections 307 and 309 shall apply to an employee
who shall be engaged to sell insurance products by an insurance
company.
General Provisions of Agency in the Civil Code
19
Article 187
(e) Insurance for a partner Section 55, Insurance Code. See Civil Code provisions.
Section 55
If the policy is secured for the benefit of a partnership, a change in the name of
the partnership does not avoid the policy. For example, the Supreme Court ruled
in one case that when the partners of a general partnership doing business
under the firm name of Sharruf & Co. obtained insurance policies and the
latter afterwards changed its name to Sharruf & Eskenazi (which are the
names of the same and only partners of said firm Sharruf & Co.), but
continuing the same business, the new firm acquires the rights of the former
under the same policies.
Civil Code provisions
Article 2011 The contract of insurance is governed by special laws. Matters
not expressly provided for in such special laws shall be
regulated by this Code.
21
(f)
Mere transfer of the thing insured does not transfer the policy, but suspends the
same till the new owner becomes the owner of both the property and the policy.
Section 58, Insurance Code
The mere transfer of a thing insured does not transfer the policy, but
suspends it until the same person becomes the owner of both the policy
and the thing insured.
22
Implicit from this provision is the rule that the policy cannot be transferred so
long as the transferee has insurable interest in the thing insured. Nevertheless,
the insurers assent is necessary for the transfer.
Exceptions. There are exceptional cases when the insurers consent is not
necessary even if successors-in-interest of the insured substitute the latter.
These include cases involving transfer through will or succession and other
instances of transfer by operation of law and in cases where there is transfer
among partners. (Sections 23 and 24, Insurance Code)
Co, Anne Lorraine Pongos |
23
Section 23
Section 24
Section 309 Any person who for compensation solicits or obtains insurance on
behalf of any insurance company or transmits for a person other
than himself an application for a policy or contract of insurance to
or from such company or offers or assumes to act in the
negotiating of such insurance shall be an insurance agent within
the intent of this section and shall thereby become liable to all the
duties, requirements, liabilities and penalties to which an
insurance agent is subject.
An insurance agent is an independent contractor and not an
employee of the company represented. Insurance agent includes
an agency leader, agency manager, or their equivalent.
Since the insurance industry is imbued with public interest, the
insurance companies upon approval of the Commissioner may
exercise wide latitude in supervising the activities of their
insurance agents to ensure the protection of the insuring public.
1.
2.
3.
4.
Four-fold test
Economic reality test
Two-tiered test (or Multi-factor test)
24
Control test thus refers to the employers power to control the employees
conduct not only as to the result of the work to be done but also with
respect to the means and methods by which the work is to be
accomplished.
In applying this test, it is the existence of the right, and not the actual
exercise thereof, that is important.
The Supreme Court has laid down in a formidable line of decisions the
elements to be generally considered in determining the existence of an
employer-employee relationship, as follows:
(a)
(b)
(c)
(d)
(2) Insurable interest likewise helps in measuring the loss of the insured.
Applying the control test, that is, whether the employer controls or has
reserved the right to control the employee not only as to the result of the
work to be done but also as to the means and method by which the same is
to be accomplished, the question of whether or not there is an employeremployee relationship for purposes of the Social Security Act has been
settled in this jurisdiction in the case of Investment Planning Corp. vs. SSS,
21 SCRA 924 (1967). In other words, where the element of control is
absent; where a person who works for another does so more or less at his
own pleasure and is not subject to definite hours or conditions of work, and
in turn is compensated according to the result of his effort, the relationship
of employer-employee does not exist. (SSS vs. Court of Appeals, 30 SCRA
210 [1969]).
If the insured has no insurable interest over the life or property he insures, the
insurance contract is considered unenforceable. If it can be established that the
contract is really a wager, the same can be considered void for being against
public policy. Thus, Section 25 of the Insurance Code provides:
Section 25
a.1 In Life Insurance That circumstances which will allow a person to take on
insurance over the life of another person for reasons that the death,
disability or injury of that person will cause damage to the emotional or
economic well being of the one who obtained the insurance.
Concept
a.2 In Property Insurance See Section 13, Insurance Code
Insurable Interest
Section 13
Concept
It may be stated generally, however, to be such an interest, arising
from the relation of the party obtaining the insurance, either as
creditor of or surety for the assured, or from ties of blood or marriage
to him, as will justify a reasonable expectation of advantage or benefit
from the continuance of his life. It is not necessary that the expectation
of advantage or benefit should always be capable of pecuniary
estimation; for a parent has an insurable interest in the life of his child,
and a child in the life of his parent, a husband in the life of his wife, and
a wife in the life of her husband. The natural affection in cases of this
kind is considered as powerful as operating more efficaciously to
protect the life of the insured than any other consideration. But in all
cases there must be a reasonable ground, founded upon the relations
of the parties to each other, either pecuniary or of blood or affinity, to
expect some benefit or advantage from the continuance of the life of
the assured. Otherwise, the contract is a mere wager, by which the
party taking the policy directly interested in the early death of the
assured. Such policies shall have the tendency to create a desire for
the event. They are, therefore, independently of any statue on the
subject, condemned, as being against public policy.
The presence of insurable interest has the following purposes:
B.
b.1 Insurable interest over the life of another person. The persons in whose life
one may have insurable interest are enumerated in Section 10 of the
Insurance Code.
Section 10
Creditor. One can insure the life 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.
b.2 Insurable interest over blood relationship Limited to Spouse and Children.
Parents are not included unless they all due under Section 10 (b), IC.
C.
Other relation provisions. Section 13, 14, 16 and 17 of the Insurance Code
Education or support. One has insurable interest on the life of any
person on whom he depends wholly or in part for education or support.
The law does not require that the person on whom one depends wholly
or in part for education or support is legally obligated to do so.
Pecuniary Interest. Every person has insurable interest in the life or
health of any person in whom he has a pecuniary interest. Accordingly,
one has insurable interest over the life of his partner or his employee.
In both cases, pecuniary benefit is derived by the person who will take
26
Section 13
Section 14
Section 17
c.1 In general, test of insurable interest in property Section 13, IC and Section
17, IC
Section 13
Section 17
c.2.2
Inchoate Interest. Inchoate interest must be founded on an
existing interest, otherwise, the loss of the property will not directly
damnify the insured.
c.2.3
Expectancy. Expectancy must likewise be coupled with an existing
interest. For instance, the interest of an heir over the properties of his
successor who is still alive is a mere expectancy that is not coupled
with an existing interest. Hence, the heir does not have insurable
interest over the properties of his successor-in-interest.
27
(5) When he has neither possession of the property nor any other
legal interest in it but stands in such relation with respect to it
that he may suffer from its destruction, loss of a legal right
dependent upon its continued existence.
exist
the
the
Expectation of benefit
must have legal basis.
Beneficiarys
interest
perfection
contract.
of
the
Expectation of benefit
need not have legal
basis or need not be
based
on
legally
enforceable obligation.
Insurable interest is not
necessary
if
the
insured took out the
policy on his own life
and
designated
another.
Beneficiary
must have insurable
interest if one took out
an insurance on the life
of another.
28
the policy. The typical loss payable clause is also known as the open
mortgage clause.
A loss payable clause should be distinguished from a union mortgage
clause where there is a transfer of an insurance from the mortgagor to the
mortgagee with the assent of insurer. The applicable statute is Section 9 of
the Insurance Code which provides:
Section 9
29