TY v FIRST NATIONAL SURETY

J. Labrador

April 29 1961

GR No. L-16138

Doctrine

The agreement contained in the insurance policies is the law between the parties. As the terms of the policies are clear,
express and specific that only amputation of the left hand should be considered as a loss thereof, an interpretation that
would include the mere fracture or other temporary disability not covered by the policies would certainly be
unwarranted.

Summary

Ty was insured in different Insurance policies that provided for personal accident policies, such that he will
be paid 650 for a total disability of the hand due to an amputation. Because of a fire in the factory, he injured
his left hand, fracturing bones of his fingers, that made him incapable of working. He then claimed the
insurance from these policies only to be denied because there was no amputation. The Trial Court and the
Supreme Court ruled in favor of the Insurance Companies as interpreting an amputation as an injured left
hand is clearly beyond the letter of the contract.

Facts

Plaintiff Diosdado C Ty, employed as operator mechanic foreman in the Broadway Cotton Factory,
in Grace Park, Caloocan, Rizal, at a monthly salary of P185.00, insured himself in 18 local
insurance companies.
Among them, 8 issued to him personal accident policies, upon payment of the premium of P8.12
for each policy. Plaintiffs beneficiary was his employer, Broadway Cotton Factory, which paid the
insurance premiums.
On December 24, 1953, a fire broke out which totally destroyed the Broadway Cotton Factory.
Unfortunately, Ty was injured as he fought his way out of the factory, and so sustained the ff
injuries:
1. Fracture, simple, proximal phalanx index finger, left;
2. Fracture, compound, comminuted, proximal phalanx, middle finger, left and 2nd phalanx, simple;
3. Fracture, compound, comminute phalanx, 4th finger, left;
4. Fracture, simple, middle phalanx, middle finger, left;
5. Lacerated wound, sutured, volar aspect, small finger, left;
6. Fracture, simple, chip, head, 1st phalanx, 5th digit, left.

He underwent medical treatment in the Orthopedic Hospital that determined that his injuries
resulted to a temporary total disability of plaintiffs left hand.
Plaintiff filed the corresponding notice of accident and notice of claim with all of the above-named
defendants to recover indemnity under Part II of the policy, which is similarly worded in all of the
policies, and which reads pertinently as follows:jgc:chanrobles.com.ph
"INDEMNITY FOR TOTAL OR PARTIAL DISABILITY
"If the Insured sustains any Bodily Injury which is effected solely through violent, external, visible
and accidental means, and which shall not prove fatal but shall result, independently of all other
causes and within sixty (60) days from the occurrence thereof, in Total or Partial Disability of the
Insured, the Company shall pay, subject to the exceptions as provided for hereinafter, the amount
set opposite such injury:jgc:chanrobles.com.ph
"PARTIAL DISABILITY
"LOSS OF:chanrob1es virtual 1aw library
x

"Either hand P650.00

Ratio/Issue
s

Held

". . . The loss of a hand shall means the loss by amputation through the bones of the wrist. . . . ."cralaw
virtua1aw library
Defendant Insurers rejected plaintiffs claim for indemnity for the reason that there being no
severance of amputation of the left hand.
o They claim that his temporary disability was not covered by his policy.
Hence, plaintiff sued the defendants in the Municipality Court of this City, and from the decision of
said Court dismissing his complaints, plaintiff appealed to this Court.
1. WON TY MAY RECOVER ON THE INSURANCE POLICIES FOR THE LOSS OF HIS LEFT
HAND, THERE BEING NO AMPUTATION, BUT MERELY PREVENTED HIM FROM DOING WOK
(NO)
*Petitioners Defense: Amputation is not necessary! The fact that I a am prevented
from pursuing my business is enough. Total Disability is always in relation to
ones occupation. Also, the contract was obscure! So, the obscure words or
stipulations should be interpreted against the person who caused the obscurity, and the
ones which caused the obscurity in the cases at bar are the defendant insurance
companies.
a. All of the conditions define partial disability as loss of either hand by a amputation
through the bones of the wrist, we cannot go beyond that meaning.
i. There was no amputation, only physical injury that caused temporary total disability.
b. The agreement contained in the insurance policies is the law between the parties. As
the terms and policies are clear, an interpretation that goes beyond the clear letter of
the policy is unwarranted.

The decision appealed from is hereby affirmed

Prepared by: Carla Cucueco