Anda di halaman 1dari 9

12/6/2016

G.R. No. 175773

TodayisTuesday,December06,2016

Search

RepublicofthePhilippines
SUPREMECOURT
Manila
SECONDDIVISION
G.R.No.175773June17,2013
MITSUBISHIMOTORSPHILIPPINESSALARIEDEMPLOYEESUNION(MMPSEU),Petitioner,
vs.
MITSUBISHIMOTORSPHILIPPINESCORPORATION,Respondent.
DECISION
DELCASTILLO,J.:
The Collective Bargaining Agreement (CBA) of the parties in this case provides that the company shoulder the
hospitalization expenses of the dependents of covered employees subject to certain limitations and restrictions.
Accordingly,coveredemployeespaypartofthehospitalizationinsurancepremiumthroughmonthlysalarydeduction
while the company, upon hospitalization of the covered employees' dependents, shall pay the hospitalization
expensesincurredforthesame.Theconflictarosewhenaportionofthehospitalizationexpensesofthecovered
employees' dependents were paid/shouldered by the dependent's own health insurance. While the company
refusedtopaytheportionofthehospitalexpensesalreadyshoulderedbythedependents'ownhealthinsurance,
the union insists that the covered employees are entitled to the whole and undiminished amount of said hospital
expenses.
By this Petition for Review on Certiorari,1 petitioner Mitsubishi Motors Philippines Salaried Employees Union
(MMPSEU)assailstheMarch31,2006Decision2andDecember5,2006Resolution3oftheCourtofAppeals(CA)
inCAG.R.SPNo.75630,whichreversedandsetasidetheVoluntaryArbitratorsDecember3,2002Decision4and
declared respondent Mitsubishi Motors Philippines Corporation (MMPC) to be under no legal obligation to pay its
coveredemployeesdependentshospitalizationexpenseswhichwerealreadyshoulderedbyotherhealthinsurance
companies.
FactualAntecedents
The parties CBA5 covering the period August 1, 1996 to July 31, 1999 provides for the hospitalization insurance
benefitsforthecovereddependents,thus:
SECTION 4. DEPENDENTS GROUP HOSPITALIZATION INSURANCE The COMPANY shall obtain group
hospitalization insurance coverage or assume under a selfinsurance basis hospitalization for the dependents of
regularemployeesuptoamaximumamountoffortythousandpesos(P40,000.00)perconfinementsubjecttothe
following:
a.Theroomandboardmustnotexceedthreehundredpesos(P300.00)perdayuptoamaximumofthirty
one (31) days. Similarly, Doctors Call fees must not exceed three hundred pesos (P300.00) per day for a
maximumofthirtyone(31)days.Anyexcessofthisamountshallbebornebytheemployee.
b. Confinement must be in a hospital designated by the COMPANY. For this purpose, the COMPANY shall
designatehospitalsindifferentconvenientplacestobeavailedofbythedependentsofemployees.Incases
of emergency where the dependent is confined without the recommendation of the company doctor or in a
hospital not designated by the COMPANY, the COMPANY shall look into the circumstances of such
confinementandarrangeforthepaymentoftheamounttotheextentofthehospitalizationbenefit.
c.ThelimitationsandrestrictionslistedinAnnex"B"mustbeobserved.
d.Paymentshallbedirecttothehospitalanddoctorandmustbecoveredbyactualbillings.
Each employee shall pay one hundred pesos (P100.00) per month through salary deduction as his share in the
payment of the insurance premium for the above coverage with the balance of the premium to be paid by the
http://www.lawphil.net/judjuris/juri2013/jun2013/gr_175773_2013.html

1/9

12/6/2016

G.R. No. 175773

COMPANY.IftheCOMPANYisselfinsuredtheonehundredpesos(P100.00)peremployeemonthlycontribution
shall be given to the COMPANY which shall shoulder the expenses subject to the above level of benefits and
subjecttothesamelimitationsandrestrictionsprovidedforinAnnex"B"hereof.
Thehospitalizationexpensesmustbecoveredbyactualhospitalanddoctorsbillsandanyamountinexcessofthe
abovementionedlevelofbenefitswillbefortheaccountoftheemployee.
Forpurposes of this provision,eligibledependentsarethecoveredemployeesnatural parents, legal spouse and
legitimate or legally adopted or step children who are unmarried, unemployed who have not attained twentyone
(21)yearsofageandwhollydependentupontheemployeeforsupport.
Thisprovisionappliesonlyincasesofactualconfinementinthehospitalforatleastsix(6)hours.
Maternitycasesarenotcoveredbythissectionbutwillbeunderthenextsucceedingsectiononmaternitybenefits.6
WhentheCBAexpiredonJuly31,1999,thepartiesexecutedanotherCBA7effectiveAugust1,1999toJuly31,
2002 incorporating the same provisions on dependents hospitalization insurance benefits but in the increased
amount of P50,000.00. The room and board expenses, as well as the doctors call fees, were also increased to
P375.00.
Onseparateoccasions,threemembersofMMPSEU,namely,ErnestoCalida(Calida),HermieJuanOabel(Oabel)
andJocelynMartin(Martin),filedclaimsforreimbursementofhospitalizationexpensesoftheirdependents.
MMPC paid only a portion of their hospitalization insurance claims, not the full amount. In the case of Calida, his
wife,Lanie,wasconfinedatSto.TomasUniversityHospitalfromSeptember4to9,1998duetoThyroidectomy.The
medicalexpensesincurredtotalledP29,967.10.Ofthisamount,P9,000.00representingprofessionalfeeswaspaid
by MEDICard Philippines, Inc. (MEDICard) which provides health maintenance to Lanie.8 MMPC only paid
P12,148.63.9 It did not pay the P9,000.00 already paid by MEDICard and the P6,278.47 not covered by official
receipts.ItrefusedtogivetoCalidathedifferencebetweentheamountofmedicalexpensesofP27,427.1010which
heclaimedtobeentitledtoundertheCBAandtheP12,148.63whichMMPCdirectlypaidtothehospital.
In the case of Martin, his father, Jose, was admitted at The Medical City from March 26 to 27, 2000 due to Acid
Peptic Disease and incurred medical expenses amounting to P9,101.30.14 MEDICard paid P8,496.00.15
Consequently, MMPC only paid P288.40,16 after deducting from the total medical expenses the amount paid by
MEDICardandtheP316.90discountgivenbythehospital.
Claiming that under the CBA, they are entitled to hospital benefits amounting to P27,427.10, P6,769.35 and
P8,123.80,respectively,whichshouldnotbereducedbytheamountspaidbyMEDICardandbyProsper,Calida,
OabelandMartinaskedforreimbursementfromMMPC.However,MMPCdeniedtheclaimscontendingthatdouble
insurance would result if the said employees would receive from the company the full amount of hospitalization
expensesdespitehavingalreadyreceivedpaymentofportionsthereoffromotherhealthinsuranceproviders.
This prompted the MMPSEU President to write the MMPC President17 demanding full payment of the
hospitalization benefits. Alleging discrimination against MMPSEU union members, she pointed out that full
reimbursementwasgiveninasimilarclaimfiledbyLuisitoCruz(Cruz),amemberoftheHourlyUnion.Inaletter
reply,18 MMPC, through its VicePresident for Industrial Relations Division, clarified that the claims of the said
MMPSEUmembershavealreadybeenpaidonthebasisofofficialreceiptssubmitted.Italsodeniedthechargeof
discrimination and explained that the case of Cruz involved an entirely different matter since it concerned the
admissibilityofcertifiedtruecopiesofdocumentsforreimbursementpurposes,whichcasehadbeensettledthrough
voluntaryarbitration.
OnAugust28,2000,MMPSEUreferredthedisputetotheNationalConciliationandMediationBoardandrequested
forpreventivemediation.19
ProceedingsbeforetheVoluntaryArbitrator
On October 3, 2000, the case was referred to Voluntary Arbitrator Rolando Capocyan for resolution of the issue
involvingtheinterpretationofthesubjectCBAprovision.20
MMPSEUallegedthatthereisnothingintheCBAwhichprohibitsanemployeefromobtainingotherinsuranceor
declares that medical expenses can be reimbursed only upon presentation of original official receipts. It stressed
thatthehospitalizationbenefitsshouldbecomputedbasedontheformulaindicatedintheCBAwithoutdeducting
the benefits derived from other insurance providers. Besides, if reduction is permitted, MMPC would be unjustly
benefitedfromthemonthlypremiumcontributedbytheemployeesthroughsalarydeduction.MMPSEUaddedthat

http://www.lawphil.net/judjuris/juri2013/jun2013/gr_175773_2013.html

2/9

12/6/2016

G.R. No. 175773

itsmembershadlegitimateclaimsundertheCBAandthatanydoubtastoanyofitsprovisionsshouldberesolved
infavorofitsmembers.Moreover,anyambiguityshouldberesolvedinfavoroflabor.21
On the other hand, MMPC argued that the reimbursement of the entire amounts being claimed by the covered
employees,includingthosealreadypaidbyotherinsurancecompanies,wouldconstitutedoubleindemnityordouble
insurance, which is circumscribed under the Insurance Code. Moreover, a contract of insurance is a contract of
indemnityandtheemployeescannotbeallowedtoprofitfromtheirdependentsloss.22
Meanwhile,thepartiesseparatelysoughtforalegalopinionfromtheInsuranceCommissionrelativetotheissueat
hand.Initsletter23totheInsuranceCommission,MMPCrequestedforconfirmationofitspositionthatthecovered
employeescannotclaiminsurancebenefitsforalossthathadalreadybeencoveredorpaidbyanotherinsurance
company. However, the Office of the Insurance Commission opted not to render an opinion on the matter as the
samemaybecomethesubjectofaformalcomplaintbeforeit.24Ontheotherhand,whenqueriedbyMMPSEU,25
theInsuranceCommission,throughAtty.RichardDavidC.FunkII(Atty.Funk)oftheClaimsAdjudicationDivision,
renderedanopinioncontainedinaletter,26viz:
Ms.CeciliaL.ParasPresident
MitsubishiMotorsPhils.
[Salaried]EmployeesUnion
OrtigasAvenueExtension,
Cainta,Rizal
Madam:
We acknowledge receipt of your letter which, to our impression, basically poses the question of
whetherornotrecoveryofmedicalexpensesfromaHealthMaintenanceOrganizationbarsrecoveryof
thesamereimbursableamountofmedicalexpensesunderacontractofhealthormedicalinsurance.
Wewishtoopinethatincasesofclaimsforreimbursementofmedicalexpenseswheretherearetwo
contractsprovidingbenefitstothateffect,recoverymaybehadonbothsimultaneously.Intheabsence
ofanOtherInsuranceprovisioninthesecoverages,thecourtshaveuniformlyheldthataninsuredis
entitled to receive the insurance benefits without regard to the amount of total benefits provided by
other insurance. (INSURANCE LAW, A Guide to Fundamental Principles, Legal Doctrines, and
CommercialPracticesRobertE.Keeton,AlauI.Widiss,p.261).Theresultisconsistentwiththepublic
policyunderlyingthecollateralsourcerulethatis,xxxthecourtshaveusuallyconcludedthatthe
liability of a health or accident insurer is not reduced by other possible sources of indemnification or
compensation.(ibid).
Verytrulyyours,
RICHARDDAVIDC.FUNKII
OfficerinCharge
ClaimsAdjudicationDivision
(SGD.)
AttorneyIV
OnDecember3,2002,theVoluntaryArbitratorrenderedaDecision27findingMMPCliabletopayorreimbursethe
amountofhospitalizationexpensesalreadypaidbyotherhealthinsurancecompanies.TheVoluntaryArbitratorheld
thattheemployeesmaydemandsimultaneouspaymentfromboththeCBAandtheirdependentsseparatehealth
insurance without resulting to double insurance, since separate premiums were paid for each contract. He also
notedthattheCBAdoesnotprohibitreimbursementincasethereareotherhealthinsurers.
ProceedingsbeforetheCourtofAppeals
MMPC filed a Petition for Review with Prayer for the Issuance of a Temporary Restraining Order and/or Writ of
PreliminaryInjunction28beforetheCA.ItclaimedthattheVoluntaryArbitratorcommittedgraveabuseofdiscretion
innotfindingthatrecoveryunderbothinsurancepoliciesconstitutesdoubleinsuranceasbothhadthesamesubject
matter,interestinsuredandriskorperilinsuredagainstinrelyingsolelyontheunauthorizedlegalopinionofAtty.
Funkandinnotfindingthattheemployeeswillbebenefitedtwiceforthesameloss.InitsComment,29MMPSEU
counteredthatMMPCwillunjustlyenrichitselfandprofitfromthemonthlypremiumspaidiffullreimbursementisnot
made.
OnMarch31,2006,theCAfoundmeritinMMPCsPetition.Itruledthatdespitethelackofaprovisionwhichbars
recovery in case of payment by other insurers, the wordings of the subject provision of the CBA showed that the
http://www.lawphil.net/judjuris/juri2013/jun2013/gr_175773_2013.html

3/9

12/6/2016

G.R. No. 175773

partiesintendedtomakeMMPCliableonlyforexpensesactuallyincurredbyanemployeesqualifieddependent.In
particular,theprovisionstipulatesthatpaymentshouldbemadedirectlytothehospitalandthattheclaimshouldbe
supported by actual hospital and doctors bills. These mean that the employees shall only be paid amounts not
covered by other health insurance and is more in keeping with the principle of indemnity in insurance contracts.
Besides,acontraryinterpretationwould"allowunscrupulousemployeestoundulyprofitfromthexxxbenefits"and
shall"openthefloodgatestoquestionableclaimsxxx."30
ThedispositiveportionoftheCADecision31reads:
WHEREFORE,theinstantpetitionisGRANTED.ThedecisionofthevoluntaryarbitratordatedDecember3,2002is
REVERSED and SET ASIDE and judgment is rendered declaring that under Art. XI, Sec. 4 of the Collective
Bargaining Agreement between petitioner and respondent effective August 1, 1999 to July 31, 2002, the formers
obligation to reimburse the Union members for the hospitalization expenses incurred by their dependents is
exclusiveofthosepaidbytheUnionmemberstothehospital.
SOORDERED.32
In its Motion for Reconsideration,33 MMPSEU pointed out that the alleged oppression that may be committed by
abusive employees is a mere possibility whereas the resulting losses to the employees are real. MMPSEU cited
Samselv.AllstateInsuranceCo.,34whereintheArizonaSupremeCourtexplicitlyruledthataninsuredmayrecover
from separate health insurance providers, regardless of whether one of them has already paid the medical
expenses incurred. On the other hand, MMPC argued in its Comment35 that the cited foreign case involves a
differentsetoffacts.
TheCA,initsResolution36datedDecember5,2006,deniedMMPSEUsmotion.
Hence,thisPetition.
Issues
MMPSEUpresentedthefollowinggroundsinsupportofitsPetition:
A.
THECOURTOFAPPEALSSERIOUSLYERREDWHENITREVERSEDTHEDECISIONDATED03
[DECEMBER] 2002 OF THE VOLUNTARY ARBITRATOR BELOW WHEN THE SAME WAS
SUPPORTED BY SUBSTANTIAL EVIDENCE, INCLUDING THE OPINION OF THE INSURANCE
COMMISSIONTHATRECOVERYFROMBOTHTHECBAANDSEPARATEHEALTHCARDSISNOT
PROHIBITEDINTHEABSENCEOFANYSPECIFICPROVISIONINTHECBA.
B.
THECOURTOFAPPEALSCOMMITTEDREVERSIBLEERRORINOVERTURNINGTHEDECISION
OFTHEVOLUNTARYARBITRATORWITHOUTEVENGIVINGANYLEGALORJUSTIFIABLEBASIS
FORSUCHREVERSAL.
C.
THECOURTOFAPPEALSCOMMITTEDGRAVEERRORINREFUSINGTOCONSIDEROREVEN
MENTIONANYTHINGABOUTTHEAMERICANAUTHORITIESCITEDINTHERECORDSTHATDO
NOTPROHIBIT,BUTINFACTALLOW,RECOVERYFROMTWOSEPARATEHEALTHPLANS.
D.
THE COURT OF APPEALS GRAVELY ERRED IN GIVING MORE IMPORTANCE TO A POSSIBLE,
HENCE MERELY SPECULATIVE, ABUSE BY EMPLOYEES OF THE BENEFITS IF DOUBLE
RECOVERYWEREALLOWEDINSTEADOFTHEREALINJURYTOTHEEMPLOYEESWHOARE
PAYING FOR THE CBA HOSPITALIZATION BENEFITS THROUGH MONTHLY SALARY
DEDUCTIONS BUT WHO MAY NOT BE ABLE TO AVAIL OF THE SAME IF THEY OR THEIR
DEPENDENTSHAVEOTHERHEALTHINSURANCE.37
MMPSEU avers that the Decision of the Voluntary Arbitrator deserves utmost respect and finality because it is
supportedbysubstantialevidenceandisinaccordancewiththeopinionrenderedbytheInsuranceCommission,an
agency equipped with vast knowledge concerning insurance contracts. It maintains that under the CBA, member
employeesareentitledtofullreimbursementofmedicalexpensesincurredbytheirdependentsregardlessofany
amountspaidbythelattershealthinsuranceprovider.Otherwise,nonrecoverywillconstituteunjustenrichmenton
http://www.lawphil.net/judjuris/juri2013/jun2013/gr_175773_2013.html

4/9

12/6/2016

G.R. No. 175773

thepartofMMPC.ItaversthatrecoveryfromboththeCBAandotherinsurancecompaniesisallowedundertheir
CBAandnotprohibitedbylawnorbyjurisprudence.
OurRuling
ThePetitionhasnomerit.
Atty.Funkerredinapplyingthe
collateralsourcerule.
TheVoluntaryArbitratorbasedhisrulingontheopinionofAtty.Funkthattheemployeesmayrecoverbenefitsfrom
differentinsuranceproviderswithoutregardtotheamountofbenefitspaidbyeach.Accordingtohim,thisviewis
consistentwiththetheoryofthecollateralsourcerule.
AspartofAmericanpersonalinjurylaw,thecollateralsourcerulewasoriginallyappliedtotortcaseswhereinthe
defendantispreventedfrombenefitingfromtheplaintiffsreceiptofmoneyfromothersources.38Underthisrule,if
an injured person receives compensation for his injuries from a source wholly independent of the tortfeasor, the
payment should not be deducted from the damages which he would otherwise collect from the tortfeasor.39 In a
recentDecision40 by the Illinois Supreme Court, the rule has been described as "an established exception to the
generalrulethatdamagesinnegligenceactionsmustbecompensatory."TheCourtwentontoexplainthatalthough
theruleappearstoallowadoublerecovery,thecollateralsourcewillhavealienorsubrogationrighttopreventsuch
a double recovery.41 In Mitchell v. Haldar,42 the collateral source rule was rationalized by the Supreme Court of
Delaware:
Thecollateralsourceruleispredicatedonthetheorythatatortfeasorhasnointerestin,andthereforenorightto
benefitfrommoniesreceivedbytheinjuredpersonfromsourcesunconnectedwiththedefendant.Accordingtothe
collateralsourcerule,atortfeasorhasnorighttoanymitigationofdamagesbecauseofpaymentsorcompensation
received by the injured person from an independent source. The rationale for the collateral source rule is based
uponthequasipunitivenatureoftortlawliability.Ithasbeenexplainedasfollows:
Thecollateralsourceruleisdesignedtostrikeabalancebetweentwocompetingprinciplesoftortlaw:(1)aplaintiff
isentitledtocompensationsufficienttomakehimwhole,butnomoreand(2)adefendantisliableforalldamages
thatproximatelyresultfromhiswrong.Aplaintiffwhoreceivesadoublerecoveryforasingletortenjoysawindfalla
defendantwhoescapes,inwholeorinpart,liabilityforhiswrongenjoysawindfall.Becausethelawmustsanction
onewindfallanddenytheother,itfavorsthevictimofthewrongratherthanthewrongdoer.
Thus,thetortfeasorisrequiredtobearthecostforthefullvalueofhisorhernegligentconductevenifitresultsina
windfallfortheinnocentplaintiff.(Citationsomitted)
Asseen,thecollateralsourceruleappliesinordertoplacetheresponsibilityforlossesonthepartycausingthem.43
Itsapplicationisjustifiedsothat"'thewrongdoershouldnotbenefitfromtheexpendituresmadebytheinjuredparty
or take advantage of contracts or other relations that may exist between the injured party and third persons."44
Thus,itfindsnoapplicationtocasesinvolvingnofaultinsurancesunderwhichtheinsuredisindemnifiedforlosses
byinsurancecompanies,regardlessofwhowasatfaultintheincidentgeneratingthelosses.45Here,itisclearthat
MMPCisanofaultinsurer.Hence,itcannotbeobligedtopaythehospitalizationexpensesofthedependentsofits
employeeswhichhadalreadybeenpaidbyseparatehealthinsuranceprovidersofsaiddependents.
TheVoluntaryArbitratorthereforeerredinadoptingAtty.Funksviewthatthecoveredemployeesareentitledtofull
paymentofthehospitalexpensesincurredbytheirdependents,includingtheamountsalreadypaidbyotherhealth
insurancecompaniesbasedonthetheoryofcollateralsourcerule.
TheconditionssetforthintheCBAprovisionindicateanintentiontolimitMMPCsliabilityonlytoactualexpenses
incurredbytheemployeesdependents,thatis,excludingtheamountspaidbydependentsotherhealthinsurance
providers.
The Voluntary Arbitrator ruled that the CBA has no express provision barring claims for hospitalization expenses
alreadypaidbyotherinsurers.Hence,thecoveredemployeescanrecoverfromboth.TheCAdidnotagree,saying
thattheconditionssetforthintheCBAimpliedanintentionofthepartiestolimitMMPCsliabilityonlytotheextent
of the expenses actually incurred by their dependents which excludes the amounts shouldered by other health
insurancecompanies.
WeagreewiththeCA.TheconditionthatpaymentshouldbedirecttothehospitalanddoctorimpliesthatMMPCis
only liable to pay medical expenses actually shouldered by the employees dependents. It follows that MMPCs
liabilityislimited,thatis,itdoesnotincludetheamountspaidbyotherhealthinsuranceproviders.Thisconditionis
obviouslyintendedtothwartnotonlyfraudulentclaimsbutalsodoubleclaimsforthesamelossofthedependents
ofcoveredemployees.
http://www.lawphil.net/judjuris/juri2013/jun2013/gr_175773_2013.html

5/9

12/6/2016

G.R. No. 175773

ItiswelltonoteatthispointthattheCBAconstitutesacontractbetweenthepartiesandassuch,itshouldbestrictly
construedforthepurposeoflimitingtheamountoftheemployersliability.46Thetermsofthesubjectprovisionare
clear and provide no room for any other interpretation. As there is no ambiguity, the terms must be taken in their
plain,ordinaryandpopularsense.47Consequently,MMPSEUcannotrelyontherulethatacontractofinsuranceis
tobeliberallyconstruedinfavoroftheinsured.Neithercanitrelyonthetheorythatanydoubtmustberesolvedin
favoroflabor.
Samselv.AllstateInsuranceCo.isnot
onallfourswiththecaseatbar.
MMPSEUcannotrelyonSamselv.AllstateInsuranceCo.wheretheSupremeCourtofArizonaallowedtheinsured
toenjoymedicalbenefitsunderanautomobilepolicyinsurancedespitebeingabletoalsorecoverfromaseparate
healthinsurer.Inthatcase,theAllstateautomobilepolicydoesnotcontainanyclauserestrictingmedicalpayment
coveragetoexpensesactuallypaidbytheinsurednordoesitspecificallyprovideforreductionofmedicalpayments
benefits by a coordination of benefits.48 However, in the case before us, the dependents group hospitalization
insuranceprovisionintheCBAspecificallycontainsaconditionwhichlimitsMMPCsliabilityonlyuptotheextentof
theexpensesthatshouldbepaidbythecoveredemployeesdependenttothehospitalanddoctor.Thisisevident
fromtheportionwhichstatesthat"paymentbyMMPCshallbedirecttothehospitalanddoctor."49Incontrast,the
AllstateautomobilepolicyexpresslygivesAllstatetheauthoritytopaydirectlytotheinsuredpersonoronthelatters
behalf all reasonable expenses actually incurred. Therefore, reliance on Samsel is unavailing because the facts
thereinaredifferentandnotdecisiveoftheissuesinthepresentcase.
Toallowreimbursementofamountspaid
underotherinsurancepoliciesshall
constitutedoublerecoverywhichisnot
sanctionedbylaw.
MMPSEU insists that MMPC is also liable for the amounts covered under other insurance policies otherwise,
MMPCwillunjustlyprofitfromthepremiumstheemployeescontributethroughmonthlysalarydeductions.
Thiscontentionisunmeritorious.
To constitute unjust enrichment, it must be shown that a party was unjustly enriched in the sense that the term
unjustlycouldmeanillegallyorunlawfully.50Aclaimforunjustenrichmentfailswhenthepersonwhowillbenefithas
avalidclaimtosuchbenefit.51
TheCBAhasprovidedforMMPCslimitedliabilitywhichextendsonlyuptotheamounttobepaidtothehospital
and doctor by the employees dependents, excluding those paid by other insurers. Consequently, the covered
employeeswillnotreceivemorethanwhatisduethemneitherisMMPCunderanyobligationtogivemorethan
whatisdueundertheCBA.
Moreover,sincethesubjectCBAprovisionisaninsurancecontract,therightsandobligationsofthepartiesmustbe
determinedinaccordancewiththegeneralprinciplesofinsurancelaw.52Beinginthenatureofanonlifeinsurance
contract and essentially a contract of indemnity, the CBA provision obligates MMPC to indemnify the covered
employees medical expenses incurred by their dependents but only up to the extent of the expenses actually
incurred.53 This is consistent with the principle of indemnity which proscribes the insured from recovering greater
than the loss.54 Indeed, to profit from a loss will lead to unjust enrichment and therefore should not be
countenanced.AsaptlyruledbytheCA,togranttheclaimsofMMPSEUwillpermitpossibleabusebyemployees.
WHEREFORE, the Petition is DENIED. The Decision dated March 31, 2006 and Resolution dated December 5,
2006oftheCourtofAppealsinCAG.R.SPNo.75630,areAFFIRMED.
SOORDERED.
MARIANOC.DELCASTILLO
AssociateJustice
WECONCUR:
ANTONIOT.CARPIO
AssociateJustice
Chairperson
ARTUROD.BRION
AssociateJustice
http://www.lawphil.net/judjuris/juri2013/jun2013/gr_175773_2013.html

JOSEPORTUGALPEREZ
AssociateJustice
6/9

12/6/2016

G.R. No. 175773

ESTELAM.PERLASBERNABE
AssociateJustice
ATTESTATION
IattestthattheconclusionsintheaboveDecisionhadbeenreachedinconsultationbeforethecasewasassigned
tothewriteroftheopinionoftheCourtsDivision.
ANTONIOT.CARPIO
AssociateJustice
Chairperson
CERTIFICATION
PursuanttoSection13,ArticleVIIIoftheConstitutionandtheDivisionChairperson'sAttestation,Icertifythatthe
conclusionsintheaboveDecisionhadbeenreachedinconsultationbeforethecasewasassignedtothewriterof
theopinionoftheCourt'sDivision.
MARIALOURDESP.A.SERENO
ChiefJustice

Footnotes
1Rollo,pp.1135.
2CArollo,pp.215223pennedbyAssociateJusticeEdgardoP.CruzandconcurredinbyAssociateJustices

RosalindaAsuncionVicenteandSesinandoE.Villon.
3Id.at274.
4Id.at3038pennedbyVoluntaryArbitratorAtty.RodolfoM.Capocyan.
5Annex"A"ofMMPCsPositionPaperbeforetheVoluntaryArbitrator,id.at8587.
6Id.at8687.
7Annex"B,"id.at8890.
8Annexes"C"and"D,"id.at9194.
9Annex"E,"id.at9596.
10P12,148.63+P9,000.00+P6,278.47.
11Annex"F,"CArollo,pp.97100.
12Id.
13Annex"G,"id.at101102.
14Annex"H,"id.at103107.
15Annex"I,"id.at108.
16Annex"J,"id.at109.
17Annex"A"ofMMPSEUsPositionPaperbeforetheVoluntaryArbitrator,id.at152.
18Annex"E,"id.at156.
19Annex"F,"id.at157.
20Annex"G,"id.at158.
http://www.lawphil.net/judjuris/juri2013/jun2013/gr_175773_2013.html

7/9

12/6/2016

G.R. No. 175773

21SeeMMPSEUsPositionPaperandReplytoMMPCsPositionPaperbeforetheVoluntaryArbitrator,id.at

144151and139142,respectively.
22SeeMMPCsPositionPaperandReplytoMMPSEUsPositionPaperbeforetheVoluntaryArbitrator,id.at

7484and110121,respectively.
23Annex"L"ofMMPCPetitionforReviewfiledbeforetheCA,id.at6465.
24SeeOctober24,2000letteroftheInsuranceCommission,Annex"M",id.at66.
25SeeNovember14,2001letterofMMPSEU,id.at182185.
26Annex"A"ofMMPSEUReplytoMMPCsPositionPaperbeforetheVoluntaryArbitrator,id.at143.
27Id.a3038.
28Id.at229.
29Id.at170181.
30Id.at222.
31Id.at215223.
32Id.at223.
33Id.at229244.
3459P.3d281(Ariz.2002).
35CArollo,pp.264272.
36Id.at274.
37Rollo,pp.1617.
38 YOUNG, MELISSA. TORT REFORM AND THE COLLATERAL SOURCE RULE <www.google.com

www.aaos.org/news/aaosnow/mar09/managing4.asp.>,(visitedMarch1,2013).
39BLACKSLAWDICTIONARYWITHPRONUNCIATIONS,(Sixthed.1990/CentennialEdition).
40Willsv.Foster,Jr.,229Ill.2d393,399(Ill.2008).
41Id.
42883A.2d32,3738(Del.2005).
43 PERILLO, JOSEPH M., THE COLLATERAL SOURCE RULES IN CONTRACT CASES, San Diego Law

Review,46SanDiegoL.Rev.705,709710(Summer,2009)<www.lexis.com.>
44Willsv.Foster,Jr.,supranote40at397.
45BLACKSLAWDICTIONARY,(Fifthed.273,1979).
46AsiaticPetroleumCo.v.DePio,46Phil167,170(1924).
47NewLifeEnterprisesv.CourtofAppeals,G.R.No.94071,March31,1992,207SCRA669,676.
48Supranote34at290.
49CArollo,p.87.
50UniversityofthePhilippinesv.PhilabIndustries,Inc.,482Phil.693,709(2004).
http://www.lawphil.net/judjuris/juri2013/jun2013/gr_175773_2013.html

8/9

12/6/2016

G.R. No. 175773

51CarCoolPhils.,Inc.v.UshioRealty&DevelopmentCorporation,515Phil.376,384(2006).
52FortuneInsuranceandSurety,Inc.v.CourtofAppeals,314Phil.184,196(1995).
53PhilamcareHealthSystems,Inc.v.CourtofAppeals,429Phil.82,90(2002).
54 The principle of indemnity in property insurance is based on Section 18 of the Insurance Code which

provides that no contract or policy of insurance on property shall be enforceable except for the benefit of
somepersonhavinganinsurableinterestinthepropertyinsured.
TheLawphilProjectArellanoLawFoundation

http://www.lawphil.net/judjuris/juri2013/jun2013/gr_175773_2013.html

9/9

Anda mungkin juga menyukai