56 - Sunlife Assurance Vs Court of Appeals
56 - Sunlife Assurance Vs Court of Appeals
56 - Sunlife Assurance Vs Court of Appeals
Court of Appeals
G.R. No. 105135 June 22, 1995
Digest by Lor Saguinsin
Facts:
1. On April 15, 1986, Robert John B. Bacani procured a life insurance contract for himself from
petitioner.
2. On June 26, 1987, the insured died in a plane crash. Respondent Bernarda Bacani filed a
claim with petitioner, seeking the benefits of the insurance policy taken by her son.
Petitioner conducted an investigation and its findings prompted it to reject the claim.
a. In its letter, petitioner informed respondent Bernarda Bacani, that the insured did
not disclose material facts relevant to the issuance of the policy, thus rendering the
contract of insurance voidable.
b. Petitioner discovered that two weeks prior to his application for insurance, the
insured was examined and confined at the Lung Center of the Philippines, where he
was diagnosed for renal failure. The insured did not disclose this.
Issue:
1. Whether the material undisclosed was relevant to the issuance of the policy that would
render it voidable? (YES)
Held:
1. Petitioner properly exercised its right to rescind the contract of insurance by reason of the
concealment employed by the insured. It must be emphasized that rescission was exercised within the
two-year contestability period as recognized in Section 48 of The Insurance Code.
Section 26 of the Insurance Code is explicit in requiring a party to a contract of insurance to
communicate to the other, in good faith, all facts within his knowledge which are material to
the contract and as to which he makes no warranty, and which the other has no means of
ascertaining.
o Materiality is to be determined not by the event, but solely by the probable and
reasonable influence of the facts upon the party to whom communication is due, in
forming his estimate of the disadvantages of the proposed contract or in making his
inquiries.
The terms of the contract are clear. The insured is specifically required to disclose to the
insurer matters relating to his health. Materiality of the information withheld does not
depend on the state of mind of the insured. Neither does it depend on the actual or physical
events which ensue. Thus, "goad faith" is no defense in concealment.
The insured's failure to disclose the fact that he was hospitalized for two weeks prior to filing
his application for insurance, raises grave doubts about his bonafides. It appears that such
concealment was deliberate on his part.
o The information which the insured failed to disclose were material and relevant to
the approval and issuance of the insurance policy. The matters concealed would
have definitely affected petitioner's action on his application, either by approving it
with the corresponding adjustment for a higher premium or rejecting the same.
Anent the finding that the facts concealed had no bearing to the cause of death of the
insured, it is well settled that the insured need not die of the disease he had failed to disclose
to the insurer. It is sufficient that his non-disclosure misled the insurer in forming his
estimates of the risks of the proposed insurance policy or in making inquiries