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CD - 3 Finman Gen. Assurance v. CA

This case involves a dispute over payment of an insurance claim following the death of the insured, Carlie Surposa. Surposa was stabbed to death by unknown assailants while walking home from a festival. The insurer, Finman General Assurance Corporation, denied the claim of Surposa's beneficiaries, arguing his death was the result of murder/assault which were not covered by the policy. The Court of Appeals and Insurance Commission ruled in favor of the beneficiaries, finding the death was accidental as Surposa did not voluntarily expose himself to danger. The Supreme Court affirmed, noting the policy did not expressly exclude murder/assault from coverage and ambiguities in insurance contracts are interpreted in favor of beneficiaries.

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Alyssa Alee Angeles Jacinto
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87 views1 page

CD - 3 Finman Gen. Assurance v. CA

This case involves a dispute over payment of an insurance claim following the death of the insured, Carlie Surposa. Surposa was stabbed to death by unknown assailants while walking home from a festival. The insurer, Finman General Assurance Corporation, denied the claim of Surposa's beneficiaries, arguing his death was the result of murder/assault which were not covered by the policy. The Court of Appeals and Insurance Commission ruled in favor of the beneficiaries, finding the death was accidental as Surposa did not voluntarily expose himself to danger. The Supreme Court affirmed, noting the policy did not expressly exclude murder/assault from coverage and ambiguities in insurance contracts are interpreted in favor of beneficiaries.

Uploaded by

Alyssa Alee Angeles Jacinto
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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FINMAN GENERAL ASSURANCE CORPORATION vs.

THE HONORABLE COURT OF APPEALS


213 SCRA 493, September 2, 1992

FACTS:

On October 22, 1986, deceased, Carlie Surposa was insured with petitioner Finman General
Assurance Corporation with his parents, spouses Julia and Carlos Surposa, and brothers Christopher,
Charles, Chester and Clifton, all surnamed, Surposa, as beneficiaries. While said insurance policy was in
full force and effect, the insured, Carlie Surposa, died on October 18, 1988 as a result of a stab wound
inflicted by one of the three (3) unidentified men. Private respondent and the other beneficiaries of said
insurance policy filed a written notice of claim with the petitioner insurance company which denied said
claim contending that murder and assault are not within the scope of the coverage of the insurance policy.
Private respondent filed a complaint with the Insurance Commission which rendered a favorable response
for the respondent. The appellate court ruled likewise.

Petitioner filed this petition alleging grave abuse of discretion on the part of the appellate court in
applying the principle of "expresso unius exclusio alterius" in a personal accident insurance policy, since
death resulting from murder and/or assault are impliedly excluded in said insurance policy considering that
the cause of death of the insured was not accidental but rather a deliberate and intentional act of the
assailant. Therefore, said death was committed with deliberate intent which, by the very nature of a personal
accident insurance policy, cannot be indemnified.

ISSUE:

Whether or not the insurer is liable for the payment of the insurance premiums.

HELD:

Yes, the insurer is still liable.

Contracts of insurance are to be construed liberally in favor of the insured and strictly against the
insurer. Thus ambiguity in the words of an insurance contract should be interpreted in favor of its
beneficiary. The terms "accident" and "accidental" as used in insurance contracts have not acquired any
technical meaning, and are construed by the courts in their ordinary and common acceptation. Thus, the
terms have been taken to mean that which happen by chance or fortuitously, without intention and design,
and which is unexpected, unusual, and unforeseen. Where the death or injury is not the natural or probable
result of the insured's voluntary act, or if something unforeseen occurs in the doing of the act which
produces the injury, the resulting death is within the protection of the policies insuring against death or injury
from accident. In the case at bar, it cannot be pretended that Carlie Surposa died in the course of an
assault or murder as a result of his voluntary act considering the very nature of these crimes. Neither can
it be said that where was a capricious desire on the part of the accused to expose his life to danger
considering that he was just going home after attending a festival.

Furthermore, the personal accident insurance policy involved herein specifically enumerated only
ten (10) circumstances wherein no liability attaches to petitioner insurance company for any injury, disability
or loss suffered by the insured as a result of any of the stimulated causes. The principle of " expresso unius
exclusio alterius" — the mention of one thing implies the exclusion of another thing — is therefore applicable
in the instant case since murder and assault, not having been expressly included in the enumeration of the
circumstances that would negate liability in said insurance policy cannot be considered by implication to
discharge the petitioner insurance company from liability for, any injury, disability or loss suffered by the
insured. Thus, the failure of the petitioner insurance company to include death resulting from murder or
assault among the prohibited risks leads inevitably to the conclusion that it did not intend to limit or exempt
itself from liability for such death.

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