INSURANCE
Atty Nelita Jesusa A. Bacaling
(3rd Year Law, University of San Agustin)
Chapter II
“TITLE 2
“FIRE INSURANCE
“SEC. 169. As used in this
Code, the term fire insurance shall include insurance against loss
by fire, lightning, windstorm, tornado or earthquake and other allied risks,
when such risks are covered by extension to fire insurance policies or under
separate policies.
1.
Take note that in order for the insurer
to be liable, the fire insurance resulting from an “allied risk” must be covered
by a rider or extension to the fire insurance policy or under separate policies.
In
the case of Gulf Resort, Inc.versus Philippines Charter Insurance Corp. (458 SCRA 550), a rider was taken to cover 2 swimming pools
against earthquake shock, but it was very clear in the policy that the rider
meant only to cover the pools and not all properties found in the resort that were also damaged because
of the earthquake. All other properties were covered under a fire insurance policy but the rider for "earthquake shock" covered only the pools. Thus, the Court ruled that no further interpretation is needed, if the terms of the contract are clear. A different ruling would have been arrived at if the rider clearly stated that it was being taken to cover all other properties found in the resort, and the proper premium for such coverage were paid. The insurer would have been liable for damage due to earthquake shock caused on all other properties.
2.
In our jurisprudence, take note that
fire is not considered as a natural disaster or calamity. This was the ruling
in Philippine Home Assurance Corp. v. CA (257 SCRA 468), however, it may be caused by lighting
or some natural disaster and therefore this must be proven first before the
claim may be covered and fire which caused damage may be considered as a
natural disaster.
“SEC. 170. An alteration
in the use or condition of a thing insured from that to which it is limited by
the policy made without the consent of the insurer, by means within the control
of the insured, and increasing the risks, entitles an insurer to rescind a
contract of fire insurance.
1.
Alteration, in order to be a ground for
rescission by the insurer must be one that:
a.
Introduces change in the use or
condition from that which is specifically limited in the policy;
b.
increases the risk;
c. is made within the control of the
insured and;
d.
made without the consent of the insurer;
“SEC. 171. An alteration
in the use or condition of a thing insured from that to which it is limited by
the policy, which does not increase the risk, does not affect a contract of
fire insurance.
>>>>>>
Even if there is an alteration in the use or condition of the thing insured but the risk is not increased, such alteration will not have any bearing on the
effectivity of the insurance.
“SEC. 172. A contract of
fire insurance is not affected by any act of the insured subsequent to the execution
of the policy, which does not violate its provisions, even though it increases
the risk and is the cause of the loss.
1.
In Sec. 172, even if there is
alteration, when it does not violate any provision, even if the alteration
increases the risk and becomes the cause of the loss, the contract of insurance
remains valid. When does this happen? When the alteration does not veer away from that which is specifically
limited in the policy.
An example would be to convert a shoe store into a clothing store and the limitation in the policy is that the premises insured must be used only as a commercial establishment for the sale of dry goods. Here, although there is an alteration, it is one that is does not violate any provision in the policy or one which still complies with the limitation stated in the policy.
An example would be to convert a shoe store into a clothing store and the limitation in the policy is that the premises insured must be used only as a commercial establishment for the sale of dry goods. Here, although there is an alteration, it is one that is does not violate any provision in the policy or one which still complies with the limitation stated in the policy.
2.
Another example is when the articles
brought into the premises are usual and necessary to the trade of the insured.
3.
There are of course what we would call
“necessary risks” that needs to be undertaken by the insured, which, even if
they actually increase the risk, could not be avoided like making repairs,
bringing paint into the premises or other similar acts.
4. In the book on Insurance by De Leon and De Leon Jr., (2014 Ed.), the author noted that " in
reality all insurance companies now state in their contracts that the policy
will be avoided upon any and all acts of the insured that increases the risks."
“SEC. 173. If there is no
valuation in the policy, the measure of indemnity in an insurance against fire
is the expense it would be to the insured at the time of the commencement of
the fire to replace the thing lost or injured in the condition in which it was
at the time of the injury; but if there is a valuation in a policy of fire
insurance, the effect shall be the same as in a policy of marine insurance.
1.
Fire insurance is a contract of
indemnity, therefore, the extent of the recovery of the insured is only based on
the extent of his loss.
2.
If the policy includes a valuation of
the property insured, then such valuation is conclusive between the parties. This is what is mentioned in Section 158 in a policy of marine insurance. From
such valuation, the parties will determine the extent of actual or partial
loss.
3.
If there is no valuation in the policy,
the measure would be the cost of replacement or repair of the property lost.
4.
Co-insurance clause. – Most fire insurance
policies include a co-insurance clause which means that the value of the
property where the premium on the insurance policy is based, must be close to
the actual value of the property. This encourages the insured to declare the
correct value of the property or the nearest approximate. Otherwise, if the
value declared is substantially less than the actual value of the property, the
insured is automatically made a co-insurer.
5.
What is the significance if the insured
is considered a co-insurer?
In case of partial loss, the insurer will not pay the full value of the loss but only such amount proportionate to the value declared. The rest of the loss shall be shouldered by the insured who undervalued his property.
In case of partial loss, the insurer will not pay the full value of the loss but only such amount proportionate to the value declared. The rest of the loss shall be shouldered by the insured who undervalued his property.
“SEC. 174. Whenever the
insured desires to have a valuation named in his policy, insuring any building
or structure against fire, he may require such building or structure to be
examined by an independent appraiser and the value of the insured’s interest
therein may then be fixed as between the insurer and the insured. The cost of
such examination shall be paid for by the insured. A clause shall be inserted
in such policy stating substantially that the value of the insured’s interest
in such building or structure has been thus fixed. In the absence of any change
increasing the risk without the consent of the insurer or of fraud on the part
of the insured, then in case of a total loss under such policy, the whole
amount so insured upon the insured’s interest in such building or structure, as
stated in the policy upon which the insurers have received a premium, shall be
paid, and in case of a partial loss the full amount of the partial loss shall
be so paid, and in case there are two (2) or more policies covering the
insured’s interest therein, each policy shall contribute pro rata to the payment of such whole or
partial loss. But in no case shall the insurer be required to pay more than the
amount thus stated in such policy. This section shall not prevent the parties
from stipulating in such policies concerning the repairing, rebuilding or
replacing of buildings or structures wholly or partially damaged or destroyed.
“SEC. 175. No policy of
fire insurance shall be pledged, hypothecated, or transferred to any person,
firm or company who acts as agent for or otherwise represents the issuing
company, and any such pledge, hypothecation, or transfer hereafter made shall
be void and of no effect insofar as it may affect other creditors of the
insured.
“TITLE 3
“CASUALTY INSURANCE
“SEC. 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, employer’s 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.
1.
The more common or familiar non-life
insurance policies such as motor-vehicle liability insurance, personal accident
and health insurance are not governed by provisions specific to each of them
but all fall under the general classification of casualty insurance.
2.
Accident Insurance is one whereby the
insurer undertakes to reimburse the insured for pecuniary loss caused by
injuries due to accidents.
3.
Health Insurance – the insurer
undertakes to indemnify the insured of his pecuniary loss caused by health
related issues.
4.
Casualty Insurance is defined in Sec.
176 of the Insurance Code, by naming all kinds of insurance it encompasses. Sec.
176 is the lone provision under title 3 as there are no other provisions stated
in the Insurance Code that would expound further on the rights and obligations
of the parties in casualty insurance agreements. Thus, the rights and
obligations as stated in their individual contracts shall govern the
relationship of the parties in a casualty insurance contract.
(End of coverage for Final Exams)
Thank you and God bless :)