Saturday, March 03, 2012

Edillon vs. Manila Bankers Life Insurance Corporation [G.R. No. L-34200, 117 SCRA 187, September 30, 1982]

Facts: Sometime in April 1969, Carmen O, Lapuz applied Manila Bankers for insurance coverage against accident and injuries. She filled up the blank application form given to her and filed the same with the respondent insurance corporation. In the said application form she gave the date of her birth as July 11, 1904. On the same date, she paid the sum of P20.00 representing the premium for which she was issued the corresponding receipt signed by an authorized agent of Manila Bankers. Upon the filing and the payment of the premium, the respondent insurance corporation issued to Carmen O. Lapuz its Certificate of Insurance. The policy was to be effective for a period of 90 days. During the effectivity of the certificate of insurance Carmen Lapuz died on a vehicular accident in the North Diversion Road. On June 7, 1969, petitioner Regina L. Edillon, a sister of the insured and who was the named beneficiary in the policy, filed her claim for the proceeds of the insurance, submitting all the necessary papers and other requisites. However, her claim was denied by the respondent corporation hence her filing of complaint in the Court of First Instance of Rizal on August 27, 1969. The respondent insurance corporation asserts that since Carmen Lapuz was over 60 years of age the policy in question was null and void because there is a provision in the certificate of insurance excluding its liability to pay claims under the policy in behalf of persons who are under the age of sixteen (16) years of age or over the age of sixty (60) years. The trial court dismissed the complaint. Hence, this petition. 

Issue: Whether or not the acceptance by the private respondent insurance corporation of the premium and the issuance of the corresponding certificate of insurance should be deemed a waiver of the exclusionary condition of overage stated in the said certificate of insurance 

Held: Yes. The age of the insured Carmen 0. Lapuz was not concealed to the insurance company. Her application for insurance coverage which was on a printed form furnished by private respondent and which contained very few items of information clearly indicated her age of the time of filing the same to be almost 65 years of age. Despite such information which could hardly be overlooked in the application form, considering its prominence thereon and its materiality to the coverage applied for, the respondent insurance corporation received her payment of premium and issued the corresponding certificate of insurance without question. The accident which resulted in the death of the insured, a risk covered by the policy, occurred on May 31, 1969 or FORTY-FIVE (45) DAYS after the insurance coverage was applied for. There was sufficient time for the private respondent to process the application and to notice that the applicant was over 60 years of age and thereby cancel the policy on that ground if it was minded to do so. If the private respondent failed to act, it is either because it was willing to waive such disqualification; or, through the negligence or incompetence of its employees for which it has only itself to blame, it simply overlooked such fact. Under the circumstances, the insurance corporation is already deemed in estoppel. Its inaction to revoke the policy despite a departure from the exclusionary condition contained in the said policy constituted a waiver of such condition 

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