Finman General Assurance Corporation v. Honorable Court of Appeals
REITERATIONFacts
The Antecedents: Carlie Surposa was insured under a personal accident insurance policy with Finman General Assurance Corporation, with his parents and brothers as beneficiaries. While the policy was in force, Carlie died from a stab wound inflicted by three unidentified men without provocation while he and his cousin were waiting for a ride. The incident occurred after attending a festival. Procedural History: The beneficiaries filed a claim, which petitioner denied, asserting that murder and assault were not within the policy's coverage. Private respondent Julia Surposa then filed a complaint with the Insurance Commission, which ordered petitioner to pay P15,000.00 plus interest. The Court of Appeals affirmed this decision. The Petition: Petitioner filed a petition for certiorari, alleging grave abuse of discretion by the Court of Appeals in applying the principle of expresso unius exclusio alterius. Petitioner argued that death from murder and assault should be impliedly excluded as they are not accidental but deliberate acts, and thus not covered by a personal accident policy.
Issue(s)
Whether death resulting from murder and assault is covered by a personal accident insurance policy. Whether the principle of expresso unius exclusio alterius applies in interpreting the exclusions of the insurance policy.
Ruling
The petition is denied for lack of merit. The Court of Appeals' decision affirming the Insurance Commission's order for petitioner to pay the proceeds of the policy with interest is upheld.
Ratio Decidendi
On the issue of coverage for death from murder and assault: The Court held that the terms "accident" and "accidental" in insurance contracts are construed in their ordinary and common acceptation, meaning events that happen by chance or fortuitously, without intention and design, and which are unexpected, unusual, and unforeseen. Death or injury is not considered accidental if it is the natural result of the insured's voluntary act. However, in this case, the insured was on his way home and was confronted by unidentified persons. The record does not show any voluntary act on the part of the insured that led to the stabbing, nor does it indicate that the assailant specifically targeted the insured with the intent to kill. Therefore, the happening was a pure accident from the victim's perspective, as it occurred without his foresight or expectation and proceeded from an unusual effect of a known cause. On the application of expresso unius exclusio alterius: The Court affirmed the applicability of the principle of expresso unius exclusio alterius (the mention of one thing implies the exclusion of another). The personal accident insurance policy enumerated specific circumstances under which no liability would attach to the insurer. Since murder and assault were not expressly included in this enumeration of excluded risks, they could not be considered excluded by implication. The failure of the petitioner to include death resulting from murder or assault among the prohibited risks led to the conclusion that it did not intend to limit or exempt itself from liability for such death. Furthermore, contracts of insurance are to be construed liberally in favor of the insured and strictly against the insurer, and any ambiguity in the words of the contract should be interpreted in favor of its beneficiary, as provided by Article 1377 of the Civil Code.
Main Doctrine
Death resulting from murder or assault is covered by a personal accident insurance policy if these risks are not expressly excluded in the enumeration of circumstances negating liability, applying the principle of expresso unius exclusio alterius and construing the policy liberally in favor of the insured.