Title
Spouses Tibay vs. Court of Appeals
Case
G.R. No. 119655
Decision Date
May 24, 1996
Fire insurance claim denied due to unpaid premium; policy invalid under Insurance Code. Supreme Court upheld insurer's non-liability, emphasizing full payment as essential for validity.

Case Digest (G.R. No. 119655)
Expanded Legal Reasoning Model

Facts:

  • Policy Issuance and Premium Payment
    • On January 22, 1987, Fortune Life and General Insurance Co., Inc. issued Fire Insurance Policy No. 136171 covering a two-storey residential building and contents of Violeta R. Tibay and/or Nicolas M. Roraldo at 5855 Zobel Street, Makati City, for ₱600,000.00, effective January 23, 1987 to January 23, 1988.
    • The total premium was set at ₱2,983.50, but on January 23, 1987, only ₱600.00 was paid, leaving a balance of ₱2,383.50.
  • Fire Loss, Claim, and Non-Waiver Agreement
    • On March 8, 1987, the insured building was completely destroyed by fire.
    • On March 10, 1987, Violeta Tibay paid the remaining premium and filed a claim with Fortune, which referred adjustment to Goodwill Adjustment Services, Inc.
    • On March 28, 1987, Tibay signed a “non-waiver agreement” with the adjuster, preserving Fortune’s right to invoke all policy conditions and defenses.
  • Administrative Denial and Judicial Proceedings
    • By letter dated June 11, 1987, Fortune denied the claim, citing violation of Policy Condition No. 2 (prepayment) and Section 77 of the Insurance Code. Attempts at settlement before the Insurance Commission failed.
    • On March 3, 1988, petitioners sued Fortune for ₱600,000.00 indemnity, 12% annual interest, ₱100,000.00 moral damages, and 20% attorney’s fees.
    • On July 19, 1990, the trial court ruled in favor of petitioners, awarding the full policy amount plus legal interest, attorney’s fees, and costs.
    • On March 24, 1995, the Court of Appeals reversed, holding the policy never became binding due to non-prepayment of premium, and ordering refund of the entire premium (₱2,983.50) plus 12% interest from March 10, 1987.

Issues:

  • Whether a fire insurance policy that stipulates full prepayment as a condition precedent becomes valid and enforceable upon mere partial payment followed by payment of the balance only after the loss.
  • Whether Fortune’s acceptance of partial premium or referral of the claim to its adjuster impliedly waived the full-payment condition or estopped it from relying on such condition.

Ruling:

  • (Subscriber-Only)

Ratio:

  • (Subscriber-Only)

Doctrine:

  • (Subscriber-Only)

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