Case Digest (G.R. No. 119655) Core Legal Reasoning Model
Core Legal Reasoning Model
Facts:
In Fire Insurance Policy No. 136171 dated January 22, 1987, private respondent Fortune Life and General Insurance Co., Inc. (“FORTUNE”) insured a two‐storey residential building of petitioners Sps. Antonio A. Tibay and Violeta R. Tibay and the Roraldo family at 5855 Zobel Street, Makati City, for ₱600,000 covering January 23, 1987 to January 23, 1988. The total premium was ₱2,983.50, of which petitioner Violeta Tibay paid only ₱600 on January 23, 1987, leaving a substantial balance unpaid. On March 8, 1987, a fire completely destroyed the insured building. Two days later (March 10, 1987) she paid the remaining premium and filed a claim. FORTUNE’s adjuster, Goodwill Adjustment Services, Inc., investigated under a non‐waiver agreement signed March 28, 1987. By letter dated June 11, 1987, FORTUNE denied coverage for breach of Policy Condition No. 2 and Section 77 of the Insurance Code. After failing to settle before the Insurance Commission, petitioners sued on March 3, 1988 for ₱6 Case Digest (G.R. No. 119655) Expanded Legal Reasoning Model
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)