Title
Sun Insurance Office, Ltd. vs. Court of Appeals
Case
G.R. No. 92383
Decision Date
Jul 17, 1992
The court found Sun Insurance liable for the full policy value due to Felix Lim, Jr.'s accidental death, rejecting claims of willful peril.
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Case Digest (G.R. No. 92383)

Facts:

  • Sun Insurance Office, Ltd. is the petitioner; Nerissa Lim is the respondent.
  • The petitioner issued Personal Accident Policy No. 05687 to Felix Lim, Jr. with a face value of P200,000.00.
  • Felix Lim, Jr. died from a bullet wound to the head on October 6, 1982, two months after the policy was issued.
  • The incident occurred after a birthday party for his mother.
  • Nerissa Lim, the beneficiary, filed a claim for the insurance payout, which was denied by the petitioner.
  • The petitioner acknowledged the death was not a suicide but argued it did not qualify as an accident.
  • Pilar Nalagon, Lim's secretary, was the only eyewitness; she testified that Lim was in a good mood and playing with his handgun, which he believed was unloaded.
  • Despite Nalagon's warning, Lim pointed the gun at his temple, and it discharged, resulting in his death.
  • After the claim denial, Nerissa Lim sued in the Regional Trial Court of Zamboanga City, which ruled in her favor.
  • The Court of Appeals upheld the decision, leading the petitioner to appeal to the Supreme Court.

Issue:

  • (Unlock)

Ruling:

  • The Supreme Court ruled that Felix Lim, Jr.'s death was an accident covered by the insurance policy.
  • The Court found that he did not willfully expose himself to needless peril, so his claim was not barred by the policy's exceptions.
  • The Court held tha...(Unlock)

Ratio:

  • The Supreme Court defined "accident" in insurance contracts as events occurring unexpectedly and without intention.
  • The Court concluded that the death was an accident due to the unforeseen discharge of the gun.
  • The petitioner argued that Lim's action of pointing the gun constituted willful exposure to peril; however, the Court noted Lim believed the gun was unloaded and did not act with reckless disregard for his life.
  • The distinction was made between willful exposure ...continue reading

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