Case Digest (G.R. No. 211212) Core Legal Reasoning Model
Core Legal Reasoning Model
Facts:
In Sun Life of Canada (Philippines), Inc. v. Ma. Daisy’s Sibya et al., Atty. Jesus S. Sibya, Jr. applied for life insurance with Sun Life on January 10, 2001, disclosing a 1987 kidney lithotripsy treated at the National Kidney Institute and authorizing Sun Life to verify his medical records. On February 5, 2001, Sun Life issued Policy No. 031097335 naming Ma. Daisy S. Sibya, Jesus Manuel S. Sibya III, and Jaime Luis S. Sibya as beneficiaries of a ₱1,000,000 death benefit. Atty. Sibya was fatally shot on May 11, 2001 in San Joaquin, Iloilo, prompting Ma. Daisy to file for the death benefit. Sun Life denied the claim on August 27, 2001, insisting that Sibya failed to disclose subsequent kidney treatments in 1994 and refunded only the premiums. The respondents pressed their claim, leading Sun Life to file a Complaint for Rescission in RTC Makati (Civil Case No. 01-1506), alleging material misrepresentation and concealment that would have prevented issuance of the policy. The respon Case Digest (G.R. No. 211212) Expanded Legal Reasoning Model
Expanded Legal Reasoning Model
Facts:
- Insurance Application and Policy Issuance
- On January 10, 2001, Atty. Jesus Sibya, Jr. applied for life insurance with Sun Life of Canada (Philippines), Inc., declaring a 1987 kidney lithotripsy under Dr. Mendoza at the National Kidney Institute, with no claimed recurrence.
- On February 5, 2001, Sun Life approved the application and issued Policy No. 031097335, naming Ma. Daisy S. Sibya, Jesus Manuel S. Sibya III, and Jaime Luis S. Sibya as beneficiaries, with a P1,000,000 death benefit if death occurred before February 5, 2021.
- Death of the Insured and Claim Denial
- On May 11, 2001, Atty. Jesus Jr. died from a gunshot wound; Ma. Daisy filed a Claimant’s Statement for the P1,000,000 death benefit.
- On August 27, 2001, Sun Life denied the claim for alleged non-disclosure of prior treatment at the National Kidney Transplant Institute in 1994 and refunded premiums instead.
- Judicial Proceedings
- Sun Life filed a Complaint for Rescission before the RTC, alleging concealment of renal-failure treatment in 1994. Respondents countered that the insured acted in good faith and authorized Sun Life to verify his history.
- On March 16, 2009, the RTC (Makati, Branch 136) dismissed Sun Life’s complaint, held no material misrepresentation, and ordered payment of P1,000,000 death benefits plus P100,000 moral damages, P100,000 exemplary damages, and P100,000 attorney’s fees and costs.
- On November 18, 2013, the CA affirmed the RTC’s award of benefits and damages but absolved Sun Life of violations of Sections 241 and 242 of the Insurance Code; its denial of reconsideration on February 13, 2014 was likewise affirmed.
- Sun Life filed a petition for review on certiorari under Rule 45 before the Supreme Court.
Issues:
- Whether the Court of Appeals erred in finding that Atty. Jesus Sibya, Jr. committed no concealment or misrepresentation in his insurance application.
- Whether Sun Life lost its right to rescind the policy upon the insured’s death within the two-year contestability period under Section 48 of Presidential Decree No. 612.
Ruling:
- (Subscriber-Only)
Ratio:
- (Subscriber-Only)
Doctrine:
- (Subscriber-Only)