Case Summary (G.R. No. 224863)
Policy Provisions and Death Claim
Policy No. 61761 excluded suicide within two years, refunding only paid premiums less indebtedness. Upon Reuben’s death on Apr 15 from a gunshot wound, Susan presented the policy and death certificate, claiming the full face value.
Insurer’s Investigation and Claim Denial
Fortune investigated, relying on a Clinical Abstract by Dr. Pagayatan recording Randolph’s statement that Reuben had expressed a desire to die moments before the shooting. Fortune denied the P15 M claim as an excepted suicide risk and refunded P80,643 (premiums less service charge), which Susan refused. Susan then sued for money and damages.
Trial Court’s Findings and Judgment
The RTC ruled in Susan’s favor, finding no insurable-interest defect and holding Fortune failed to prove suicide by preponderance. The court disallowed Randolph’s statement as res gestae, discounted Dr. Fortun’s testimony on gunpowder residue, and credited Dr. Nulud’s autopsy findings indicating an accident. The RTC awarded P15 million plus 12% interest from May 18 2011, P50,000 attorney’s fees, and costs.
Court of Appeals’ Reversal
The CA set aside the RTC decision, dismissing the complaint. It deemed Randolph’s statement to Dr. Pagayatan spontaneous and admissible, accepted Dr. Fortun’s opinion that bullet trajectory and absence of residue supported suicide, and concluded the death was self-inflicted, an excluded risk.
Issues on Laches and Burden of Proof
The SC addressed: (1) whether Fortune waived its objection to Susan’s late motion for reconsideration (one day beyond 15-day period), and (2) whether Fortune bore the burden to prove that Reuben’s death resulted from suicide.
Admissibility of Res Gestae Statements
The Court held Randolph’s statement to Dr. Pagayatan inadmissible hearsay, not within the limited res gestae exception. Dr. Pagayatan lacked personal knowledge, and the statement occurred after sufficient time for reflection.
Credibility of Expert Testimony
The SC found Dr. Fortun’s testimony insufficient to establish suicide: she did not perform an autopsy or scene examination, relied solely on documents (including Dr. Nulud’s report), and admitted her expertise did not cover forensic chemistry. Conversely, Dr. Nulud’s hands-on autopsy, extensive medico-legal experience, and negative paraffin test supported an accidental shooting.
Accident versus Suicide Determination
Weight was given to Dr. Nulud’s findings (bullet trajectory, no muzzle imprint, negative paraffin) and police investigator Caramat’s conclusion of accidental discharge. Dr. Fortun’s concession that a front-to-back wound could occur accidentally further weakened the suicide theory.
Insurable Interest and Liability Extent
Susan’s insurable interest as creditor was valid under Section 10(c) of the Insurance Code. The policy assignment letter covered indebtedness “up to the extent” of Susan’s claim, without limiting to pre-policy investments. At death, Reuben owed Susan P16 million, but Susan had already received P2 million from Rossana, leaving P14 million outstanding.
Computation of Recoverable Amount
Consistent with anti-wagering
Case Syllabus (G.R. No. 224863)
Antecedents
- On February 17, 2011, petitioner Susan Co Dela Fuente invested ₱2,000,000 in Reuben Protacio’s lending business; she added ₱1,000,000 on March 3 and another ₱1,000,000 on March 14, totaling ₱4,000,000 before the insurance policy.
- On March 10, 2011, Reuben applied for a ₱15,000,000 life insurance policy with Fortune Life Insurance Co., Inc., naming Susan as revocable beneficiary; policy No. 61761 issued on March 25, 2011 upon payment of ₱82,500, containing a two-year suicide exclusion.
- On March 28, 2011, Susan invested an additional ₱12,000,000, bringing her total investment to ₱16,000,000.
- Reuben died April 15, 2011 from a chest gunshot wound; Medico-Legal Report No. M-239-2011 by Dr. Voltaire P. Nulud confirmed “gunshot wound, trunk.”
- Fortune’s investigation included Dr. Allen Pagayatan’s clinical abstract quoting Reuben’s brother Randolph that Reuben “already wanted to die”; Fortune denied Susan’s claim and refunded ₱80,643 net premiums, which Susan refused.
RTC Decision
- The Regional Trial Court granted Susan’s complaint, ordering Fortune to pay ₱15,000,000 plus 12% interest from May 18, 2011, ₱50,000 attorney’s fees, and costs.
- Held that Randolph’s statement to Dr. Pagayatan was not part of res gestae due to lapse of time; Dr. Raquel Fortun’s expert testimony lacked weight absent personal examination; Fortune failed to prove suicide by preponderance.
CA Decision
- The Court of Appeals reversed and dismissed Susan’s complaint.
- Found Reuben’s death to be suicide based on:
- Admissibility of Randolph’s statement as spontaneous res gestae to Dr. Pa