Title
Sun Life of Canada , Inc. vs. Sibya
Case
G.R. No. 211212
Decision Date
Jun 8, 2016
Insured disclosed 1987 kidney treatment; Sun Life denied claim citing undisclosed 1994 treatment. SC ruled no concealment, upheld incontestability clause, ordered death benefits paid.
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Case Summary (G.R. No. 211212)

Petition for Review on Certiorari

  • The case involves a petition for review on certiorari under Rule 45 of the Rules of Court.
  • The petitioner, Sun Life of Canada (Philippines), Inc., seeks to annul the Decision and Resolution of the Court of Appeals (CA).
  • The CA affirmed the Regional Trial Court (RTC) ruling, which ordered Sun Life to pay death benefits and damages to the respondents.
  • The CA modified the RTC decision by absolving Sun Life from charges of violating the Insurance Code.

Statement of Facts

  • Atty. Jesus Sibya, Jr. applied for life insurance with Sun Life on January 10, 2001, disclosing prior kidney treatment.
  • Sun Life approved the application and issued Insurance Policy No. 031097335 on February 5, 2001, naming the respondents as beneficiaries.
  • Atty. Jesus Jr. died on May 11, 2001, from a gunshot wound, prompting Ma. Daisy to file a claim for death benefits.
  • Sun Life denied the claim, citing non-disclosure of Atty. Jesus Jr.'s medical history and subsequently filed a Complaint for Rescission against the respondents.

Ruling of the RTC

  • The RTC dismissed Sun Life's complaint on March 16, 2009, ruling that Sun Life violated the Insurance Code by refusing to pay the claim.
  • The RTC found no material concealment or misrepresentation by Atty. Jesus Jr. in his insurance application.
  • The court ordered Sun Life to pay P1,000,000.00 in death benefits, along with moral and exemplary damages, and attorney's fees.

Ruling of the CA

  • The CA affirmed the RTC's decision on November 18, 2013, ordering Sun Life to pay the death benefits and damages.
  • The CA modified the RTC's ruling by absolving Sun Life from violations of the Insurance Code, finding no fraudulent intent in Atty. Jesus Jr.'s application.
  • Sun Life's Motion for Partial Reconsideration was denied on February 13, 2014, leading to the petition for review.

Main Issue

  • The primary issue is whether the CA erred in affirming the RTC's finding that there was no concealment or misrepresentation in Atty. Jesus Jr.'s insurance application.

Ruling of the Court

  • The Supreme Court found the petition without merit, referencing the precedent set in Manila Bankers Life Insurance Corporation v. Aban.
  • The Court emphasized that if the insured dies within the two-year contestability period, the insurer must fulfill its obligations under the policy.
  • Sun Life's right to rescind the policy was rendered moot by Atty. Jesus Jr.'s death occurring only three months after the policy's issuance.

Findings on Concealment and Misrepresentation

  • The Court agreed with the CA's conclusion that Sun Life failed to demonstrate concealment or misrepresentation by Atty. Jesus Jr.
  • Atty. Jesus Jr. had disclosed his medical history and authorized Sun Life to investigate further.
  • The Court noted that Atty. Jesus Jr.&#...continue reading

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