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FINMAN GENERAL ASSURANCE CORPORATION v. CA

FACTS:

Carlie Surposa was insured with Finman General Assurance Corporation under a personal accident insurance policy. While the policy was in effect, Carlie Surposa was killed as a result of a stab wound inflicted by unidentified individuals. The beneficiaries of the insurance policy filed a claim for the proceeds, but the insurance company denied the claim, arguing that murder and assault were not covered under the policy. The Insurance Commission ordered the insurance company to pay the proceeds of the policy, which was affirmed by the Court of Appeals.

ISSUES:

  1. Whether death resulting from murder and assault is covered under the personal accident insurance policy.

  2. Whether the principle of "expressio unius exclusio alterius" applies in this case.

RULING:

  1. The Supreme Court held that death resulting from murder and assault is covered under the personal accident insurance policy. The Court explained that the terms "accident" and "accidental" in insurance contracts are construed in their ordinary and common meaning, which means something that happens by chance or fortuitously, without intention and design, and is unexpected, unusual, and unforeseen. The Court applied the rule that death or injury does not result from an accident within the terms of an accident policy if it is the natural result of the insured's voluntary act, unaccompanied by anything unforeseen except the death or injury. However, if something unforeseen occurs in the doing of the act which produces the injury, the resulting death is within the protection of the policy.

  2. The Court also ruled that the principle of "expressio unius exclusio alterius" does not apply in this case. The personal accident insurance policy specifically enumerated ten circumstances wherein no liability attaches to the insurance company, and murder and assault were not included in this enumeration. Therefore, the insurance company cannot be discharged from liability for death resulting from murder or assault. The Court further emphasized that contracts of insurance should be construed liberally in favor of the insured and strictly against the insurer, and any ambiguity should be interpreted in favor of the beneficiary of the contract.

PRINCIPLES:

  • The terms "accident" and "accidental" in insurance contracts are construed in their ordinary and common acceptation, meaning something that happens by chance or fortuitously, without intention and design, and is unexpected, unusual, and unforeseen.

  • Death or injury does not result from an accident within the terms of an accident policy if it is the natural result of the insured's voluntary act, unaccompanied by anything unforeseen except the death or injury.

  • The principle of "expressio unius exclusio alterius" applies when the enumeration of one thing implies the exclusion of another thing in a contract. However, if a prohibited risk is not expressly included in the enumeration, it cannot be considered by implication to discharge the insurer from liability.

  • Contracts of insurance should be construed liberally in favor of the insured and strictly against the insurer, and any ambiguity should be interpreted in favor of the beneficiary of the contract.