SECOND DIVISION
UNITED MERCHANTS CORPORATION, Petitioner, - versus - COUNTRY BANKERS INSURANCE CORPORATION, Respondent. |
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G.R. No. 198588 Present: CARPIO, J.,
Chairperson, BRION, PEREZ, SERENO, and REYES, JJ. Promulgated: July 11, 2012 |
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D E C I S I O N
CARPIO, J.:
The Case
This Petition for Review on Certiorari[1] seeks to reverse the Court
of Appeals Decision[2] dated 16 June 2011 and its
Resolution[3] dated 8 September 2011 in
CA-G.R. CV No. 85777. The Court of Appeals reversed the Decision[4] of the Regional Trial
Court (RTC) of Manila, Branch 3, and ruled that the claim on the Insurance
Policy is void.
The Facts
The facts, as culled from the records,
are as follows:
Petitioner United Merchants
Corporation (UMC) is engaged in the business of buying, selling, and
manufacturing Christmas lights. UMC leased a warehouse at 19-B Dagot Street,
San Jose Subdivision, Barrio Manresa, Quezon City, where UMC assembled and
stored its products.
On 6 September 1995, UMCs General
Manager Alfredo Tan insured UMCs stocks
in trade of Christmas lights against fire with defendant Country Bankers
Insurance Corporation (CBIC) for P15,000,000.00. The Fire Insurance Policy No. F-HO/95-576
(Insurance Policy) and Fire Invoice No. 12959A, valid until 6 September 1996,
states:
AMOUNT OF INSURANCE: FIFTEEN
MILLION PESOS
PHILIPPINE
CURRENCY
x x x
PROPERTY INSURED: On stocks in trade only, consisting of Christmas
Lights, the properties of the Assured or held by them in trust, on commissions,
or on joint account with others and/or for which they are responsible in the
event of loss and/or damage during the currency of this policy, whilst
contained in the building of one lofty storey in height, constructed of
concrete and/or hollow blocks with portion of galvanized iron sheets, under
galvanized iron rood, occupied as Christmas lights storage.[5]
On 7 May 1996, UMC and CBIC executed
Endorsement F/96-154 and Fire Invoice No. 16583A to form part of the Insurance
Policy. Endorsement F/96-154 provides that UMCs stocks in trade were insured
against additional perils, to wit: typhoon, flood, ext. cover, and full
earthquake. The sum insured was also increased to P50,000,000.00 effective
7 May 1996 to 10 January 1997. On 9 May 1996, CBIC issued Endorsement F/96-157
where the name of the assured was changed from Alfredo Tan to UMC.
On 3 July 1996, a
fire gutted the warehouse rented by UMC. CBIC designated CRM Adjustment
Corporation (CRM) to investigate and evaluate UMCs loss by reason of the fire.
CBICs reinsurer, Central Surety, likewise requested the National Bureau of
Investigation (NBI) to conduct a parallel investigation. On 6 July 1996, UMC,
through CRM, submitted to CBIC its Sworn Statement of Formal Claim, with proofs
of its loss.
On 20 November 1996, UMC demanded for
at least fifty percent (50%) payment of its claim from CBIC. On 25 February
1997, UMC received CBICs letter, dated 10 January 1997, rejecting UMCs claim
due to breach of Condition No. 15 of the Insurance Policy. Condition No. 15
states:
If the claim be in any respect fraudulent, or if any false
declaration be made or used in support thereof, or if any fraudulent means or
devices are used by the Insured or anyone acting in his behalf to obtain any
benefit under this Policy; or if the loss or damage be occasioned by the
willful act, or with the connivance of the Insured, all the benefits under this
Policy shall be forfeited.[6]
On 19 February 1998, UMC filed a Complaint[7] against CBIC with the RTC
of Manila. UMC anchored its insurance claim on the Insurance Policy, the Sworn
Statement of Formal Claim earlier submitted, and the Certification dated 24
July 1996 made by Deputy Fire Chief/Senior Superintendent Bonifacio J. Garcia
of the Bureau of Fire Protection. The Certification dated 24 July 1996 provides
that:
This is to certify that
according to available records of this office, on or about 6:10 P.M. of July 3,
1996, a fire broke out at United Merchants Corporation located at 19-B Dag[o]t
Street, Brgy. Manresa, Quezon City incurring an estimated damage of Fifty-Five
Million Pesos (P55,000,000.00) to the building and contents, while the
reported insurance coverage amounted to Fifty Million Pesos (P50,000,000.00)
with Country Bankers Insurance Corporation.
The Bureau
further certifies that no evidence was gathered to prove that the establishment
was willfully, feloniously and intentionally set on fire.
That the
investigation of the fire incident is already closed being ACCIDENTAL in
nature.[8]
In its Answer with Compulsory
Counterclaim[9]
dated 4 March 1998, CBIC admitted the
issuance of the Insurance Policy to UMC but raised the following defenses: (1)
that the Complaint states no cause of action; (2) that UMCs claim has already prescribed; and
(3) that UMCs fire claim is tainted with fraud. CBIC alleged that UMCs claim was fraudulent
because UMCs Statement of Inventory showed that it had no stocks in trade as
of 31 December 1995, and that UMCs
suspicious purchases for the year 1996 did not even amount to P25,000,000.00.
UMCs GIS and Financial Reports further revealed that it had insufficient
capital, which meant UMC could not afford the alleged P50,000,000.00
worth of stocks in trade.
In its Reply[10] dated 20 March 1998, UMC
denied violation of Condition No. 15 of the Insurance Policy. UMC claimed that
it did not make any false declaration because the invoices were genuine and the
Statement of Inventory was for internal revenue purposes only, not for its
insurance claim.
During trial, UMC presented five
witnesses. The first witness was Josie Ebora (Ebora), UMCs disbursing officer.
Ebora testified that UMCs stocks in trade, at the time of the fire, consisted
of: (1) raw materials for its Christmas lights; (2) Christmas lights already assembled; and (3)
Christmas lights purchased from local suppliers. These stocks in trade were
delivered from August 1995 to May 1996. She stated that Straight Cargo Commercial
Forwarders delivered the imported materials to the warehouse, evidenced by
delivery receipts. However, for the year 1996, UMC had no importations and only
bought from its local suppliers. Ebora identified the suppliers as Fiber
Technology Corporation from which UMC bought stocks worth P1,800,000.00
on 20 May 1996; Fuze Industries Manufacturer Philippines from which UMC bought
stocks worth P19,500,000.00 from 20 January 1996 to 23 February 1996;
and Tomco Commercial Press from which UMC bought several Christmas boxes. Ebora
testified that all these deliveries were not yet paid. Ebora also presented
UMCs Balance Sheet, Income Statement and Statement of Cash Flow. Per her
testimony, UMCs purchases amounted to P608,986.00 in 1994; P827,670.00
in 1995; and P20,000,000.00 in 1996. Ebora also claimed that UMC had
sales only from its fruits business but no sales from its Christmas lights for
the year 1995.
The next witness, Annie Pabustan
(Pabustan), testified that her company provided about 25 workers to assemble
and pack Christmas lights for UMC from 28 March 1996 to 3 July 1996. The third
witness, Metropolitan Bank and Trust Company (MBTC) Officer Cesar Martinez,
stated that UMC opened letters of credit with MBTC for the year 1995 only. The
fourth witness presented was Ernesto Luna (Luna), the delivery checker of
Straight Commercial Cargo Forwarders. Luna affirmed the delivery of UMCs goods
to its warehouse on 13 August 1995, 6 September 1995, 8 September 1995, 24 October 1995, 27
October 1995, 9 November 1995, and 19 December 1995. Lastly, CRMs adjuster
Dominador Victorio testified that he inspected UMCs warehouse and prepared
preliminary reports in this connection.
On the other hand, CBIC presented the
claims manager Edgar Caguindagan (Caguindagan), a Securities and Exchange
Commission (SEC) representative, Atty. Ernesto Cabrera (Cabrera), and NBI
Investigator Arnold Lazaro (Lazaro). Caguindagan testified that he inspected
the burned warehouse on 5 July 1996, took pictures of it and referred the claim
to an independent adjuster. The SEC representatives testimony was dispensed
with, since the parties stipulated on the existence of certain documents, to
wit: (1) UMCs GIS for 1994-1997; (2) UMCs Financial Report as of 31 December 1996; (3) SEC Certificate
that UMC did not file GIS or Financial Reports for certain years; and (4) UMCs
Statement of Inventory as of 31 December 1995 filed with the BIR.
Cabrera and Lazaro testified that they
were hired by Central Surety to investigate UMCs claim. On 19 November 1996,
they concluded that arson was committed based from their interview with barangay
officials and the pictures showing that blackened surfaces were present at
different parts of the warehouse. On cross-examination, Lazaro admitted that
they did not conduct a forensic investigation of the warehouse, nor did they
file a case for arson.
For rebuttal, UMC presented Rosalinda
Batallones (Batallones), keeper of the
documents of UCPB General Insurance, the insurer of Perfect Investment
Company, Inc., the warehouse owner. When
asked to bring documents related to the insurance of Perfect Investment
Company, Inc., Batallones brought the papers of Perpetual Investment, Inc.
The Ruling of the Regional Trial Court
On 16 June 2005, the RTC of Manila,
Branch 3, rendered a Decision in favor of UMC, the dispositive portion of which
reads:
WHEREFORE,
judgment is hereby rendered in favor of plaintiff and ordering defendant to pay
plaintiff:
a) the sum of P43,930,230.00
as indemnity with interest thereon at 6% per annum from November 2003 until fully paid;
b) the sum of P100,000.00
for exemplary damages;
c) the sum of P100,000.00
for attorneys fees; and
d) the costs of
suit.
Defendants
counterclaim is denied for lack of merit.
SO
ORDERED.[11]
The RTC found no dispute as to UMCs
fire insurance contract with CBIC. Thus, the RTC ruled for UMCs entitlement to
the insurance proceeds, as follows:
Fraud is never
presumed but must be proved by clear and convincing evidence. (see Alonso v.
Cebu Country Club, 417 SCRA 115 [2003]) Defendant failed to establish by clear
and convincing evidence that the documents submitted to the SEC and BIR were
true. It is common business practice for corporations to have 2 sets of
reports/statements for tax purposes. The stipulated documents of plaintiff
(Exhs. 2 8) may not have been accurate.
The conflicting
findings of defendants adjuster, CRM Adjustment [with stress] and that
made by Atty. Cabrera & Mr. Lazaro for Central Surety shall be resolved in
favor of the former. Definitely the formers finding is more credible as it was
made soon after the fire while that of the latter was done 4 months later.
Certainly it would be a different situation as the site was no longer the same
after the clearing up operation which is normal after a fire incident. The
Christmas lights and parts could have been swept away. Hence the finding of the
latter appears to be speculative to benefit the reinsurer and which defendant
wants to adopt to avoid liability.
The CRM
Adjustment report found no arson and confirmed substantial stocks in the
burned warehouse (Exhs. QQQ) [underscoring supplied]. This is bolstered by
the BFP certification that there was no proof of arson and the fire was
accidental (Exhs. PPP). The certification by a government agency like BFP is
presumed to be a regular performance of official duty. Absent convincing
evidence to the contrary, the presumption of regularity in the performance of
official functions has to be upheld. (People vs. Lapira, 255 SCRA 85) The
report of UCPB General Insurances adjuster also found no arson so that the
burned warehouse owner PIC was indemnified.[12]
Hence, CBIC
filed an appeal with the Court of Appeals (CA).
The Ruling of the Court of Appeals
On 16 June 2011, the CA promulgated
its Decision in favor of CBIC. The dispositive portion of the Decision reads:
WHEREFORE, in view of the foregoing
premises, the instant appeal is GRANTED and the
Decision of the Regional Trial Court, of the National Judicial Capital
Region, Branch 3 of the City of Manila dated June 16, 2005 in Civil Case No.
98-87370 is REVERSED and SET ASIDE. The
plaintiff-appellees claim upon its insurance policy is deemed avoided.
SO ORDERED.[13]
The CA ruled that UMCs claim under
the Insurance Policy is void. The CA found that the fire was intentional in
origin, considering the array of evidence submitted by CBIC, particularly the
pictures taken and the reports of Cabrera and Lazaro, as opposed to UMCs
failure to explain the details of the alleged fire accident. In addition, it
found that UMCs claim was overvalued through fraudulent transactions. The CA
ruled:
We have
meticulously gone over the entirety of the evidence submitted by the parties
and have come up with a conclusion that the claim of the plaintiff-appellee was
indeed overvalued by transactions which were fraudulently concocted so that the
full coverage of the insurance policy will have to be fully awarded to the
plaintiff-appellee.
First, We turn to the backdrop of the plaintiff-appellees
case, thus, [o]n September 6, 1995 its stocks-in-trade were insured for Fifteen
Million Pesos and on May 7, 1996 the same was increased to 50 Million Pesos.
Two months thereafter, a fire gutted the plaintiff-appellees warehouse.
Second,
We consider the reported purchases of the plaintiff-appellee as shown in its
financial report dated December 31, 1996 vis--vis the testimony of Ms. Ebora
thus:
1994- P608,986.00
1995- P827,670.00
1996- P20,000,000.00 (more or less) which
were purchased for a period of one month.
Third,
We shall also direct our attention to the alleged true and complete purchases
of the plaintiff-appellee as well as the value of all stock-in-trade it had at
the time that the fire occurred. Thus:
Exhibit |
Source |
Amount (pesos) |
Dates Covered |
Exhs. P-DD, inclusive |
Fuze Industries Manufacturer Phils. |
19,550,400.00 |
January 20, 1996 January 31, 1996 February 12, 1996 February 20, 1996 February 23, 1996 |
Exhs.
EE-HH, inclusive |
Tomco
Commercial Press |
1,712,000.00 |
December 19, 1995 January 24, 1996 February 21, 1996 November 24, 1995 |
Exhs. II-QQ, inclusive |
Precious Belen Trading |
2,720,400.00 |
January 13, 1996 January 19, 1996 January 26, 1996 February 3, 1996 February 13, 1996 February 20, 1996 February 27, 1996 |
Exhs. RR- EEE, inclusive |
Wisdom
Manpower Services |
361,966.00 |
April 3, 1996 April 12, 1996 April 19, 1996 April 26, 1996 May 3, 1996 May 10, 1996 May 17, 1996 May 24, 1996 June 7, 1996 June 14, 1996 June 21, 1996 June 28, 1996 July 5, 1996 |
Exhs. GGG- NNN, inclusive |
Costs of Letters of Credit for imported raw materials |
15,159,144.71 |
May 29, 1995 June 15, 1995 July 5, 1995 September 4, 1995 October 2, 1995 October 27, 1995 January 8, 1996 March 19, 1996 |
Exhs. GGG-11 - GGG-24, HHH-12, HHH-22, III-11, III-14, JJJ-13,
KKK-11, LLL-5 |
SCCFI
statements of account |
384,794.38 |
June 15, 1995 June 28, 1995 August 1, 1995 September 4, 1995 September 8, 1995 September 11, 1995 October 30, 199[5] November 10, 1995 December 21, 1995 |
|
TOTAL |
44,315,024.31 |
|
Fourth,
We turn to the allegation of fraud by the defendant-appellant by thoroughly
looking through the pieces of evidence that it adduced during the trial. The
latter alleged that fraud is present in the case at bar as shown by the
discrepancy of the alleged purchases from that of the reported purchases made
by plaintiff-appellee. It had also averred that fraud is present when upon
verification of the address of Fuze Industries, its office is nowhere to be
found. Also, the defendant-appellant expressed grave doubts as to the purchases
of the plaintiff-appellee sometime in 1996 when such purchases escalated to a
high 19.5 Million Pesos without any contract to back it up.[14]
On 7 July 2011, UMC filed a Motion
for Reconsideration,[15] which the CA denied in
its Resolution dated 8 September 2011. Hence, this petition.
The Issues
UMC
seeks a reversal and raises the following issues for resolution:
I.
WHETHER THE COURT OF
APPEALS MADE A RULING INCO[N]SISTENT WITH LAW, APPLICABLE JURISPRUDENCE AND
EVIDENCE AS TO THE EXISTENCE OF ARSON AND FRAUD IN THE ABSENCE OF MATERIALLY
CONVINCING EVIDENCE.
II.
WHETHER THE
COURT OF APPEALS MADE A RULING INCONSISTENT WITH LAW, APPLICABLE JURISPRUDENCE
AND EVIDENCE WHEN IT FOUND THAT PETITIONER BREACHED ITS WARRANTY.[16]
The Ruling of the Court
At the outset, CBIC assails this
petition as defective since what UMC ultimately wants this Court to review are
questions of fact. However, UMC argues that where the findings of the CA are in
conflict with those of the trial court, a review of the facts may be made. On
this procedural issue, we find UMCs claim meritorious.
A petition for review under Rule 45 of the Rules of Court
specifically provides that only questions of law may be raised. The findings of
fact of the CA are final and conclusive and this Court will not review them on
appeal,[17]
subject to exceptions as when the findings of the appellate court conflict with
the findings of the trial court.[18]
Clearly, the present case falls under the exception. Since
UMC properly raised the conflicting findings of the lower courts, it is proper
for this Court to resolve such contradiction.
Having settled the procedural issue,
we proceed to the primordial issue which boils down to whether UMC is
entitled to claim from CBIC the full coverage of its fire insurance policy.
UMC contends that because it had
already established a prima facie case against CBIC which failed to
prove its defense, UMC is entitled to claim the full coverage under the
Insurance Policy. On the other hand, CBIC contends that because arson and fraud
attended the claim, UMC is not entitled to recover under Condition No. 15 of
the Insurance Policy.
Burden of proof is the duty of any party to present evidence to
establish his claim or defense by the amount of evidence required by law,[19] which is
preponderance of evidence in civil cases.[20] The party, whether
plaintiff or defendant, who asserts the affirmative of the issue has the burden
of proof to obtain a favorable judgment.[21] Particularly, in insurance
cases, once an insured makes out a prima
facie case in its favor, the burden of evidence shifts to the insurer to
controvert the insureds prima facie
case.[22] In the present case, UMC established a prima
facie case against CBIC. CBIC does not dispute that UMCs stocks in trade
were insured against fire under the Insurance Policy and that the warehouse,
where UMCs stocks in trade were stored, was gutted by fire on 3 July 1996,
within the duration of the fire insurance. However, since CBIC alleged an
excepted risk, then the burden of evidence shifted to CBIC to prove such
exception.
An insurer who seeks to defeat a
claim because of an exception or limitation in the policy has the burden of
establishing that the loss comes within the purview of the exception or
limitation.[23]
If loss is proved apparently within a contract of insurance,
the burden is upon the insurer to establish that the loss arose from a cause of
loss which is excepted or for which it is not liable, or from a cause which
limits its liability.[24]
In the present case, CBIC failed to discharge its primordial burden of
establishing that the damage or loss was caused by arson, a limitation in the
policy.
In prosecutions for arson, proof of
the crime charged is complete where the evidence establishes: (1) the corpus delicti, that is, a fire caused
by a criminal act; and (2) the identity of the defendants as the one
responsible for the crime.[25]
Corpus delicti means the substance of
the crime, the fact that a crime has actually been committed.[26]
This is satisfied by proof of the bare occurrence of the fire and of its having
been intentionally caused.[27]
In
the present case, CBICs evidence did not prove that the fire was intentionally
caused by the insured. First, the findings of CBICs witnesses, Cabrera
and Lazaro, were based on an investigation conducted more than four months
after the fire. The testimonies of Cabrera and Lazaro, as to the boxes doused
with kerosene as told to them by barangay officials, are hearsay because
the barangay officials were not presented in court. Cabrera and Lazaro
even admitted that they did not conduct a forensic investigation of the
warehouse nor did they file a case for arson.[28]
Second, the Sworn Statement of Formal Claim submitted by UMC, through
CRM, states that the cause of the fire was faulty electrical
wiring/accidental in nature. CBIC is bound by this evidence because in its
Answer, it admitted that it designated CRM to evaluate UMCs loss. Third,
the Certification by the Bureau of Fire Protection states that the fire was
accidental in origin. This Certification enjoys the presumption of regularity,
which CBIC failed to rebut.
Contrary to UMCs allegation, CBICs
failure to prove arson does not mean that it also failed to prove fraud. Qua
Chee Gan v. Law Union[29] does not apply in the present case.
In Qua Chee Gan,[30]
the Court dismissed the allegation of fraud based on the dismissal of the arson
case against the insured, because the evidence was identical in both cases,
thus:
While
the acquittal of the insured in the arson case is not res judicata on the
present civil action, the insurers evidence, to judge from the decision in the
criminal case, is practically identical in both cases and must lead to the same
result, since the proof to establish the defense of connivance at the fire in
order to defraud the insurer cannot be materially less convincing than that
required in order to convict the insured of the crime of arson (Bachrach vs.
British American Assurance Co., 17 Phil. 536). [31]
In the present case, arson and fraud
are two separate grounds based on two different sets of evidence, either of
which can void the insurance claim of UMC. The absence of one does not
necessarily result in the absence of the
other. Thus, on the allegation of
fraud, we affirm the findings of the Court of Appeals.
Condition
No. 15 of the Insurance Policy provides that all the benefits under the policy
shall be forfeited, if the claim be in any respect fraudulent, or if any false
declaration be made or used in support thereof, to wit:
15. If the claim be in any respect fraudulent, or if any false
declaration be made or used in support thereof, or if any fraudulent means or
devices are used by the Insured or anyone acting in his behalf to obtain any
benefit under this Policy; or if the loss or damage be occasioned by the
willful act, or with the connivance of the Insured, all the benefits under this
Policy shall be forfeited.
In
Uy Hu & Co. v. The Prudential Assurance Co., Ltd.,[32]
the Court held that where a fire insurance policy provides
that if the claim be in any respect fraudulent, or if any false declaration be
made or used in support thereof, or if any fraudulent means or devices are used
by the Insured or anyone acting on his behalf to obtain any benefit under this
Policy, and the evidence is conclusive that the proof of claim which the
insured submitted was false and fraudulent both as to the kind, quality and
amount of the goods and their value destroyed by the fire, such a proof of
claim is a bar against the insured from recovering on the policy even for the
amount of his actual loss.
In the present case, as proof of its
loss of stocks in trade amounting to P50,000,000.00, UMC submitted its
Sworn Statement of Formal Claim together with the following documents: (1)
letters of credit and invoices for raw materials, Christmas lights and cartons
purchased; (2) charges for assembling the Christmas lights; and (3) delivery
receipts of the raw materials. However, the charges for assembling the Christmas lights and delivery receipts
could not support its insurance claim. The Insurance Policy provides that CBIC
agreed to insure UMCs stocks in trade. UMC defined stock in trade as tangible personal
property kept for sale or traffic.[33] Applying
UMCs definition, only the letters of credit and invoices for raw materials,
Christmas lights and cartons may be considered.
The invoices, however, cannot be
taken as genuine. The invoices reveal that the stocks in trade purchased for
1996 amounts to P20,000,000.00 which were purchased in one month. Thus,
UMC needs to prove purchases amounting to P30,000,000.00 worth of stocks
in trade for 1995 and prior years. However, in the Statement of Inventory it
submitted to the BIR, which is considered an entry in official records,[34]
UMC stated that it had no stocks in trade as of 31 December 1995. In its
defense, UMC alleged that it did not include as stocks in trade the raw
materials to be assembled as Christmas lights, which it had on 31 December
1995. However, as proof of its loss, UMC submitted invoices for raw materials,
knowing that the insurance covers only stocks in trade.
Equally
important, the invoices (Exhibits P-DD) from Fuze Industries Manufacturer
Phils. were suspicious. The purchases, based on the invoices and without any
supporting contract, amounted to P19,550,400.00 worth of Christmas
lights from 20 January 1996 to 23 February 1996. The uncontroverted testimony
of Cabrera revealed that there was no Fuze Industries Manufacturer Phils.
located at 55 Mahinhin St., Teachers Village, Quezon City, the business
address appearing in the invoices and the records of the Department of Trade
& Industry. Cabrera testified that:
A: Then we went personally to the address as I stated a
while ago appearing in the record furnished by the United Merchants Corporation
to the adjuster, and the adjuster in turn now, gave us our basis in conducting
investigation, so we went to this place which according to the records, the
address of this company but there was no office of this company.
Q: You mentioned Atty. Cabrera that
you went to Diliman, Quezon City and discover the address indicated by the
United Merchants as the place of business of Fuze Industries Manufacturer,
Phils. was a residential place, what then did you do after determining that it
was a residential place?
A: We went to the owner of the alleged company as
appearing in the Department of Trade & Industry record, and as appearing a
certain Chinese name Mr. Huang, and the address as appearing there is somewhere
in Binondo. We went personally there together with the NBI Agent and I am with
them when the subpoena was served to them, but a male person approached us and
according to him, there was no Fuze Industries Manufacturer, Phils., company in
that building sir.[35]
In Yu Ban
Chuan v. Fieldmens Insurance, Co.,
Inc.,[36]
the Court ruled that the submission of false invoices to the adjusters
establishes a clear case of fraud and misrepresentation which voids the insurers liability
as per condition of the policy. Their falsity is the best evidence of the
fraudulent character of plaintiffs claim.[37]
In Verendia v. Court of Appeals,[38]
where the insured presented a fraudulent lease contract to support his claim
for insurance benefits, the Court held
that by its false declaration, the insured forfeited all benefits under the
policy provision similar to Condition No. 15 of the Insurance Policy in this
case.
Furthermore, UMCs Income Statement indicated that
the purchases or costs of sales are P827,670.00 for 1995 and P1,109,190.00
for 1996 or a total of P1,936,860.00.[39]
To corroborate this fact, Ebora testified that:
Q:
Based on your 1995 purchases, how much were the purchases made in 1995?
A: The purchases made by United Merchants
Corporation for the last year 1995 is P827,670.[00] sir
Q: And how about in 1994?
A: In 1994, its P608,986.00
sir.
Q: These purchases were made for the
entire year of 1995 and 1994 respectively, am I correct?
A:
Yes sir, for the year 1994 and 1995.[40]
(Emphasis supplied)
In its 1996 Financial Report, which
UMC admitted as existing, authentic and duly executed during the 4 December
2002 hearing, it had P1,050,862.71 as total assets and P167,058.47
as total liabilities.[41]
Thus,
either amount in UMCs Income Statement or Financial Reports is twenty-five
times the claim UMC seeks to enforce. The RTC itself recognized that UMC
padded its claim when it only allowed P43,930,230.00 as insurance claim.
UMC
supported its claim of P50,000,000.00 with the Certification from the
Bureau of Fire Protection stating that x x x a fire broke out at United
Merchants Corporation located at 19-B Dag[o]t Street, Brgy. Manresa, Quezon
City incurring an estimated damage of Fifty- Five Million Pesos (P55,000,000.00)
to the building and contents x x x. However, this Certification
only proved that the estimated damage of P55,000,000.00 is shared by
both the building and the stocks in trade.
It has long
been settled that a false and material statement made with an intent to deceive
or defraud voids an insurance policy.[42] In Yu Cua v. South British Insurance Co.,[43]
the claim was fourteen times bigger than the real loss; in Go Lu v.
Yorkshire Insurance Co,[44]
eight times; and in Tuason v. North China Insurance Co.,[45]
six times. In the present case, the claim is twenty five times the
actual claim proved.
The most liberal human judgment cannot
attribute such difference to mere innocent error in estimating or counting but
to a deliberate intent to demand from insurance companies payment for indemnity
of goods not existing at the time of the fire.[46]
This constitutes the so-called fraudulent claim which, by
express agreement between the insurers and the insured, is a ground for the
exemption of insurers from civil liability.[47]
In its Reply,
UMC admitted the discrepancies when it stated that discrepancies
in its statements were not covered by the warranty such that
any discrepancy in the declaration in other instruments or documents as to
matters that may have some relation to the insurance coverage voids the policy.[48]
On UMCs allegation
that it did not breach any warranty, it may be argued that the discrepancies do
not, by themselves, amount to a breach of warranty. However, the Insurance Code
provides that a policy may declare that a violation of specified provisions thereof
shall avoid it.[49] Thus, in fire insurance policies, which contain
provisions such as Condition No. 15 of the Insurance Policy, a fraudulent
discrepancy between the actual loss and that claimed in the proof of loss voids
the insurance policy. Mere filing of such a claim will exonerate the insurer.[50]
Considering that all the circumstances point to the
inevitable conclusion that UMC padded its claim and was guilty of fraud, UMC
violated Condition No. 15 of the Insurance Policy. Thus, UMC
forfeited whatever benefits it may be entitled under the Insurance Policy, including
its insurance claim.
While it is a cardinal principle of insurance law that a
contract of insurance is to be construed liberally in favor of the insured and
strictly against the insurer company,[51]
contracts of insurance, like other contracts, are to be construed according to
the sense and meaning of the terms which the parties themselves have used.[52]
If such terms are clear and unambiguous, they must be taken and understood in
their plain, ordinary and popular sense. Courts are not permitted to make contracts
for the parties; the function and duty of the courts is simply to enforce and
carry out the contracts actually made.[53]
WHEREFORE, we DENY the petition.
We AFFIRM the 16 June
2011 Decision and the 8 September 2011 Resolution of the Court of Appeals in
CA-G.R. CV No. 85777.
SO ORDERED.
ANTONIO T. CARPIO
Senior Associate Justice
WE CONCUR:
ARTURO D. BRION
Associate Justice
JOSE PORTUGAL PEREZ MARIA LOURDES P. A.
SERENO
Associate Justice Associate Justice
BIENVENIDO L. REYES
Associate Justice
CERTIFICATION
I certify that the conclusions in the above
Decision had been reached in consultation before the case was assigned to the
writer of the opinion of the Courts Division.
ANTONIO
T. CARPIO
Senior Associate Justice
(Per Section 12, R.A. 296,
The Judiciary Act of 1948, as amended)
[1] Under Rule 45 of the 1997 Rules
of Civil Procedure.
[2] Rollo, pp. 37-62. Penned by Associate Justice Edwin D. Sorongon
with Associate Justices Rosalinda
Asuncion-Vicente and Romeo F. Barza, concurring.
[3] Id. at 65-66.
[4] Id. at 207-210. Penned by Judge Antonio I. De Castro.
[5] Id. at 14.
[6] Id. at 83.
[7] Id. at 74-80.
[8] Id. at 92.
[9] Id. at
123-128.
[10] Id. at 130-132.
[11] Id. at 210.
[12] Id. at 209.
[13] Id. at 61-62.
[14] Id. at 54-56.
[15] Id. at 344-355.
[16] Id. at 16-17.
[17] Microsoft Corp.
v. Maxicorp. Inc., 481 Phil. 550 (2004) citing Amigo v. Teves, 96 Phil. 252 (1954).
[18] Id. citing Ramos,
et al. v. Pepsi-Cola Bottling Co. of the Phils., et al., 125 Phil. 701
(1967).
[19] Rules of Court,
Rule 131, Sec.1.
[20] Rules of Court,
Rule 133, Sec.1.
[21] DBP Pool of
Accredited Insurance Companies v. Radio Mindanao Network, Inc., 516 Phil. 110 (2006).
[22] Id. citing
Jison v. Court of Appeals, 350 Phil. 138 (1998).
[23] Id.
[24] Id.; Country Bankers Insurance Corp. v. Lianga
Bay and Community Multi-Purpose Cooperative, Inc.,
425 Phil. 511 (2002).
[25] Gonzales, Jr. v.
People, G.R. No. 159950, 12 February 2007, 515 SCRA 480.
[26] People v. De
Leon, G.R. No. 180762, 4 March 2009, 580 SCRA 617.
[27] People v. Oliva, 395 Phil. 265 (2000).
[28] Rollo, p.
171.
[29] 98 Phil. 85 (1955).
[30] Id.
[31] Id. at 98-99.
[32] 51 Phil. 231
(1927).
[33] Rollo, p.
60.
[34] Governed by Rule 130 of the Rules of Court.
Section 44, Rule 130 of the Rules of Court states:
Sec.
44. Entries in official records. Entries in official records made in the
performance of his duty by a public officer of the Philippines, or by a person
in the performance of a duty specially enjoined by law, are prima
facie evidence of the facts therein stated.
[35] Rollo, p.
189.
[36] 121
Phil. 1275 (1965).
[37] Id.
[38] G.R. No. 75605, 22 January 1993,
217 SCRA 417.
[39] Rollo, p.
186.
[40] Id.
[41] Id. at 191.
[42] Tan
It v. Sun Insurance Office, 51 Phil. 212
(1927), citing Yu Cua v. South British Insurance Co., 41 Phil. 134 (1920); Go Lu v. Yorkshire
Insurance Co., 43 Phil. 633 (1922); Tuason v. North China Insurance Co., 47 Phil.
14 (1924).
[43] 41
Phil. 134 (1920).
[44] 43
Phil. 633 (1922).
[45] 47
Phil. 14 (1924).
[46] Sharruf & Co. v. Baloise Fire
Insurance, Co., 64 Phil. 258 (1937).
[47] Id.
[48] Rollo, p.
385.
[49] The
Insurance Code, Sec. 75.
[50] Yu
Cua v. South British Insurance Co., supra note
43.
[51] Pacific Banking
Corporation v. Court of Appeals, 250 Phil. 1 (1988).
[52] Id.
[53] Id.