Summary: Finman General Assurance Corporation vs. Court of Appeals (GR 100970, 2 September 1992)

Finman General Assurance Corporation vs. Court of Appeals
[GR 100970, 2 September 1992]
Second Division, Nocon (J): 4 concur

Facts: On 22 October 1986, deceased Carlie Surposa was insured with Finman General Assurance Corporation under Finman General Teachers Protection Plan Master Policy 2005 and Individual Policy 08924 with his parents, spouses Julia and Carlos Surposa, and brothers Christopher, Charles, Chester and Clifton, all surnamed Surposa, as beneficiaries. While said insurance policy was in full force and effect, the insured, Carlie Surposa, died on 18 October 1988 as a result of a stab wound inflicted by one of 3 unidentified men without provocation and warning on the part of the former as he and his cousin, Winston Surposa, were waiting for a ride on their way home along Rizal-Locsin Streets, Bacolod City after attending the celebration of the "Maskarra Annual Festival." Thereafter, Julia Surposa and the other beneficiaries of said insurance policy filed a written notice of claim with Finman which denied said claim contending that murder and assault are not within the scope of the coverage of the insurance policy. On 24 February 1989, Surposa filed a complaint with the Insurance Commission which subsequently rendered a decision, ordering Finman liable to pay Surposa the sum of P15,000.00 representing the proceeds of the policy with interest from the date of the filing of the complaint until fully satisfied. As no evidence was submitted to prove the claim for mortuary aid in the sum of P1,000.00, the same was not entertained. On 11 July 1991, the appellate court affirmed said decision. Finman filed the petition for certiorari.

Issue: Whether the death was committed with deliberate intent which, by the very nature of a personal accident insurance policy, cannot be indemnified.

Held: NO. The terms "accident" and "accidental," as used in insurance contracts have not acquired any technical meaning, and are construed by the courts in their ordinary and common acceptation. Thus, the terms have been taken to mean that which happen by chance or fortuitously, without intention and design, and which is unexpected, unusual, and unforeseen. An accident is an event that takes place without one's foresight or expectation — an event that proceeds from an unknown cause, or is an unusual effect of a known cause and, therefore, not expected. The generally accepted rule is that, death or injury does not result from accident or accidental means 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. There is no accident when a deliberate act is performed unless some additional, unexpected, independent, and unforeseen happening occurs which produces or brings about the result of injury or death. In other words, where the death or injury is not the natural or probable result of the insured's voluntary act, or if something unforeseen occurs in the doing of the act which produces the injury, the resulting death is within the protection of the policies insuring against death or injury from accident. Herein, it cannot be pretended that Carlie Surposa died in the course of an assault or murder as a result of his voluntary act considering the very nature of these crimes. In the first place, the insured and his companion were on their way home from attending a festival. They were confronted by unidentified persons. The record is barren of any circumstance showing how the stab wound was inflicted. Nor can it be pretended that the malefactor aimed at the insured precisely because the killer wanted to take his life. In any event, while the act may not exempt the unknown perpetrator from criminal liability, the fact remains that the happening was a pure accident on the part of the victim. The insured died from an event that took place without his foresight or expectation, an event that proceeded from an unusual effect of a known cause and, therefore, not expected. Neither can it be said that there was a capricious desire on the part of the accused to expose his life to danger considering that he was just going home after attending a festival. Furthermore, the personal accident insurance policy involved specifically enumerated only 10 circumstances wherein no liability attaches to Finamn for any injury, disability or loss suffered by the insured as a result of any of the stipulated causes. The principle of "expresso unius exclusio alterius" — the mention of one thing implies the exclusion of another thing — is therefore applicable in the present case since murder and assault, not having been expressly included in the enumeration of the circumstances that would negate liability in said insurance policy cannot be considered by implication to discharge Finman from liability for any injury, disability or loss suffered by the insured. Thus, the failure of Finman to include death resulting from murder or assault among the prohibited risks leads inevitably to the conclusion that it did not intend to limit or exempt itself from liability for such death.

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