Musngi v. West Coast Life Assurance Co.- False Representation

61 PHIL 864

Facts:

>  Arsenio Garcia was insured by West Coast twice in 1931.  In both policies, he was asked to answer the question: “what physician or practitioners have you consulted or been treated by, and for what illness or ailment?

>  In both policies, he answered in the negative.  It turned out that from 1929 to 1939, he went to see several physicians for a number of ailments.  So when he died in 1942, the company refused to pay the proceeds of the insurance.

Issue:

Whether or not the answer given by Arsenio in the policies justifies the company’s refusal to pay?

Held:

YES.

Aresenio knew that he was suffering from a number of ailments, yet, he concealed this.  Such concealment and his false statements constituted fraud, because the insurance company by reasons of such statement accepted the risk which it would otherwise have rejected.