Sindayen v. Insular Life- Policy of Insurance

62 PHIL 9

Facts:

>  Arturo Sindayen was a linotype operator in the Bureau of Printing.  He and his wife Fortunat went to Camiling to spend Christmas with his aunt Felicidad Estrada.

>  On Dec. 26, 1932, while still in Camiling, he made a written application to Insular Life, through its agent, Cristobal Hendoza, for a policy of insurance on his life in the sum of 1,000.

>  He paid the agent P15 as part of the first premium.  It was agreed that the policy, when and if issued, should be delivered to Felicidad with whom Sindayen left the sum P25.06 to complete the payment of the first annual premium of P40.06.

>  On Jan 1, 1933, Sindayen was examined by Insular’s doctor who made a favorable report to Insular.

>  The next day, Sindayen returned to Manila and resumed his work.  On Jan. 11, 1933, Insular accepted the risk and issued a policy, and mailed the same to its agent for delivery to the insured.

>  On Jan. 12, 1933, Sindayen complained of a severe headache.  ON Jan. 15, 1933, he called a physician who found that Sindayen was suffering from acute nephritis and uremia.  His illness did not yield to treatment and on Jan. 19, 1933, he died.

>  The policy which the company issued and mailed in manila on Jan. 11 1933 was received by its agent in Camilin on Jan. 16, 1933.  On Jan 18, 1933, the agent, in accordance with his agreement with the insured delivered the policy to Felicided upon her payment of the balance of the 1st year’s premium.

>  The agent asked Felicidad if her nephew was in good health and she replied that she believed so because she had no information that he was sick, and thereupon , the policy was handed to her by the agent.

>  On Jan. 20, 1933, the agent learned of the death of Sindayen, afterwhich he called upon Felicidad and asked her to return the policy.  Felicidad did so.

>  On Feb. 4, 1933, the company obtained from Sindayen’s widow Fortunata (also the beneficiary), her signature on a legal document whereby in consideration of the sum 40.06 representing the amount of premium paid, Fortunata thereby releases forever and discharges Insular from any and all claims and obligations she may have against the latter.

>  A check for the above-mentioned amount was drawn in the name of Fortunata, but the same was never encashed.

>  Instead, it was returned to Insular and this complaint to enforce payment under the  policy was instituted.

>  The application which Sindayen signed in Camiling contained the following provisions:

“xxx

(3) That the said policy shall not take effect until the first premium has been paid and the policy has been delivered to and accepted by me, while I am in good health.”


>  The main defense of the company is the policy never took effect because of par. 3 of the application, since at the time of the delivery of the agent, the insured was not in good health.


Issue:

Whether or not the policy took effect.


Held:

YES.

There is one line of American cases which holds that the stipulation contained par. 3 is in the nature of a condition precedent, that is to say, that there can be no valid delivery to the insured unless he is in good health at that time; that this condition precedent goes to the very essence of the contract and cannot be waived by the agent making delivery of the policy; HOWEVER, there is also a number of American decision which state the contrary.


These decisions say that an agent to whom a life insurance policy (similar to the one at bar) was sent with instruction to deliver it to the insured, has authority to bind the company by making such delivery, ALTHOUGH the insured was NOT in good health at the time of delivery, on the theory that the delivery of the policy being the final act to the consummation of the contract, the condition as to the insured’s good health was WAIVED by the company.


These same cases further hold that the delivery of the policy by the agent to the insured consummates the contract even though the agent knew that the insured was NOT in good health at the time, the theory being, that his knowledge is the company’s knowledge; and his delivery is the company’s delivery; that when the delivery is made notwithstanding this knowledge of the defect, the company is deemed to have WAIVED such defect.


The agent, Mendoza was duly licensed by the Insurance Commission to act for Insular Life.  He had the authority given by him by the company to withhold the delivery of the policy to the insured until the first premium has been paid and the policy has been delivered to and accepted by the insured while he is in good health.  Whether that condition had been met or not plainly calls for the exercise of discretion.  Mendoza’s decision that the condition had been met by the insured and that it was proper to make delivery of the policy to him is just as binding on the company as if the decision had been made by its Board of Directors.  Admittedly, Mendoza made a mistake of judgment because he acted on insufficient evidence as to the state of health of the insured, and this mistake cannot be said to be induced by any misconduct on the part of the insured.


It is in the interest of not only of the applicant but of all insurance companies as well that there should be some act which gives the applicant the definite assurance that the contract has been consummated.  This sense of security and of piece of mind that one’s dependents are provided for without risk of either loss or of litigation is the bedrock of life insurance.


A cloud will be thrown over the entire insurance business if the condition of health of the insured at the time of the delivery of the policy may be inquired into years afterwards with the view of avoiding the policy on the ground that it never took effect because of an alleged lack of good health at the time of delivery.


It is therefore in the public interest that we are constrained to hold, as we do, that the delivery of the policy to the insured by an agent of the company who is authorized to make delivery or withhold delivery is the final act which binds the company and the insured, in the absence of fraud or other legal grounds for rescission.  The fact that the agent to whom it has entrusted this duty is derelict or negligent or even dishonest in the performance of the duty which has been entrusted to him would create an obligation based upon the authorized acts of the agent toward a third party who was not in collusion with the agent.