9.
contract of adhesion
Republic of the Philippines
SUPREME COURT
Manila
EN BANC
G.R. No. L-21574
June 30, 1966
SIMON DE LA CRUZ, plaintiff and appellee,
vs.
THE CAPITAL INSURANCE and SURETY CO., INC., defendant
and appellant.
Achacoso, Nera and Ocampo for defendant and appellant.
Agustin M. Gramata for plaintiff and appellee.
BARRERA, J.:
This is an appeal by the Capital Insurance & Surety Company,
Inc., from the decision of the Court of First Instance of
Pangasinan (in Civ Case No. U-265), ordering it to indemnify
therein plaintiff Simon de la Cruz for the death of the latter's son,
to pay the burial expenses, and attorney's fees.
Eduardo de la Cruz, employed as a mucker in the Itogon-Suyoc
Mines, Inc. in Baguio, was the holder of an accident insurance
policy (No. ITO-BFE-170) underwritten by the Capital Insurance &
Surety Co., Inc., for the period beginning November 13, 1956 to
November 12, 1957. On January 1, 1957, in connection with the
celebration of the New Year, the Itogon-Suyoc Mines, Inc.
sponsored a boxing contest for general entertainment wherein the
insured Eduardo de la Cruz, a non-professional boxer
participated. In the course of his bout with another person,
likewise a non-professional, of the same height, weight, and size,
Eduardo slipped and was hit by his opponent on the left part of
the back of the head, causing Eduardo to fall, with his head hitting
the rope of the ring. He was brought to the Baguio General
Hospital the following day. The cause of death was reported as
hemorrhage, intracranial, left.
Simon de la Cruz, the father of the insured and who was named
beneficiary under the policy, thereupon filed a claim with the
insurance company for payment of the indemnity under the
insurance policy. As the claim was denied, De la Cruz instituted
the action in the Court of First Instance of Pangasinan for specific
performance. Defendant insurer set up the defense that the death
of the insured, caused by his participation in a boxing contest,
was not accidental and, therefore, not covered by insurance. After
due hearing the court rendered the decision in favor of the plaintiff
which is the subject of the present appeal.
It is not disputed that during the ring fight with another nonprofessional boxer, Eduardo slipped, which was unintentional. At
this opportunity, his opponent landed on Eduardo's head a blow,
which sent the latter to the ropes. That must have caused the
cranial injury that led to his death. Eduardo was insured "against
death or disability caused by accidental means". Appellant insurer
now contends that while the death of the insured was due to head
injury, said injury was sustained because of his voluntary
participation in the contest. It is claimed that the participation in
the boxing contest was the "means" that produced the injury
which, in turn, caused the death of the insured. And, since his
inclusion in the boxing card was voluntary on the part of the
insured, he cannot be considered to have met his death by
"accidental means".
1wph1.t
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.1
Appellant however, would like to make a distinction between
"accident or accidental" and "accidental means", which is the
term used in the insurance policy involved here. It is argued that
to be considered within the protection of the policy, what is
required to be accidental is the means that caused or brought the
death and not the death itself. It may be mentioned in this
connection, that the tendency of court decisions in the United
States in recent years is to eliminate the fine distinction between
the terms "accidental" and "accidental means" and to consider
them as legally synonymous.2 But, even if we take appellant's
theory, the death of the insured in the case at bar would still be
entitled to indemnification under the policy. 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.3 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.4 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
policies insuring against death or injury from accident.
In the present case, while the participation of the insured in the
boxing contest is voluntary, the injury was sustained when he slid,
giving occasion to the infliction by his opponent of the blow that
threw him to the ropes of the ring. Without this unfortunate
incident, that is, the unintentional slipping of the deceased,
perhaps he could not have received that blow in the head and
would not have died. The fact that boxing is attended with some
risks of external injuries does not make any injuries received in
the course of the game not accidental. In boxing as in other
equally physically rigorous sports, such as basketball or baseball,
death is not ordinarily anticipated to result. If, therefore, it ever
does, the injury or death can only be accidental or produced by
some unforeseen happening or event as what occurred in this
case.
Furthermore, the policy involved herein specifically excluded from
its coverage
(e) Death or disablement consequent upon the Insured
engaging in football, hunting, pigsticking, steeplechasing,
polo-playing, racing of any kind, mountaineering, or
motorcycling.
Death or disablement resulting from engagement in boxing
contests was not declared outside of the protection of the
insurance contract. Failure of the defendant insurance company
to include death resulting from a boxing match or other sports
among the prohibitive risks leads inevitably to the conclusion that
it did not intend to limit or exempt itself from liability for such
death.5
Wherefore, in view of the foregoing considerations, the decision
appealed from is hereby affirmed, with costs against appellant. so
ordered.
Concepcion, C.J., Reyes, J.B.L., Dizon, Regala, Makalintal,
Bengzon, J.P., Zaldivar and Sanchez, JJ., concur.
