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554 SUPREME COURT REPORTS ANNOTATED
Sun Insurance Office, Ltd. vs. Court of Appeals
*
G.R. No. 92383. July 17, 1992.
SUN INSURANCE OFFICE, LTD., petitioner, vs. THE
HON. COURT OF APPEALS and NERISSA LIM,
respondents.
Insurance Law; Definition of accident.—An accident is an
event which happens without any human agency or, if happening
through human agency, an event which, under the circumstances,
is unusual to and not expected by the person to whom it happens.
It has also been defined as an injury which happens by reason of
some violence or casualty to the insured without his design,
consent, or voluntary cooperation.
Same; Same; Court is convinced that the incident that
resulted in Lim’s death was indeed an accident.—In light of these
definitions, the Court is convinced that the incident that resulted
in Lim’s death was indeed an accident. The petitioner, invoking
the case of De la Cruz v. Capital Insurance, says that “there is no
accident when a deliberate act is performed unless some
additional, unexpected, independent and unforeseen happening
occurs which produces or brings about their injury or death.”
There was such a happening. This was the firing of the gun,
which was the additional unexpected and independent and
unforeseen occurrence that led to the insured person’s death.
Same; Same; Suicide and willful exposure to needless peril are
in pari materia because they both signify a disregard for one’s life.
—It should be noted at the outset that suicide and willful
exposure to needless peril are in pari materia because they both
signify a disregard for one’s life. The only difference is in degree,
as suicide imports a positive act of ending such life whereas the
second act indicates a reckless risking of it that is almost suicidal
in intent.
Same; Contract; There is nothing in the policy that relieves the
insurer of the responsibility to pay the indemnity agreed upon if
the insured is shown to have contributed to his own accident.—
Lim was unquestionably negligent and that negligence cost him
his own life. But it should not prevent his widow from recovering
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from the insurance policy he obtained precisely against accident.
There is nothing in the policy that relieves the insurer of the
responsibility to pay the indemnity agreed upon if the insured is
shown to have contributed to
_______________
*FIRST DIVISION.
555
VOL. 211,JULY17,1992 555
Sun Insurance Office, Ltd. vs. Court of Appeals
his own accident. Indeed, most accidents are caused by
negligence. There are only four exceptions expressly made in the
contract to relieve the insurer from liability, and none of these
exceptions is applicable in the case at bar.
Same; Same; As a rule, insurance contracts are supposed to be
interpreted liberally in favor of the assured.—It bears noting that
insurance contracts are as a rule supposed to be interpreted
liberally in favor of the assured. There is no reason to deviate
from this rule, especially in view of the circumstances of this case
as above analyzed.
Civil Law; Damages; The Supreme Court holds that the
award of moral and exemplary damages and of attorney’s fees is
unjust and so must be disapproved.—On the second assigned
error, however, the Court must rule in favor of the petitioner. The
basic issue raised in this case is, as the petitioner correctly
observed, one of first impression. It is evident that the petitioner
was acting in good faith when it resisted the private respondent’s
claim on the ground that the death of the insured was covered by
the exception. The issue was indeed debatable and was clearly not
raised only for the purpose of evading a legitimate obligation. We
hold therefore that the award of moral and exemplary damages
and of attorney’s fees is unjust and so must be disapproved.
PETITION for review from the decision of the Court of
Appeals. Lapeña, Jr., J.
The facts are stated in the opinion of the Court.
Alfonso Felix, Jr. for petitioner.
Armando T. Puno for private respondent.
CRUZ, J.:
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The petitioner issued Personal Accident Policy No. 05687 to
Felix Lim, Jr. with a face value of P200,000.00. Two
months later, he was dead with a bullet wound in his head.
As beneficiary, his wife Nerissa Lim sought payment on the
policy but her claim was rejected. The petitioner agreed
that there was no suicide. It argued, however, that there
was no accident either.
Pilar Nalagon, Lim’s secretary, was the only eyewitness
to his death. It happened on October 6, 1982, at about 10
o’clock in the evening, after his mother’s birthday party.
According to Nalagon, Lim was in a happy mood (but not
drunk) and was
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556 SUPREME COURT REPORTS ANNOTATED
Sun Insurance Office, Ltd. vs. Court of Appeals
playing with his handgun, from which he had previously
removed the magazine. As she watched television, he stood
in front of her and pointed the gun at her. She pushed it
aside and said it might be loaded. He assured her it was
not and then pointed it to his temple. The next moment
there was an explosion1 and Lim slumped to the floor. He
was dead before he fell.
The widow sued the petitioner in the Regional2 Trial
Court of Zamboanga City and was sustained. The
petitioner was sentenced to pay her P200,000.00,
representing the face value of the policy, with interest at
the legal rate; P10,000.00 as moral damages; P5,000.00 as
exemplary damages; P5,000.00 as actual and compensatory
damages; and P5,000.00 as attorney’s fees, plus the costs of
the suit. This decision was affirmed 3 on appeal, and the
motion for reconsideration was denied. The petitioner then
came to this Court to fault the Court of Appeals for
approving the payment of the claim and the award of
damages.
The term “accident” has been defined as follows:
The words “accident” and “accidental” have never acquired any
technical signification in law, and when used in an insurance
contract are to be construed and considered according to the
ordinary understanding and common usage and speech of people
generally. In substance, the courts are practically agreed that the
words “accident” and “accidental” mean that which happens by
chance or fortuitously, without intention or design, and which is
unexpected, unusual, and unforeseen. The definition that has
usually been adopted by the courts is that an accident is an event
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that takes place without one’s foresight or expectation—an event
that proceeds from an unknown cause, or 4
is an unusual effect of a
known case, and therefore not expected.
An accident is an event which happens without any human
agency or, if happening through human agency, an event which,
under the circumstances, is unusual to and not expected by the
person to whom it happens. It has also been defined as an injury
which happens by reason of some violence or casualty to the
insured without his
_________________
1TSN, October 1, 1985, pp. 25-30.
2Decided by Judge Omar J. Amen.
3Penned by Justice Nicolas P. Lapeña, Jr., with Campos, Jr. and Cui,JJ.,
concurring.
443 Am. Jur. 2d 627.
557
VOL. 211,JULY17,1992 557
Sun Insurance Office, Ltd. vs. Court of Appeals
5
design, consent, or voluntary co-operation.
In light of these definitions, the Court is convinced that the
incident that resulted in Lim’s death was indeed an
accident. The petitioner,
6
invoking the case of De la Cruz v.
Capital Insurance, says that “there is no accident when a
deliberate act is performed unless some additional,
unexpected, independent and unforeseen happening occurs
which produces or brings about their injury or death.”
There was such a happening. This was the firing of the
gun, which was the additional unexpected and independent
and unforeseen occurrence that led to the insured person’s
death.
The petitioner also cites one of the four exceptions
provided for in the insurance contract and contends that
the private petitioner’s claim is barred by such provision. It
is there stated:
Exceptions—
The company shall not be liable in respect of
1. Bodily injury
x x x
b. consequent upon
i) The insured person attempting to commit suicide or
willfully exposing himself to needless peril except in an attempt to
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save human life.
To repeat, the parties agree that Lim did not commit
suicide. Nevertheless, the petitioner contends that the
insured willfully exposed himself to needless peril and thus
removed himself from the coverage of the insurance policy.
It should be noted at the outset that suicide and willful
exposure to needless peril are in pari materia because they
both signify a disregard for one’s life. The only difference is
in degree, as suicide imports a positive act of ending such
life whereas the second act indicates a reckless risking of it
that is almost suicidal in intent. To illustrate, a person who
walks a tightrope one thousand meters above the ground
and without
________________
5Ibid., p. 628.
617 SCRA 559.
558
558 SUPREME COURT REPORTS ANNOTATED
Sun Insurance Office, Ltd. vs. Court of Appeals
any safety device may not actually be intending to commit
suicide, but his act is nonetheless suicidal. He would thus
be considered as “willfully exposing himself to needless
peril” within the meaning of the exception in question.
The petitioner maintains that by the mere act of
pointing the gun to his temple, Lim had willfully exposed
himself to needless peril and so came under the exception.
The theory is that a gun is per se dangerous and should
therefore be handled cautiously in every case.
That posture is arguable. But what is not is that, as the
secretary testified, Lim had removed the magazine from
the gun and believed it was no longer dangerous. He
expressly assured her that the gun was not loaded. It is
submitted that Lim did not willfully expose himself to
needless peril when he pointed the gun to his temple
because the fact is that he thought it was not unsafe to do
so. The act was precisely intended to assure Nalagon that
the gun was indeed harmless.
The contrary view is expressed by the petitioner thus:
Accident insurance policies were never intended to reward the
insured for his tendency to show off or for his miscalculations.
They were intended to provide for contingencies. Hence, when I
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miscalculate and jump from the Quezon Bridge into the Pasig
River in the belief that I can overcome the current, I have wilfully
exposed myself to peril and must accept the consequences of my
act. If I drown I cannot go to the insurance company to ask them
to compensate me for my failure to swim as well as I thought I
could. The insured in the case at bar deliberately put the gun to
his head and pulled the trigger. He wilfully exposed himself to
peril.
The Court certainly agrees that a drowned man cannot go
to the insurance company to ask for compensation. That
might frighten the insurance people to death. We also
agree that under the circumstances narrated, his
beneficiary would not be able to collect on the insurance
policy for it is clear that when he braved the currents
below, he deliberately exposed himself to a known peril.
The private respondent maintains that Lim did not.
That is where she says the analogy fails. The petitioner’s
hypothetical swimmer knew when he dived off the Quezon
Bridge that the currents below were dangerous. By
contrast, Lim did not know
559
VOL. 211,JULY17,1992 559
Sun Insurance Office, Ltd. vs. Court of Appeals
that the gun he put to his head was loaded.
Lim was unquestionably negligent and that negligence
cost him his own life. But it should not prevent his widow
from recovering from the insurance policy he obtained
precisely against accident. There is nothing in the policy
that relieves the insurer of the responsibility to pay the
indemnity agreed upon if the insured is shown to have
contributed to his own accident. Indeed, most accidents are
caused by negligence. There are only four exceptions
expressly made in the contract to relieve the insurer from
liability, and
**
none of these exceptions is applicable in the
case at bar.
__________________
**Exceptions The Company shall not be liable in respect of
1. bodily injury
a) sustained
i) while the Insured Person is engaging in (or practicing for or taking
part in training peculiar to) any of the Excluded Activities.
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by any person before such person attains the Lower Age Limit or
ii) after the expiry of the Period of Insurance during which such
person attains the Upper Age Limit.
b) consequent upon
i) the Insured Person committing or attempting to commit suicide or
wilfully exposing himself to needless peril except in an attempt to
save human life.
ii) war, invasion, act of foreign enemy, hostilities (whether war be
declared or not) civil war, rebellion, revolution, insurrection, or
military or usurped power.
2. bodily injury or Death Disablement or Mecial Expenses consequent
upon or contributed to by the Insured Person
a) having taken a drug unless the Insured proves that the drug was
taken in accordance with proper medical prescription and
directions and not for treatment of drug addiction.
b) suffering from pre-existing physical or mental defect or infirmity
which had not been declared to and accepted in writing by the
Company.
3. Death Disablement or Medical Expenses consequent upon or
contributed to by the Insured Person being pregnant or suffering
560
560 SUPREME COURT REPORTS ANNOTATED
Sun Insurance Office, Ltd. vs. Court of Appeals
It bears noting that insurance contracts are as a rule
supposed to be interpreted liberally in favor of the assured.
There is no reason to deviate from this rule, especially in
view of the circumstances of this case as above analyzed.
On the second assigned error, however, the Court must
rule in favor of the petitioner. The basic issue raised in this
case is, as the petitioner correctly observed, one of first
impression. It is evident that the petitioner was acting in
good faith when it resisted the private respondent’s claim
on the ground that the death of the insured was covered by
the exception. The issue was indeed debatable and was
clearly not raised only for the purpose of evading a
legitimate obligation. We hold therefore that the award of
moral and exemplary damages and of attorney’s fees is
unjust and so must be disapproved.
In order that a person may be made liable to the payment of
moral damages, the law requires that his act be wrongful. The
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adverse result of an action does not per se make the act wrongful
and subject the act or to the payment of moral damages. The law
could not have meant to impose a penalty on the right to litigate;
such right is so precious that moral damages may not be charged
on those
7
who may exercise it erroneously. For these the law taxes
costs.
The fact that the results of the trial were adverse to Barreto
did not alone make his act in bringing the action wrongful
because in most cases one party will lose; we would be imposing
an unjust condition or limitation on the right to litigate. We hold
that the award of moral damages in the case at bar is not justified
by the facts and circumstances as well as the law.
If a party wins, he cannot, as a rule, recover attorney’s fees and
litigation expenses, since it is not the fact of winning alone that
entitles him to recover such damages of the exceptional
circumstances enumerated in Art. 2208. Otherwise, every time a
defendant wins, automatically the plaintiff must pay attorney’s
fees thereby putting a premium on the right to litigate which
should not be so. For
8
those expenses, the law deems the award of
costs as sufficient.
_________________
from sickness or disease not resulting from bodily injury or suffering
from bodily injury due to a gradually operating cause.
4. Risks of Murder and Assault.
7Barreto vs. Arevalo, 99 Phil. 771.
8Rizal Surety vs. Court of Appeals, 20 SCRA 61.
561
VOL. 211,JULY17,1992 561
Sun Insurance Office, Ltd. vs. Court of Appeals
WHEREFORE, the challenged decision of the Court of
Appeals is AFFIRMED insofar as it holds the petitioner
liable to the private respondent in the sum of P200,000.00
representing the face value of the insurance contract, with
interest at the legal rate from the date of the filing of the
complaint until the full amount is paid, but MODIFIED
with the deletion of all awards for damages, including
attorney’s fees, except the costs of the suit.
SO ORDERED.
Griño-Aquino, Medialdea and Bellosillo, JJ.,
concur.
Decision affirmed, but modified.
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Note.—An insurance contract is a contract of adhesion.
The terms of such contract are to be construed strictly
against the party which prepared the contract (Western
Guaranty Corporation vs. Court of Appeals, 187 SCRA 652).
——o0o——
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