GR L 5642; (February, 1954) (Digest)
G.R. No. L-5642; February 25, 1954
HERMINIA Q. KANAPI, plaintiff-appellant, vs. THE INSULAR LIFE ASSURANCE CO., LTD., defendant-appellee.
FACTS
On August 1, 1948, the defendant insurance company issued a life insurance policy on the life of Henry G. Kanapi, the plaintiff’s husband. The policy promised to pay the plaintiff, as beneficiary, P5,000 upon the insured’s death from natural causes, and an additional P5,000 if death resulted from accidental means, as per an “Accidental Death Benefit Policy Clause.” This clause was expressly made subject to exceptions, including that it would not apply where death resulted from injury “intentionally inflicted by a third party.” The insured died from a bullet wound inflicted without provocation by one Conrado Quemosing, who was later convicted of murder. The defendant paid the plaintiff the basic P5,000 but refused to pay the additional P5,000 under the accidental death benefit clause, citing the exception for injuries intentionally inflicted by a third party.
ISSUE
Whether the plaintiff is entitled to the additional P5,000 under the accidental death benefit clause of the insurance policy, given that the insured’s death resulted from an injury intentionally inflicted by a third party.
RULING
No. The Supreme Court affirmed the lower court’s dismissal of the action. The accidental death benefit clause required proof that death resulted directly from bodily injury sustained in an accident. However, the agreed facts established that the insured was murdered, meaning his death resulted from an injury “intentionally inflicted by a third party.” This scenario falls squarely under exception 5(e) of the clause, which explicitly excludes from coverage any injury inflicted intentionally by a third party, regardless of provocation. The Court rejected the appellant’s argument that an unprovoked assault was inferentially excluded because it was not mentioned in the exception for provoked assaults, holding that such unprovoked assaults are expressly covered by exception 5(e). Therefore, the additional benefit was not payable.