Showing posts with label insurance. Show all posts
Showing posts with label insurance. Show all posts

Saturday, September 1, 2012

Valenzuela v. CA


ARTURO VALENZUELA and HOSPITALITA VALENZUELA v. CA, BIENVENIDO ARAGON, ROBERT PARNELL, CARLOS CATOLICO and THE PHILIPPINE AMERICAN GENERAL INSURANCE COMPANY
1990 / Gutierrez, Jr.

FACTS
Arturo Valenzuela [Valenzuela] is a general agent of Philippine American General Insurance Company [Philamgen] since 1965. As such, he was authorized to solicit and sell in behalf of Philamgen all kinds of non-life insurance, and in consideration of services rendered was entitled to receive the full agent's commission of 32.5% from Philamgen. From 1973 to 1975, Valenzuela solicited marine insurance from Delta Motors. However, Valenzuela did not receive his full commission.
In 1977, Philamgen started to become interested in and expressed its intent to share in the commission due Valenzuela on a 50-50 basis, but he refused. In 1978, Philamgen and its President [Aragon] insisted on the sharing of the commission with Valenzuela, but he firmly reiterated his objection to the proposals. Because of the refusal of Valenzuela, Philamgen and its officers took drastic action. They reversed the commission due him by not crediting in his account the commission earned from the Delta Motors insurance, placed agency transactions on a cash and carry basis, threatened the cancellation of policies issued by his agency, and started to leak out news that Valenzuela has a substantial account with Philamgen. This resulted in the decline of his business as insurance agent. Philamgen terminated the General Agency Agreement of Valenzuela in December 1978.
                Valenzuela filed a complaint against Philamgen, and the RTC ruled in his favor, as his termination was found to be unjustified. However, the CA ruled in favor of Philamgen, as CA ordered Valenzuela to pay Philamgen the amount corresponding to the unpaid and uncollected premiums.

ISSUE & HOLDING
WON Valenzuela should be held liable for unpaid and uncollected premiums. NO.

RATIO
Under Section 77 of the Insurance Code, the remedy for the non-payment of premiums is to put an end to and render the insurance policy not binding.

Philippine Phoenix Surety and Insurance v. Woodworks (1979)
  • The non-payment of premium does not merely suspend but puts an end to an insurance contract since the time of the payment is peculiarly of the essence of the contract.
  • An insurer cannot treat a contract as valid for the purpose of collecting premiums and invalid for the purpose of indemnity. (Citing Insurance Law and Practice by John Alan Appleman)
  • The foregoing findings are buttressed by Section 776 of the Insurance Code (PD 612), which now provides that no contract of insurance by an insurance company is valid and binding unless and until the premium thereof has been paid, notwithstanding any agreement to the contrary

Arce v. The Capital Insurance and Surety
  • Unless premium is paid, an insurance contract does not take effect.
  • Delgado (Capital Insurance & Surety Co., Inc. v. Delgado) was decided in the light of the Insurance Act before Sec. 72 was amended by the underscored portion. Prior to the Amendment, an insurance contract was effective even if the premium had not been paid so that an insurer was obligated to pay indemnity in case of loss and correlatively he had also the right to sue for payment of the premium. But the amendment to Sec. 72 has radically changed the legal regime in that unless the premium is paid there is no insurance.

Since the premiums have not been paid, the policies issued have lapsed. The insurance coverage did not go into effect or did not continue and the obligation of Philamgen as insurer ceased. Hence, for Philamgen which had no more liability under the lapsed and inexistent policies to demand, much less sue Valenzuela for the unpaid premiums would be the height of injustice and unfair dealing. In this instance, with the lapsing of the policies through the nonpayment of premiums by the insured there were no more insurance contracts to speak of.

RTC DECISION REINSTATED

Velasco v. Apostol


LAURA VELASCO and GRETA ACOSTA v. JUDGE SERGIO APOSTOL and MAHARLIKA INSURANCE
1989 / Regalado

FACTS
On 27 Nov 1973, around 230 PM, Laura Velasco and Greta Acosta were riding in Velascos Mercury car when an N/S taxicab driven by Dominador Santos [registered in the name of Alice Artuz, c/o Norberto Santos] crossed the center island towards their direction, and collided with their car at the left front part. The taxicab tried to return to its original lane, but was unable to climb the island. It backtracked, hitting again Velasco’s car in the left near portion, causing the latter's back portion to turn toward the center hitting a jeepney on its right, which was travelling along their side.
                Velasco and Acosta sued the taxicab driver and its registered owners, claiming actual, moral and exemplary damages plus attorney's fees. Maharlika Insurance was impleaded as a defendant in an amended complaint, with an allegation that the N/S taxicab was insured against third party liability for 20k with Maharlika at the time of the accident.
Maharlika claimed that there was no cause of action against it because at the time of the accident, the alleged insurance policy was not in force due to non-payment of the premium. It further averred that even if the taxicab had been insured, the complaint would still be premature since the policy provides that the insurer would be liable only when the insured becomes legally liable.
RTC ruled in favor of Velasco and Acosta, finding that the proximate cause of the accident was the taxicab driver’s negligence. However, Maharlika was exonerated on the ground that the policy was not in force for failure to pay the initial premium and for their concealment of a material fact. The payment was accepted by Maharlika without any knowledge that the risk insured against had already occurred since such fact was concealed by the insured and was not revealed to Maharlika.
The accident occurred on 27 Nov 1973 while the initial premium was paid only on 11 Dec 1973. Velasco and Acosta maintain that in spite of this late payment, the policy is binding because there was an implied agreement to grant a credit extension so as to make the policy effective. To them, the subsequent acceptance of the premium and delivery of the policy estops Maharlika from asserting that the policy is ineffective.

ISSUE & HOLDING
WON Maharlika Insurance is liable. NOT LIABLE. RTC JUDGMENT AFFIRMED.

RATIO
It should be noted that this controversy arose under the aegis of the old insurance law, Act No. 2427, as amended. The former insurance law, which applies to this case, provided that:
An insurer is entitled to the payment of premium as soon as the thing insured is exposed to the peril insured against, unless there is clear agreement to grant the insured credit extension of the premium due. No policy issued by an insurance company is valid and binding unless and until the premium thereof has been paid.
The insurance policy in question would be valid and binding notwithstanding the non-payment of the premium if there was a clear agreement to grant to the insured credit extension. Such agreement may be express or implied.
SC finds no cogent proof of any such implied agreement. Had there really been a credit extension, the insured would not have had any apprehension or hesitation to inform Maharlika at the time of or before the payment of the premium that an accident for which the insurer may be held liable had already happened. Under such circumstances, notice alone is necessary and the insured need not pay the premium because whatever premium may have been due may already be deducted upon the satisfaction of the loss under the policy. Velasco and Acosta failed to point out any other circumstances showing that prepayment of premium was not intended to be insisted upon. They have thus failed to discharge the burden of proving their allegation of the existence of the purported credit extension agreement.
                SC noted that in the present law, Section 77 of the Insurance Code of 1978 has deleted the clause "unless there is clear agreement to grant the insured credit extension of the premium due" which was involved in this controversy.
The fact withheld could not have influenced Maharlika in entering into the supposed contract or in estimating the character of the risk or in fixing the rate premium, because no such contract existed at the time of the accident. There was nothing to rescind at that point in time. What should be apparent from such actuations of the taxicab owner/s is the presence of bad faith on their part, a reprehensible disregard of the principle that insurance contracts are uberrimae fidae and demand the most abundant good faith. 

UCPB General Insurance v. Masagana Telamart (2001)


UCPB GENERAL INSURANCE [UCPB] v. MASAGANA TELAMART [Masagana]
2001 / Davide, Jr.

FACTS [SEE 1999 CASE DIGEST FOR THE OTHER FACTS]
CA disagreed with UCPBs stand that Masagana’s tender of payment of the premiums on 13 July 1992 did not result in the renewal of the policies, having been made beyond the effective date of renewal as provided under Policy Condition No. 26:
Renewal Clause. -- Unless the company at least 45 days in advance of the end of the policy period mails or delivers to the assured at the address shown in the policy notice of its intention not to renew the policy or to condition its renewal upon reduction of limits or elimination of coverages, the assured shall be entitled to renew the policy upon payment of the premium due on the effective date of renewal.

The following facts have been established:
1.  For years, UCPB had been issuing fire policies to th Masagana, and these policies were annually renewed.
2.  UCPB had been granting Masagana a 60-90-day credit term within which to pay the premiums on the renewed policies.
3.  There was no valid notice of non-renewal of the policies, as there is no proof that the notice sent by ordinary mail was received by Masagana, and the copy allegedly sent to Zuellig was ever transmitted to Masagana.
4.  The premiums for the policies were paid by Masagana within the 60- 90-day credit term and were duly accepted and received by UCPB’s cashier.

ISSUE & HOLDING
WON IC 77 must be strictly applied to UCPB’s advantage despite its practice of granting a 60- to 90-day credit term for the payment of premiums. NO. MASAGANA WINS THIS TIME. 1999 DECISION SET ASIDE; CA DECISION AFFIRMED

RATIO
SEC. 77.  An insurer is entitled to payment of the premium as soon as the thing insured is exposed to the peril insured against.  Notwithstanding any agreement to the contrary, no policy or contract of insurance issued by an insurance company is valid and binding unless and until the premium thereof has been paid, except in the case of a life or an industrial life policy whenever the grace period provision applies.

This was formerly Act 2427, Section 72:
SEC. 72.  An insurer is entitled to payment of premium as soon as the thing insured is exposed to the peril insured against, unless there is clear agreement to grant the insured credit extension of the premium due.  No policy issued by an insurance company is valid and binding unless and until the premium thereof has been paid. (Underscoring supplied)

IC 77 does not restate the portion of IC 72 expressly permitting an agreement to extend the period to pay the premium.  However, there are exceptions to IC 77.

  1. In case of a life or industrial life policy whenever the grace period provision applies [Sec. 77]
  2. Any acknowledgment of the receipt of premium is conclusive evidence of payment [Sec. 78]
  3. If the parties have agreed to the payment in installments of the premium and partial payment has been made at the time of loss [Makati Tuscany Condominium v. CA]
  4. The insurer may grant credit extension for the payment of the premium [Makati Tuscany Condominium
  5. Estoppel
IC 77 merely precludes the parties from stipulating that the policy is valid even if premiums are not paid, but does not expressly prohibit an agreement granting credit extension, and such an agreement is not contrary to morals, good customs, public order or public policy. [Makati Tuscany Condominium v. CA]

ON EXCEPTION #4. If the insurer has granted the insured a credit term for the payment of the premium and loss occurs before the expiration of the term, recovery on the policy should be allowed even though the premium is paid after the loss but within the credit term.
It would be unjust and inequitable if recovery on the policy would not be permitted against UCPB, which had consistently granted a 60-90-day credit term for the payment of premiums despite its full awareness of IC 77.  Estoppel bars it from taking refuge under said section, since Masagana relied in good faith on such practice.  

UCPB General Insurance v. Masagana Telamart (1999)


UCPB GENERAL INSURANCE [UCPB] v. MASAGANA TELAMART [Masagana]
1999 / Pardo

FACTS
In 1991, UCPB issued 5 fire insurance policies covering Masagana Telamart’s various properties for the period from 22 May 1991 to 22 May 1992.
On March 1992 [~2 months before policy expiration], UCPB evaluated the policies and decided not to renew them upon expiration of their terms on 22 May 1992.  UCPB advised Masaganas broker of its intention not to renew the policies. On April 1992 [~1 month before policy expiration], UCPB gave written notice to Masagana of the non-renewal of the policies. On June 1992 [policy already expired], Masaganas property covered by 3 UCPB-issued policies was razed by fire.
On 13 July 1992, Masagana presented to UCPB’s cashier 5 manager's checks, representing premium for the renewal of the policies for another year.
It was only on the following day, 14 July 1992, when Masagana filed with UCPB a formal claim for indemnification of the insured property razed by fire. On the same day, UCPB returned the 5 manager's checks, and rejected Masaganas claim since the policies had expired and were not renewed, and the fire occurred on 13 June 1992 (or before tender of premium payment).
            Masagana filed a civil complaint for recovery of the face value of the policies covering the insured property razed by fire. RTC ruled in favor of Masagana, as it found it to have complied with the obligation to pay the premium; hence, the replacement-renewal policy of these policies are effective and binding for another year [22 May 1992 – 22 May 1993].
            CA affirmed RTC, holding that following previous practice, Masagana was allowed a 60-90 day credit term for the renewal of its policies, and that the acceptance of the late premium payment suggested that payment could be made later.

ISSUE & HOLDING
WON the fire insurance policies had expired on 22 May 1992, or had been extended or renewed by an implied credit arrangement though actual payment of premium was tendered on a later date after the occurrence of the risk insured against [fire]. FIRE INSURANCE POLICIES HAD EXPIRED

RATIO
An insurance policy, other than life is not valid and binding until actual payment of the premium.  Any agreement to the contrary is void. The parties may not agree expressly or impliedly on the extension of credit or time to pay the premium and consider the policy binding before actual payment.

The case of Malayan Insurance v. Cruz-Arnaldo cited by the CA is not applicable. In that case, payment of the premium was made on before the occurrence of the fire.  In the present case, the payment of the premium for renewal of the policies was tendered a month after the fire occurred.  Masagana did not even give UCPB a notice of loss within a reasonable time after occurrence of the fire.

CA DECISION REVERSED 

Saturday, July 28, 2012

Qua Chee Gan v. Law Union and Rock Insurance


QUA CHEE GAN v. LAW UNION AND ROCK INSURANCE
1955 / JBL Reyes / Appeal from CFI judgment

Qua Chee Gan owned 4 warehouses or bodegas used for the storage of copra and hemp, which were insured with Law Union, and the lose made payable to PNB as mortgage of the hemp and copra. Fire broke out and destroyed bodegas 1, 3 ad 4. QCG informed LU by telegram, and the next day, fire adjusters arrived to conduct an investigation. LU resisted payment, claiming violation of warranties and conditions, filing of fraudulent claims, and that the fire had been deliberately caused by QCG or by other persons in connivance with him.
            QCG, his brother, and some employees were indicted and tried for arson, but they were acquitted. Thereafter, the civil suit to collect the insurance money proceeded to its trial. CFI rendered a decision in QCG’s favor.

CFI AFFIRMED; LAW UNION LIABLE

On false and fraudulent claims
CFI found that the discrepancies were a result of QCG’s erroneous interpretation of the provisions of the insurance policies and claim forms, caused by his imperfect English, and that the misstatements were innocently made and without intent to defraud. The rule is that to avoid a policy, the false swearing must be willful and with intent to defraud which was not the cause.

On the storage of gasoline
Ambiguities or obscurities must be strictly interpreted against the party that caused them. This rigid application of the rule has become necessary in view of current business practices. In contrast to contracts entered into by parties bargaining on an equal footing, a contract of insurance calls for greater strictness and vigilance on the part of courts of justice with a view to protect the weaker party from abuses and imposition, and prevent their becoming traps for the unwary. The contract of insurance is one of perfect good faith (uferrimal fidei) not for the insured alone, but equally so for the insurer; in fact, it is more so for the latter, since its dominant bargaining position carries with it stricter responsibility.
            QCG admitted that there were 36 cans of gasoline in Bodega 2. Gasoline is not specifically mentioned among the prohibited articles listed in the hemp warranty. The cause relied upon LU speaks of oils. In ordinary parlance, “oils” means “lubricants” and not gasoline or kerosene. The prohibition of keeping gasoline could have been expressed clearly and unmistakably.

On fire hydrants warranty
LU is estopped from claiming that there was a violation of such warranty, since it knew that from the start, the number of hydrants it demanded never existed, yet it issued policies and received premiums.

vda. de Canilang v. CA


THELMA vda. de CANILANG v. CA and GREAT PACIFIC LIFE ASSURANCE
1993 / Feliciano / Petition for review on certiorari of CA decision

On June 1982, Jaime Canilang was diagnosed as suffering from sinus tachycardia. Two months later, he was found to have acute bronchitis. The next day, he applied for a “non-medical” insurance policy with Great Pacific and named his wife Thelma as his beneficiary. A year later, he died of congestive heart failure, anemia, and chronic anemia. When Thelma filed a claim with Great Pacific, it was denied on the ground that Jaime concealed material information.
            Thelma filed a complaint against Great Pacific with the Insurance Commission for recovery of the insurance proceeds. She testified that she was not aware of any serious illness suffered by Jaime, and that what she knew was that he died because of a kidney disorder. Great Pacific presented a physician who explained that Jaime’s application had been approved based on his medical declaration, and that medical examinations are required only in cases where applicant indicated that he has undergone medical consultation and hospitalization.
The Insurance Commission held that there was no intentional concealment on Jaime’s part. It also held that Great Pacific waived its right to inquire into Jaime’s health condition by issuing the policy despite the lack of answers to some of the pertinent questions in the application. It said BP 874, which voids an insurance contract WON concealment was made intentionally, was not applicable since the law became effective only on 1985.
CA reversed IC. CA said that the issue is WON there was material concealment, and not WON Canilang ‘intentionally’ made material concealment. It held that Jaime’s failure to disclose previous medical consultation and treatment constituted material information.

CANILANG FAILED TO DISCLOSE MATERIAL INFORMATION

The applicable law at that time was PD 1460 (Insurance Code of 1978). Under said law, the information concealed must be such which the concealing party knew and ought to have communicated—those which are material to the contract. The test of materiality is determined not by the event, but solely by the probable and reasonable influence of the facts upon the party to whom communication is due, in forming his estimate of the disadvantages of the proposed contract, or in making his inquiries.
Canilang failed to disclose material information when he did not indicate under the caption ‘Exceptions’ that he twice consulted a doctor who found him to be suffering from sinus tachycardia and acute bronchitis. This failure to communicate must have been intentional, since Jaime could have been aware that his heartbeat would rise to high levels and that he consulted a doctor twice before applying for insurance.
The preceding statute, Act 2427, provided that a concealment, whether intentional or unintentional, entitles the injured party to rescind a contract of insurance. However, in PD 1460, this phrase was not present. [The current law, BP 874, has the phrase.] SC rejected the IC’s unspoken theory that the deletion of the phrase intended to limit the kinds of concealment to intentional concealments. The provision is properly read as referring to ANY concealment [“intentional” and “unintentional” cancel each other out].

CA AFFIRMED; PETITION DENIED

Fieldmen's Insurance v. vda. de Songco


FIELDMEN’S INSURANCE v. MERCEDES VARGAS vda. DE SONGCO, et al. and CA
1968 / Fernando / Review of CA decision

Federico Songco, a man of scant education [first grader], owned a private jeepney. He was induced by Fieldmen’s Insurance agent Benjamin Sambat to apply for a Common Carrier’s Liability Insurance Policy covering his motor vehicle. [As testified by Songco’s son Amor later,] Federico said that his vehicle is an ‘owner’ private vehicle and not for passengers, but agent Sambat said that they can insure whatever kind of vehicle because their company is not owned by the government, so they could do what they please whenever they believe a vehicle is insurable. Songco paid an annual premium and he was issued a Common Carriers Accident Insurance Policy. After the policy expired, he renewed the policy. During the effectivity of the renewed policy, the insured vehicle while being driven by Rodolfo Songco [duly licensed driver and Federico’s son] collided with a car. As a result, Federico and Rodolfo died, while Carlos (another son) and his wife Angelita, and a family friend sustained physical injuries.
            The lower court held that Fieldmen’s Insurance cannot escape liability under a common carrier insurance policy on the pretext that what was insured was a private vehicle and not a common carrier, the policy being issued upon the agent’s insistence. CA affirmed the lower court.

CA DECISION AFFIRMED; FIELDMEN’S INSURANCE IS LIABLE

From Qua Chee Gan v. Law Union and Rock InsuranceWhere inequitable conduct is shown by an insurance firm, it is estopped from enforcing forfeitures in its favor, in order to forestall fraud or imposition on the insured. Estoppel is primarily based on the doctrine of good faith and the avoidance of harm that will befall the innocent party due to its injurious reliance.

Fieldmen’s Insurance incurred legal liability under the policy. Since some of the conditions in the policy were impossible to comply with under the existing conditions at the time and inconsistent with the known facts, the insurer is estopped from asserting breach of such conditions. Except for the fact that the passengers were not fare-paying, their status as beneficiaries under the policy is recognized. Even if the be assumed that there was an ambiguity, such must be strictly interpreted against the party that caused them.

The contract of insurance is one of perfect good faith (uberrima fides) not for the insured alone, but equally so for the insurer; in fact, it is more so for the latter, since its dominant bargaining position carries with it stricter responsibility.

Sunlife Assurance v. CA


SUNLIFE ASSURANCE v. CA and SPS. ROLANDO and BERNARDA BACANI
1995 / Quiason / Petition for review on certiorari of a CA decision

FACTS
On April 1986, Robert John Bacani procured for himself a life insurance contract from Sunlife. He was issued a policy valued at 100k with double indemnity in case of accidental death, and his beneficiary was his mother, Bernarda. On June 1987, Robert died in a plane crash.
Bernarda filed a claim with Sunlife, seeking the benefits of her son’s insurance policy. The findings of the investigation conducted by Sunlife prompted it to reject the claim. Sunlife informed Bernarda that Robert did not disclose material facts relevant to the policy issuance, thus rendering the contract voidable. Sunlife claimed that Robert gave false statements in his application when he answered questions regarding consulting doctors [re: urine, kidney, bladder disorder], submitting to medical exams, and being admitted to a hospital within the past 5 years. Robert only said that he consulted a doctor for cough and flu complications. Sunlife discovered that 2 weeks prior to Robert’s application for insurance, he was examined and confined at the Lung Center where he was diagnosed for renal failure. A check representing the premiums paid was attached to the letter.
Sps. Bacani filed an action for specific performance against Sunlife. RTC ruled in favor of Sps. Bacani, saying that the facts concealed by Robert were made in good faith and under a belief that they need not be disclosed. It also held that Robert’s health history was immaterial since the insurance policy was “non-medical.” CA affirmed RTC.

SUNLIFE PROPERLY EXERCISED ITS RIGHT TO RESCIND THE CONTRACT BY REASON OF ROBERT’S CONCEALMENT

RATIO
“Good faith” is no defense in concealment. Materiality is to be determined solely by the probable and reasonable influence of the facts upon the party to whom communication is due, in forming his estimate of the disadvantages of the proposed contract or in making his inquiries. Materiality does not depend on the insured’s state of mind, nor does it depend on the actual or physical events that ensue.
            The matters concealed would have affected Sunlife’s action on Robert’s application, as it would have approved it with the corresponding adjustment for a higher premium or it would have rejected it. A disclosure may have warranted a medical examination by Sunlife in order for it to assess the risk involved in accepting the application. In addition, Robert’s failure to disclose his hospitalization raises grave doubts about his good faith.

The argument that Sunlife’s waiver of the medical examination debunks the materiality of the facts concealed is untenable. The waiver of a medical examination [in a non-medical insurance contract] renders even more material the information required of the applicant, for such information constitutes an important factor which the insurer takes into consideration in deciding WON to issue the policy. Moreover, this argument by Sps. Bacani would make ineffective the provision that allows rescission where there is concealment.

The insured need not die of the disease he had failed to disclose. It is sufficient that his non-disclosure misled the insurer in forming his estimates of the risks of the proposed insurance policy or in making inquiries.

CA DECISION REVERSED; SUNLIFE’S PETITION GRANTED

Yu Pang Cheng v. CA


YU PANG CHENG v. CA
1959 / Bautista Angelo / Petition for review by certiorari of a CA decision

FACTS
On September 1950, Yu Pang Eng submitted his application for insurance to an insurance company [defendant]. He answered “no” to questions on his medical history (stomach diseases, dizziness, ulcers, vertigo, cancer, tumors, etc.) as well as to the question of WON he consulted any physician regarding said diseases. Upon payment of the first premium, the company issued to him an insurance policy. On December 1950, he went to St. Luke’s for medical treatment but he died two months later. According to the death certificate, he died of infiltrating medullary carcinoma, Grade 4, advanced cardiac and of lesser curvature, stomach metastases spleen.
His brother and beneficiary, Yu Pang Cheng [petitioner], demanded from the insurance company the payment of the policy proceeds [10k], but his demand was refused so he brought the present action. The insurance company’s defense was that the insured was guilty of misrepresentation and concealment of material facts in that he gave false and untruthful answers to questions asked him in his application; hence, the effect is the avoiding of the policy.
It appears that the insured entered the Chinese General Hospital for medical treatment on January 1950 [before application for insurance policy], complaining of dizziness, anemia, abdominal pains and tarry stools. His illness history shows that this started a year ago as frequent dizziness. An x-ray picture of his stomach and the diagnosis was that he suffered from peptic ulcer, bleeding.

INSURED IS GUILTY OF CONCEALMENT OF MATERIAL FACTS

Concealment is a neglect to communicate that which a party knows and ought to communicate. Whether intentional or not, concealment entitles the insurer to rescind the contract. The law requires the insured to communicate to the insurer all facts within his knowledge which are material to the contract and which the other party has not the means of ascertaining. The materiality is determined not by the event but by the probable and reasonable influence of the facts upon the party to whom the communication is due.
The insured’s negative answers to the questions on his previous ailments, or his concealment of his hospitalization deprived the insurance company of the opportunity to make the necessary inquiry as to the nature of his past illness so that it may form its estimate relative to the approval of his application. Had the insurance company been given such opportunity, it would not probably consent to the policy issuance.