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Insurance Case Digest: De la Cruz v. Capital Ins. & Surety Co, Inc. (1966)

G.R. No. L-21574           June 30, 1966
Lessons Applicable: Liability of Insurer for Suicide and Accidental Death (Insurance)
Laws Applicable: 

FACTS:

  • Eduardo de la Cruz, employed as a mucker in the Itogon-Suyoc Mines, Inc. in Baguio, was the holder of an accident insurance policy "against death or disability caused by accidental means"
  • January 1, 1957: For the celebration of the New Year, the Itogon-Suyoc Mines, Inc. sponsored a boxing contest for general entertainment wherein Eduardo, a non-professional boxer participated
  • In the course of his bout with another non-professional boxer 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.  He died due to hemorrhage, intracranial.
  • 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
  • The Capital Insurance and Surety co., inc denied stating that the death caused by his participation in a boxing contest was not accidental
  • RTC: favored Simon
ISSUE: W/N the cause of death was accident

HELD:YES.

  • Eduardo slipped, which was unintentional
  • 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
    • happen by chance or fortuitously, without intention and design, and which is unexpected, unusual, and unforeseen
    • event that takes place without one's foresight or expectation
    • event that proceeds from an unknown cause, or is an unusual effect of a known cause and, therefore, not expected
  • 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
  • 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 is not
  • 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