G.R. No. L-8151December 16, 1955VIRGINIA CALANOC,petitioner,vs.COURT OF APPEALS and THE PHILIPPINE AMERICAN LIFE INSURANCE CO.,respondents.Lucio Javillonar for petitioner.J. A. Wolfson, Manuel Y. Mecias, Emilio Abello and Anselmo A. Reyes for respondents.BAUTISTA ANGELO,J.:This suit involves the collection of P2, 000 representing the value of a supplemental policy covering accidental death which was secured by one Melencio Basilio from the Philippine American Life Insurance Company. The case originated in the Municipal Court of Manila and judgment being favorable to the plaintiff it was appealed to the court of first instance. The latter court affirmed the judgment but on appeal to the Court of Appeals the judgment was reversed and the case is now before us on a petition for review.Melencio Basilio was a watchman of the Manila Auto Supply located at the corner of Avenida Rizal and Zurbaran. He secured a life insurance policy from the Philippine American Life Insurance Company in the amount of P2,000 to which was attached a supplementary contract covering death by accident. On January 25, 1951, he died of a gunshot wound on the occasion of a robbery committed in the house of Atty. Ojeda at the corner of Oroquieta and Zurbaan streets. Virginia Calanoc, the widow, was paid the sum of P2,000, face value of the policy, but when she demanded the payment of the additional sum of P2,000 representing the value of the supplemental policy, the company refused alleging, as main defense, that the deceased died because he was murdered by a person who took part in the commission of the robbery and while making an arrest as an officer of the law which contingencies were expressly excluded in the contract and have the effect of exempting the company from liability.The pertinent facts which need to be considered for the determination of the questions raised are those reproduced in the decision of the Court of Appeals as follows:The circumstances surrounding the death of Melencio Basilio show that when he was killed at about seven o'clock in the night of January 25, 1951, he was on duty as watchman of the Manila Auto Supply at the corner of Avenida Rizal and Zurbaran; that it turned out that Atty. Antonio Ojeda who had his residence at the corner of Zurbaran and Oroquieta, a block away from Basilio's station, had come home that night and found that his house was well-lighted, but with the windows closed; that getting suspicious that there were culprits in his house, Atty. Ojeda retreated to look for a policeman and finding Basilio in khaki uniform, asked him to accompany him to the house with the latter refusing on the ground that he was not a policeman, but suggesting that Atty. Ojeda should ask the traffic policeman on duty at the corner of Rizal Avenue and Zurbaran; that Atty. Ojeda went to the traffic policeman at said corner and reported the matter, asking the policeman to come along with him, to which the policeman agreed; that on the way to the Ojeda residence, the policeman and Atty. Ojeda passed by Basilio and somehow or other invited the latter to come along; that as the tree approached the Ojeda residence and stood in front of the main gate which was covered with galvanized iron, the fence itself being partly concrete and partly adobe stone, a shot was fired; that immediately after the shot, Atty. Ojeda and the policeman sought cover; that the policeman, at the request of Atty. Ojeda, left the premises to look for reinforcement; that it turned out afterwards that the special watchman Melencio Basilio was hit in the abdomen, the wound causing his instantaneous death; that the shot must have come from inside the yard of Atty. Ojeda, the bullet passing through a hole waist-high in the galvanized iron gate; that upon inquiry Atty. Ojeda found out that the savings of his children in the amount of P30 in coins kept in his aparador contained in stockings were taken away, the aparador having been ransacked; that a month thereafter the corresponding investigation conducted by the police authorities led to the arrest and prosecution of four persons in Criminal Case No. 15104 of the Court of First Instance of Manila for 'Robbery in an Inhabited House and in Band with Murder'.It is contended in behalf of the company that Basilio was killed which "making an arrest as an officer of the law" or as a result of an "assault or murder" committed in the place and therefore his death was caused by one of the risks excluded by the supplementary contract which exempts the company from liability. This contention was upheld by the Court of Appeals and, in reaching this conclusion, made the following comment:From the foregoing testimonies, we find that the deceased was a watchman of the Manila Auto Supply, and, as such, he was not boud to leave his place and go with Atty. Ojeda and Policeman Magsanoc to see the trouble, or robbery, that occurred in the house of Atty. Ojeda. In fact, according to the finding of the lower court, Atty. Ojeda finding Basilio in uniform asked him to accompany him to his house, but the latter refused on the ground that he was not a policeman and suggested to Atty. Ojeda to ask help from the traffic policeman on duty at the corner of Rizal Avenue and Zurbaran, but after Atty. Ojeda secured the help of the traffic policeman, the deceased went with Ojeda and said traffic policeman to the residence of Ojeda, and while the deceased was standing in front of the main gate of said residence, he was shot and thus died. The death, therefore, of Basilio, although unexpected, was not caused by an accident, being a voluntary and intentional act on the part of the one wh robbed, or one of those who robbed, the house of Atty. Ojeda. Hence, it is out considered opinion that the death of Basilio, though unexpected, cannot be considered accidental, for his death occurred because he left his post and joined policeman Magsanoc and Atty. Ojeda to repair to the latter's residence to see what happened thereat. Certainly, when Basilio joined Patrolman Magsanoc and Atty. Ojeda, he should have realized the danger to which he was exposing himself, yet, instead of remaining in his place, he went with Atty. Ojeda and Patrolman Magsanoc to see what was the trouble in Atty. Ojeda's house and thus he was fatally shot.We dissent from the above findings of the Court of Appeals. For one thing, Basilio was a watchman of the Manila Auto Supply which was a block away from the house of Atty. Ojeda where something suspicious was happening which caused the latter to ask for help. While at first he declied the invitation of Atty. Ojeda to go with him to his residence to inquire into what was going on because he was not a regular policeman, he later agreed to come along when prompted by the traffic policeman, and upon approaching the gate of the residence he was shot and died. The circumstance that he was a mere watchman and had no duty to heed the call of Atty. Ojeda should not be taken as a capricious desire on his part to expose his life to danger considering the fact that the place he was in duty-bound to guard was only a block away. In volunteering to extend help under the situation, he might have thought, rightly or wrongly, that to know the truth was in the interest of his employer it being a matter that affects the security of the neighborhood. No doubt there was some risk coming to him in pursuing that errand, but that risk always existed it being inherent in the position he was holding. He cannot therefore be blamed solely for doing what he believed was in keeping with his duty as a watchman and as a citizen. And he cannot be considered as making an arrest as an officer of the law, as contended, simply because he went with the traffic policeman, for certainly he did not go there for that purpose nor was he asked to do so by the policeman.Much less can it be pretended that Basilio died in the course of an assault or murder considering the very nature of these crimes. In the first place, there is no proof that the death of Basilio is the result of either crime for the record is barren of any circumstance showing how the fatal shot was fired. Perhaps this may be clarified in the criminal case now pending in court as regards the incident but before that is done anything that might be said on the point would be a mere conjecture. Nor can it be said that the killing was intentional for there is the possibility that the malefactor had fired the shot merely to scare away the people around for his own protection and not necessarily to kill or hit the victim. In any event, while the act may not excempt the triggerman from liability for the damage done, the fact remains that the happening was a pure accident on the part of the victim. The victim could have been either the policeman or Atty. Ojeda for it cannot be pretended that the malefactor aimed at the deceased precisely because he wanted to take his life.We take note that these defenses are included among the risks exluded in the supplementary contract which enumerates the cases which may exempt the company from liability. While as a general rule "the parties may limit the coverage of the policy to certain particular accidents and risks or causes of loss, and may expressly except other risks or causes of loss therefrom" (45 C. J. S. 781-782), however, it is to be desired that the terms and phraseology of the exception clause be clearly expressed so as to be within the easy grasp and understanding of the insured, for if the terms are doubtful or obscure the same must of necessity be interpreted or resolved aganst the one who has caused the obscurity. (Article 1377, new Civil Code) And so it has bene generally held that the "terms in an insurance policy, which are ambiguous, equivacal, or uncertain . . .are to be construed strictly and most strongly against the insurer, and liberally in favor of the insured so as to effect the dominant purpose of indemnity or payment to the insured, especially where a forfeiture is involved" (29 Am. Jur., 181), and the reason for this rule is that he "insured usually has no voice in the selection or arrangement of the words employed and that the language of the contract is selected with great care and deliberation by experts and legal advisers employed by, and acting exclusively in the interest of, the insurance company." (44 C. J. S., p. 1174.)Insurance is, in its nature, complex and difficult for the layman to understand. Policies are prepared by experts who know and can anticipate the bearings and possible complications of every contingency. So long as insurance companies insist upon the use of ambiguous, intricate and technical provisions, which conceal rather than frankly disclose, their own intentions, the courts must, in fairness to those who purchase insurance, construe every ambiguity in favor of the insured. (Algoe vs. Pacific Mut. L. Ins. Co., 91 Wash. 324, LRA 1917A, 1237.)lawphi1.netAn insurer should not be allowed, by the use of obscure phrases and exceptions, to defeat the very purpose for which the policy was procured. (Moore vs. Aetna Life Insurance Co., LRA 1915D, 264.)We are therefore persuaded to conclude that the circumstances unfolded in the present case do not warrant the finding that the death of the unfortunate victim comes within the purview of the exception clause of the supplementary policy and, hence, do not exempt the company from liability.Wherefore, reversing the decision appealed from, we hereby order the company to pay petitioner-appellant the amount of P2,000, with legal interest from January 26, 1951 until fully paid, with costs.Paras, C. J., Bengzon, Padilla, Montemayor, Reyes, A., Jugo, Labrador, Concepcion, and Reyes, J. B. L., JJ., concur.G.R. No. L-25579 March 29, 1972EMILIA T. BIAGTAN, JUAN T. BIAGTAN, JR., MIGUEL T. BIAGTAN, GIL T. BIAGTAN and GRACIA T. BIAGTAN,plaintiffs-appellees,vs.THE INSULAR LIFE ASSURANCE COMPANY, LTD.,defendant-appellant.Tanopo, Millora, Serafica, and Saez for plaintiff-appellees.Araneta, Mendoza and Papa for defendant-appellant.MAKALINTAL,J.:pThis is an appeal from the decision of the Court of First Instance of Pangasinan in its Civil Case No. D-1700.The facts are stipulated. Juan S. Biagtan was insured with defendant InsularLife Assurance Company under Policy No. 398075 for the sum of P5,000.00 and, under a supplementary contract denominated "Accidental Death Benefit Clause, for an additional sum of P5,000.00 if "the death of the Insured resulted directly from bodily injury effected solely through external and violent means sustained in an accident ... and independently of all other causes." The clause, however,expressly provided that it would not apply where death resulted from an injury"intentionally inflicted by another party."On the night of May 20, 1964, or during the first hours of the following day a band of robbers entered the house of the insured Juan S. Biagtan. What happened then is related in the decision of the trial court as follows:...; that on the night of May 20, 1964 or the first hours of May 21, 1964, while the said life policy and supplementary contract were in full force and effect, the house of insured Juan S. Biagtan was robbed by a band of robbers who were charged in and convicted by the Court of First Instance of Pangasinan for robbery with homicide; that in committing the robbery, the robbers, on reaching the staircase landing on the second floor, rushed towards the door of the second floor room, where they suddenly met a person near the door of oneof the rooms who turned out to be the insured Juan S. Biagtan who received thrusts from their sharp-pointed instruments, causing wounds on the body of said Juan S. Biagtan resulting in his death at about 7 a.m. on the same day, May 21, 1964;Plaintiffs, as beneficiaries of the insured, filed a claim under the policy. The insurance company paid the basic amount of P5,000.00 but refused to pay the additional sum of P5,000.00 under the accidental death benefit clause, on the ground that the insured's death resulted from injuries intentionally inflicted by third parties and therefore was not covered. Plaintiffs filed suit to recover, and after due hearing the courta quorendered judgment in their favor. Hence the present appeal by the insurer.The only issue here is whether under the facts are stipulated and found by the trial court the wounds received by the insured at the hands of the robbers nine in all, five of them mortal and four non-mortal were inflicted intentionally. The court, in ruling negatively on the issue, stated that since the parties presented no evidence and submitted the case upon stipulation, there was no "proof that the act of receiving thrust (sic) from the sharp-pointed instrument of the robbers was intended to inflict injuries upon the person of the insured or any other person or merely to scare away any person so as to ward off any resistance or obstacle that might be offered in the pursuit of their main objective which was robbery."The trial court committed a plain error in drawing the conclusion it did from the admitted facts. Nine wounds were inflicted upon the deceased, all by means of thrusts with sharp-pointed instruments wielded by the robbers. This is a physical fact as to which there is no dispute. So is the fact that five of those wounds caused the death of the insured. Whether the robbers had the intent to kill or merely to scare the victim or to ward off any defense he might offer, it cannot be denied that the act itself of inflicting the injuries was intentional. It should be noted that the exception in the accidental benefit clause invoked by the appellant does not speak of the purpose whether homicidal or not of a third party in causing the injuries, but only of the fact that such injuries have been "intentionally" inflicted this obviously to distinguish them from injuries which, although received at the hands of a third party, are purely accidental. This construction is the basic idea expressed in the coverage of the clause itself, namely, that "the death of the insured resulted directly from bodily injury effected solely through external and violent means sustained in anaccident... and independently of all other causes." A gun which discharges while being cleaned and kills a bystander; a hunter who shoots at his prey and hits a person instead; an athlete in a competitive game involving physical effort who collides with an opponent and fatally injures him as a result: these are instances where the infliction of the injury is unintentional and therefore would be within the coverage of an accidental death benefit clause such as thatin question in this case. But where a gang of robbers enter a house and coming face to face with the owner, even if unexpectedly, stab him repeatedly, it is contrary to all reason and logic to say that his injuries are not intentionally inflicted, regardless of whether they prove fatal or not. As it was, in the present case they did prove fatal, and the robbers have been accused and convicted of the crime of robbery with homicide.The case ofCalanoc vs. Court of Appeals, 98 Phil. 79, is relied upon by the trial court in support of its decision. The facts in that case, however, are different from those obtaining here. The insured there was a watchman in a certain company, who happened to be invited by a policeman to come along as the latter was on his way to investigate a reported robbery going on in a private house. As the two of them, together with the owner of the house, approached and stood in front of the main gate, a shot was fired and it turned out afterwards that the watchman was hit in the abdomen, the wound causing his death. Under those circumstances this Court held that it could not be said that the killing was intentional for there was the possibility that the malefactor had fired the shot to scare people around for his own protection andnot necessarrily to kill or hit the victim. A similar possibility is clearly ruled out by the facts in the case now before Us. For while a single shot fired from a distance, and by a person who was not even seen aiming at the victim, could indeed have been fired without intent to kill or injure, nine wounds inflicted with bladed weapons at close range cannot conceivably be considered as innocent insofar as such intent is concerned. The manner of execution of the crime permits no other conclusion.Court decisions in the American jurisdiction, where similar provisions in accidental death benefit clauses in insurance policies have been construed, may shed light on the issue before Us. Thus, it has been held that "intentional" as used in an accident policy excepting intentional injuries inflicted by the insured or any other person, etc., implies the exercise of the reasoning faculties, consciousness and volition.1Where a provision of the policy excludes intentional injury, it is the intention of the person inflicting the injury that is controlling.2If the injuries suffered by the insured clearly resulted from the intentional act of a third person the insurer is relieved from liability as stipulated.3In the case ofHutchcraft's Ex'r v. Travelers' Ins. Co., 87 Ky. 300, 8 S.W. 570, 12 Am. St. Rep. 484, the insured was waylaid and assassinated for the purpose of robbery. Two (2) defenses were interposed to the action to recover indemnity, namely: (1) that the insured having been killed by intentional means, his death was not accidental, and (2) that the proviso in the policy expressly exempted the insurer from liability in case the insured died from injuries intentionally inflicted by another person. In rendering judgment for the insurance company the Court held that while the assassination of the insured was as to him an unforeseen event and therefore accidental, "the clause of the proviso that excludes the (insurer's) liability, in case death or injury is intentionally inflicted by another person, applies to this case."InButero v. Travelers' Acc. Ins. Co., 96 Wis. 536, 65 Am. St. Rep. 61, 71 S.W. 811, the insured was shot three times by a person unknown late on a dark and stormy night, while working in the coal shed of a railroad company. The policy did not cover death resulting from "intentional injuries inflicted by the insured or any other person." The inquiry was as to the question whether the shooting that caused the insured's death was accidental or intentional; and the Court found that under the facts, showing that the murderer knew his victim and that he fired with intent to kill, there could be no recovery under the policy which excepted death from intentional injuries inflicted by any person.WHEREFORE, the decision appealed from is reversed and the complaint dismissed, without pronouncement as to costs.Zaldivar, Castro, Fernando and Villamor, JJ., concur.Makasiar, J., reserves his vote.Separate OpinionsBARREDO,J.,concurring During the deliberations in this case, I entertained some doubts as to the correctness and validity of the view upheld in the main opinion penned by Justice Makalintal. Further reflection has convinced me, however, that there are good reasons to support it.At first blush, one would feel that every death not suicidal should be considered accidental, for the purposes of an accident insurance policy or a life insurance policy with a double indemnity clause in case death results from accident. Indeed, it is quite logical to think that any event whether caused by fault, negligence, intent of a third party or any unavoidable circumstance, normally unforeseen by the insured and free from any possible connivance on his part, is an accident in the generally accepted sense of the term. And if I were convinced that in including in the policy the provision in question, both the insurer and the insured had in mind to exclude thereby from the coverage of the policy only suicide whether unhelped or helped somehow by a third party, I would disregard the American decisions cited and quoted in the main opinion as not even persuasive authorities. But examining the unequivocal language of the provision in controversy and considering that the insured accepted the policy without asking that it be made clear that the phrase "injury intentionally inflicted by a third party" should be understood to refer only to injuries inflicted by a third party without any wilful intervention on his part (of the insured) or, in other words, without any connivance with him (the insured) in order to augment the proceeds of the policy for his benificiaries, I am inclined to agree that death caused by criminal assault is not covered by the policies of the kind here in question, specially if the assault, as a matter of fact, could have been more or less anticipated, as when the insured happens to have violent enemies or is found in circumstances that would make his life fair game of third parties.As to the rest, I have no doubt that the killing of the insured in this case is as intentional as any intentional act can be, hence this concurrence.TEEHANKEE,J.,dissenting:The sole issue at bar is the correctnessin lawof the lower court's appealed decision adjudging defendant insurance company liable, under its supplementary contract denominated "Accidental Death Benefit Clause" with the deceased insured, to plaintiffs-beneficiaries (excluding plaintiff Emilia T. Biagtan) in an additional amount of P5,000.00 (with corresponding legal interest) and ruling that defendant company had failed to present any evidence to substantiate its defense that the insured's death came within the stipulated exceptions.Defendant's accidental death benefit clause expressly provides:ACCIDENTAL DEATH BENEFIT. (hereinafter called the benefit). Upon receipt and approval of due proof that the death of the Insured resulted directly from bodily injury effected solely through external and violent means sustained in an accident, within ninety days after the date of sustaining such injury, and independently of all other causes, this Company shall pay, in addition to the sum insured specified on the first page of this Policy, a further sum equal to said sum insured payable at the same time and in the same manner as said sum insured, provided, that such death occurred during the continuance of this Clause and of this Policy and before the sixtieth birthday of the Insured."1A long list of exceptions and an Automatic Discontinuance clause immediately follow thereafter, thus:EXCEPTIONS. The Benefit shall not apply if the Insured's death shall result, either directly or indirectly, from any one of the following causes:(1) Self-destructionorself-inflicted injuries, whether the Insured be sane or insane;(2) Bodily or mental infirmity or diseaseof any kind;(3) Poisoning or infection, other than infection occurring simultaneously with and in consequence of a cut or wound sustained in an accident;(4) Injuries of which there isno visible contusions or wound on the exteriorof the body, drowning and internal injuries revealed by autopsy excepted;(5) Anyinjuries received(a) whileon police dutyin any military, naval or police organization; (b) in anyriot,civil commotion, insurrectionor waror any act incident thereto; (c) whiletravellingas a passenger or otherwisein any form of submarine transportation, or while engaging in submarine operations; (d) inany violation of the law by the Insured or assault provoked by the Insured; (e) that has beeninflicted intentionally by a third party, either with or without provocation on the part of the Insured, and whether or not the attack or the defense by the third party was caused by a violation of the law by the Insured;(6) Operating or riding in or descending from any kind of aircraftif the Insured is a pilot, officer or member of the crew of the aircraft or is giving or receiving any kind of training or instruction or has any duties aboard the aircraft or requiring descent therefrom; and(7) Atomic energy explosionof any nature whatsoever.The Company, before making any payment under this Clause, shall have the right and opportunity to examine the body and make an autopsy thereof.AUTOMATIC DISCONTINUANCE. This Benefit shallautomatically terminateand the additional premium therefor shall cease to be payable when and if:(1) This Policy is surrendered for cash, paid-up insurance or extended term insurance; or(2) The benefit under the Total and Permanent Disability Waiver of Premium Certificate is granted to the insured; or(3) The Insured engages inmilitary, naval or aeronautic service in time of war; or(4) The policy anniversary immediately preceding the sixtieth birthday of the Insured is reached.2It is undisputed that, as recited in the lower court's decision, the insured met his death, as follows: "that on the night of May 20, 1964 or the first hours of May 21, 1964, while the said life policy and supplementary contract were in full force and effect, the house of insured Juan S. Biagtan was robbed by a band of robbers who were charged in and convicted by the Court of First Instance of Pangasinan for robbery with homicide; that in committing the robbery, the robbers, on reaching the staircase landing of the second floor, rushed towards the doors of the second floor room, where they suddenly met a person near the door of one of the rooms who turned out to be the insured Juan S. Biagtan who received thrust from their sharp-pointed instruments, causing wounds on the body of said Juan S. Biagtan resulting in his death at about 7 a.m. on the same day, May 21, 1964." 3Defendant company, while admitting the above-recited circumstances under which the insured met his death, disclaimed liability under its accidental death benefit clause under paragraph 5 of its stipulated "Exceptions" on its theory that the insured's death resulted from injuries "intentionally inflicted by a third party," i.e. the robbers who broke into the insured's house and inflicted fatal injuries on him.The case was submitted for decision upon the parties' stipulation of facts that (1) insurance companies such as the Lincoln National Life Insurance Co. and Sun Life Assurance Co. of Canada with which the deceased insured Juan S. Biagtan was also insured for much larger sums under similar contracts with accidental death benefit provisions have promptly paid the benefits thereunder to plaintiffs-beneficiaries; (2) the robbers who caused the insured's death were charged in and convicted by the Court of First Instance of Pangasinan for the crime of robbery with homicide; and (3) the injuries inflicted on the insured by the robbers consisted of five mortal and four non-mortal wounds.4The lower court thereafter rendered judgment against defendant, as follows:There is no doubt that the insured, Juan S. Biagtan, met his death as a result of the wounds inflicted upon him by the malefactors on the early morning of May 21, 1964 by means of thrusts from sharp-pointed instruments delivered upon his person, and there is likewise no question that the thrusts were made on the occasion of the robbery. However, it is defendants' position that the killing of the insured was intentionally done by the malefactors, who were charged with and convicted of the crime of robbery with homicide by the Court of First Instance of Pangasinan.It must be noted here thatno evidence whatsoever was presented by the parties who submitted the case for resolution upon the stipulation of factspresented by them. Thus,the court does not have before it proofthat the act of receiving thrust(s) from the sharp-pointed instrument of the robbers wasintended to inflict injuriesupon the person of the insured or any other person ormerely to scare away any person so as to ward off any resistance or obstacle that might be offeredin the pursuit of their main objective which was robbery. It was held thatwhere a provision of the policy excludes intentional injury, it is the intention of the person inflicting the injury that is controlling ... and to come within the exception, the act which causes the injury must be wholly intentional, not merely partly.The case at bar has some similarity with the case ofVirginia Calanoc vs. Court of Appeals, et al., L-8151, promulgated December 16, 1965, where the Supreme Court ruled that "the shot (which killed the insured) was merely to scare away the people around for his own protection and not necessarily to kill or hit the victim."In the Calanoc case, one Melencio Basilio, a watchman of a certain company, took out life insurance from the Philippine American Life Insurance Company in the amount of P2,000.00 to which was attached a supplementary contract covering death by accident. Calanoc died of gunshot wounds on the occasion of a robbery committed in the house of a certain Atty. Ojeda in Manila. The insured's widow was paid P2,000.00, the face value of the policy, but when she demanded payment of the additional sum of P2,000.00 representing the value of the supplemental policy, the company refused alleging, as main defense, that the deceased died because he was murdered by a person who took part in the commission of the robbery and while making an arrest as an officer of the law which contingencies were (as in this case) expressly excluded in the contract and have the effect of exempting the company from liability.The facts in the Calanoc case insofar as pertinent to this case are, as found by the Court of Appeals in its decision which findings of fact were adopted by the Supreme Court, as follows:"...that on the way to the Ojeda residence (which was then being robbed by armed men), the policeman and Atty. Ojeda passed by Basilio (the insured) and somehow or other invited the latter to come along; that as the three approached the Ojeda residence and stood in front of the main gate which was covered by galvanized iron, the fence itself being partly concrete and partly adobe stone, a shot was fired; ... that it turned out afterwards that the special watchman Melencio Basilio was hit in the abdomen, the wound causing his instantaneous death ..."The Court of Appeals arrived at the conclusion that the death of Basilio, although unexpected, was not caused by an accident, being a voluntary and intentional act on the part of the one who robbed, or one of those who robbed, the house of Atty. Ojeda.In reversing this conclusion of the Court of Appeals, the Supreme Court said in part:"... Nor can it be said that the killing was intentional for there is the possibility that the malefactors had fired the shot merely to scare away the people around for his own protection and not necessarily to kill or hit the victim. In any event,while the act may not exempt the triggerman from ability for the damage done, the fact remains that the happening was a pure accidentt on the part of the victim."With this ruling of the Supreme Court, and the utter absence of evidence in this case as to the real intention of the malefactorsin making a thrust with their sharp-pointed instrument on any person, the victim in particular, the case falls squarely within the ruling in the Calanoc vs. Court of Appeals case.It is the considered view of this Court that the insureddied because of an accidentwhich happened on the occasion of the robbery being committed in his house.His death was not sought (at least no evidence was presented to show it was), and therefore was fortuitous. "Accident" was defined as that which happens by chance or fortuitously, without intention or design, and which is unexpected, unusual and unforeseen, or that which 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. (29 Am. Jur. 706).There is no question that the defense set up by the defendant company is one of those included among the risks excluded in the supplementary contract.However, there is no evidence here that the thrusts with sharp-pointed instrument(which led to the death of the insured)was "intentional," (sic) so as to exempt the company from liability. It could safely be assumed that it was purely accidentalconsidering that the principal motive of the culprits was robbery, the thrusts being merely intended to scare away persons who might offer resistance or might obstruct them from pursuing their main objective which was robbery.5It is respectfully submitted that the lower court committed no error in law in holding defendant insurance company liable to plaintiffs-beneficiaries under its accidental death benefit clause, by virtue of the following considerations:1. The case ofCalanoccited by the lower court is indeed controlling here.6This Court, there construing a similar clause, squarely ruled that fatal injuries inflicted upon an insured by a malefactor(s) during the latter's commission of a crime are deemed accidental and within the coverage of such accidental death benefit clauses and the burden of proving that the killing was intentional so as to have it fall within the stipulated exception of having resulted from injuries "intentionally inflicted by a third party" must be discharged by the insurance company. This Court there clearly held that in such cases where the killing does not amount to murder, it must be held to be a "pure accident" on the part of the victim, compensable with double-indemnity, even though the malefactor is criminally liable for his act. This Court rejected the insurance-company's contrary claim, thus:Much less can it be pretended that Basilio died in the course of an assault or murder considering the very nature of these crimes. In the first place, there is no proof that the death of Basilio is the result of either crime forthe record is barren of any circumstance showing how the fatal shot was fired. Perhaps this may be clarified in the criminal case now pending in court a regards the incident but before that is done anything that might be said on the point would be a mere conjecture.Nor can it be said that the killing was intentional for there is the possibility that the malefactor had fired the shot merely to scare away the people aroundfor his own protection and not necessarily to kill or hit the victim. In any event,while the act may not exempt the triggerman from liabilityfor the damage done, the fact remains thatthe happening was a pure accident on the part of the victim. The victim could have been either the policeman or Atty. Ojeda for it cannot be pretended that the malefactor aimed at the deceased precisely because he wanted to take his life. 72. Defendant company patently failed to discharge its burden of proving that the fatal injuries were inflicted upon the deceasedintentionally, i.e.deliberately. The lower court correctly held that since the case was submitted upon the parties' stipulation of facts which did not cover the malefactors' intent at all, there was an "utter absence of evidence in this case as to the real intention of the malefactors in making a thrust with their sharp-pointed instrument(s) on any person, the victim in particular." From the undisputed facts,supra,8the robbers had "rushed towards the doors of the second floor room, where they suddenly met a person ... who turned out to be the insured Juan S. Biagtan who received thrusts from their pointed instruments." The thrusts were indeed properly termed "purely accidental" since they seemed to be a reflex action on the robbers' part upon their being surprised by the deceased. To argue, as defendant does, that the robbers' intent to kill must necessarily be deduced from the four mortal wounds inflicted upon the deceased is to beg the question. Defendant must suffer the consequences of its failure to discharge its burden of proving by competent evidence, e.g. the robbers' or eyewitnesses' testimony, that the fatal injuries wereintentionally inflicted upon the insuredso as to exempt itself from liability.3. Furthermore, plaintiffs-appellees properly assert in their brief that the sole error assigned by defendant company, to wit, that the fatal injuries were not accidental as held by the lower court but should be held to have beenintentionally inflicted, raises a question of fact which defendant is now barred from raising, since it expressly limited its appeal to this Court purely "onquestions of law", per its noitice of appeal,9Defendant is therefore confined to "raising only questions of law" and "no other questions" under Rule 42, section 2 of the Rules of Court10and is deemed to have conceded the findings of fact of the trial court, since he thereby waived all questions of facts.114. It has long been an established rule of construction of so-called contracts of adhesion such as insurance contracts, where the insured is handed a printed insurance policy whose fine-print language has long been selected with great care and deliberation by specialists and legal advisers employed by and acting exclusively in the interest of the insurance company, that the terms and phraseology of the policy, particularly of any exception clauses, must be clearly expressed so as to be easily understood by the insured and any "ambiguous, equivocal or uncertain terms" are to be "construed strictly and most strongly against the insurer and liberally in favor of the insured so as to effect the dominant purpose of indemnity or payment to the insured, especially where a forfeiture is involved.The Court so expressly held inCalanocthat:... While as a general rule "the parties may limit the coverage of the policy to certain particular accidents and risks or causes of loss, and may expressly except other risks or causes of loss therefrom" (45 C.J.S. 781-782), however, it is to be desired that the terms and phraseology ofthe exception clause be clearly expressed so as to be within the easy grasp and understanding of the insured, for if the terms are doubtful or obscure the same must of necessity be interpreted or resolved against the one who has caused the obscurity. (Article 1377, new Civil Code) And so it has been generally held that the "terms in an insurance policy, which are ambiguous, equivocal, or uncertain ...are to be construed strictly and most strongly against the insurer, and liberally in favor of the insured so as to effect the dominant purpose of indemnity or payment to the insured, especially where a forfeiture is involved" (29 AM. Jur., 181), and the reason for this rule is thatthe "insured usually has no voice in the selection or arrangement of the words employedand that the language of the contract is selected with great care and deliberation by experts and legal advisers employed by, and acting exclusively in the interest of, the insurance company." (44 C.J.S., p. 1174)Insurance is, in its nature, complex and difficult for the layman to understand.Policies are prepared by expertswho know and can anticipate the bearing and possible complications of every contingency.So long as insurance companies insist upon the use of ambiguous, intricate and technical provisions, which conceal rather than frankly disclose, their own intentions, the courts must, in fairness to those who purchase insurance construe every ambiguity in favor of the insured." (Algoe vs. Pacific Mut. L. Ins. Co., 91 Wash. 324 LRA 1917A, 1237.)"Aninsurershould not be allowed, by the use ofobscure phrases and exceptions, to defeat the very purpose for which the policy was procured." (Moore vs. Aetna Life Insurance Co., LRA 1915D, 164).12The Court has but recently reiterated this doctrine inLandicho vs. GSIS13and again applied the provisions of Article 1377 of our Civil Code that "The interpretation of obscure words or stipulations in a contract shall not favor the party who caused the obscurity."5. The accidental death benefit clause assuring the insured's beneficiaries of double indemnity, upon payment of an extra premium, in the event that the insured meets violent accidental death is contractually stipulated as follows in the policy: "that the death of the insured resulteddirectly from bodily injuryeffectedsolely through external and violent meanssustained in anaccident,"supra. The policy then lists numerous exceptions, which may be classified as follows: Injuries effected throughnon-external meanswhich are excepted: self-destruction, bodily or mental infirmity or disease, poisoning or infection, injuries with novisiblecontusions or exterior wounds (exceptions 1 to 4 of policy clause); Injuriescaused by some act of the insured which is proscribedby the policy, and are therefore similarly exepted: injuries received while on police duty, while travelling in any form of submarine transportation, orin any violation of law by the insured or assault provoked by the insured, or in any aircraft if the insured is a pilot or crew member; [exceptions 5 (a), (c) and (d), and 6 of the policy clause]; and Accidentsexpressly excluded: where death resulted in any riot, civil commotion, insurrection or war or atomic energy explosion. (Exceptions 5[b] and 7 of policy clause).The only exception which isnotsusceptible of classification is that provided in paragraph 5 (e), the very exception herein involved, which would also except injuries "inflicted intentionally by a third party, either with or without provocationon the part of the insured, andwhether or notthe attack or the defense by the third party wascaused by a violation of the law by the insured."This ambiguous clause conflicts with all the other four exceptions in the same paragraph 5 particularly that immediately preceding it in item (d) which excepts injuries received where the insured has violated the law or provoked the injury, while this clause, construed as the insurance company now claims, would seemingly except alsoall other injuries, intentionally inflicted by a third party, regardless of any violation of law or provocation by the insured, and defeat the very purpose of the policy of giving the insured double indemnity in case of accidental death by "external and violent means" in the very language of the policy."It is obvious from the very classification of the exceptions and applying the rule ofnoscitus a sociisthat the double-indemnity policy covers the insured against accidental death, whether caused by fault, negligence or intent of a third party which is unforeseen and unexpected by the insured. All the associated words and concepts in the policy plainly exclude the accidental death from the coverage of the policy only where the injuries are self-inflicted or attended by some proscribed act of the insured or are incurred in some expressly excluded calamity such as riot, war or atomic explosion.Finally, the untenability of herein defendant insurer's claim that the insured's death fell within the exception is further heightened by the stipulated fact that two other insurance companies which likewise covered the insured for which larger sums under similar accidental death benefit clauses promptly paid the benefits thereof to plaintiffs-beneficiaries.I vote accordingly for the affirmancein totoof the appealed decision, with costs against defendant-appellant.Concepcion, C.J. and Reyes, J.B.L., J., concur.Separate OpinionsBARREDO,J.,concurring During the deliberations in this case, I entertained some doubts as to the correctness and validity of the view upheld in the main opinion penned by Justice Makalintal. Further reflection has convinced me, however, that there are good reasons to support it.At first blush, one would feel that every death not suicidal should be considered accidental, for the purposes of an accident insurance policy or a life insurance policy with a double indemnity clause in case death results from accident. Indeed, it is quite logical to think that any event whether caused by fault, negligence, intent of a third party or any unavoidable circumstance, normally unforeseen by the insured and free from any possible connivance on his part, is an accident in the generally accepted sense of the term. And if I were convinced that in including in the policy the provision in question, both the insurer and the insured had in mind to exclude thereby from the coverage of the policy only suicide whether unhelped or helped somehow by a third party, I would disregard the American decisions cited and quoted in the main opinion as not even persuasive authorities. But examining the unequivocal language of the provision in controversy and considering that the insured accepted the policy without asking that it be made clear that the phrase "injury intentionally inflicted by a third party" should be understood to refer only to injuries inflicted by a third party without any wilful intervention on his part (of the insured) or, in other words, without any connivance with him (the insured) in order to augment the proceeds of the policy for his benificiaries, I am inclined to agree that death caused by criminal assault is not covered by the policies of the kind here in question, specially if the assault, as a matter of fact, could have been more or less anticipated, as when the insured happens to have violent enemies or is found in circumstances that would make his life fair game of third parties.As to the rest, I have no doubt that the killing of the insured in this case is as intentional as any intentional act can be, hence this concurrence.TEEHANKEE,J.,dissenting:The sole issue at bar is the correctnessin lawof the lower court's appealed decision adjudging defendant insurance company liable, under its supplementary contract denominated "Accidental Death Benefit Clause" with the deceased insured, to plaintiffs-beneficiaries (excluding plaintiff Emilia T. Biagtan) in an additional amount of P5,000.00 (with corresponding legal interest) and ruling that defendant company had failed to present any evidence to substantiate its defense that the insured's death came within the stipulated exceptions.Defendant's accidental death benefit clause expressly provides:ACCIDENTAL DEATH BENEFIT. (hereinafter called the benefit). Upon receipt and approval of due proof that the death of the Insured resulted directly from bodily injury effected solely through external and violent means sustained in an accident, within ninety days after the date of sustaining such injury, and independently of all other causes, this Company shall pay, in addition to the sum insured specified on the first page of this Policy, a further sum equal to said sum insured payable at the same time and in the same manner as said sum insured, provided, that such death occurred during the continuance of this Clause and of this Policy and before the sixtieth birthday of the Insured."1A long list of exceptions and an Automatic Discontinuance clause immediately follow thereafter, thus:EXCEPTIONS. The Benefit shall not apply if the Insured's death shall result, either directly or indirectly, from any one of the following causes:(1) Self-destructionorself-inflicted injuries, whether the Insured be sane or insane;(2) Bodily or mental infirmity or diseaseof any kind;(3) Poisoning or infection, other than infection occurring simultaneously with and in consequence of a cut or wound sustained in an accident;(4) Injuries of which there isno visible contusions or wound on the exteriorof the body, drowning and internal injuries revealed by autopsy excepted;(5) Anyinjuries received(a) whileon police dutyin any military, naval or police organization; (b) in anyriot,civil commotion, insurrectionor waror any act incident thereto; (c) whiletravellingas a passenger or otherwisein any form of submarine transportation, or while engaging in submarine operations; (d) inany violation of the law by the Insured or assault provoked by the Insured; (e) that has beeninflicted intentionally by a third party, either with or without provocation on the part of the Insured, and whether or not the attack or the defense by the third party was caused by a violation of the law by the Insured;(6) Operating or riding in or descending from any kind of aircraftif the Insured is a pilot, officer or member of the crew of the aircraft or is giving or receiving any kind of training or instruction or has any duties aboard the aircraft or requiring descent therefrom; and(7) Atomic energy explosionof any nature whatsoever.The Company, before making any payment under this Clause, shall have the right and opportunity to examine the body and make an autopsy thereof.AUTOMATIC DISCONTINUANCE. This Benefit shallautomatically terminateand the additional premium therefor shall cease to be payable when and if:(1) This Policy is surrendered for cash, paid-up insurance or extended term insurance; or(2) The benefit under the Total and Permanent Disability Waiver of Premium Certificate is granted to the insured; or(3) The Insured engages inmilitary, naval or aeronautic service in time of war; or(4) The policy anniversary immediately preceding the sixtieth birthday of the Insured is reached.2It is undisputed that, as recited in the lower court's decision, the insured met his death, as follows: "that on the night of May 20, 1964 or the first hours of May 21, 1964, while the said life policy and supplementary contract were in full force and effect, the house of insured Juan S. Biagtan was robbed by a band of robbers who were charged in and convicted by the Court of First Instance of Pangasinan for robbery with homicide; that in committing the robbery, the robbers, on reaching the staircase landing of the second floor, rushed towards the doors of the second floor room, where they suddenly met a person near the door of one of the rooms who turned out to be the insured Juan S. Biagtan who received thrust from their sharp-pointed instruments, causing wounds on the body of said Juan S. Biagtan resulting in his death at about 7 a.m. on the same day, May 21, 1964." 3Defendant company, while admitting the above-recited circumstances under which the insured met his death, disclaimed liability under its accidental death benefit clause under paragraph 5 of its stipulated "Exceptions" on its theory that the insured's death resulted from injuries "intentionally inflicted by a third party," i.e. the robbers who broke into the insured's house and inflicted fatal injuries on him.The case was submitted for decision upon the parties' stipulation of facts that (1) insurance companies such as the Lincoln National Life Insurance Co. and Sun Life Assurance Co. of Canada with which the deceased insured Juan S. Biagtan was also insured for much larger sums under similar contracts with accidental death benefit provisions have promptly paid the benefits thereunder to plaintiffs-beneficiaries; (2) the robbers who caused the insured's death were charged in and convicted by the Court of First Instance of Pangasinan for the crime of robbery with homicide; and (3) the injuries inflicted on the insured by the robbers consisted of five mortal and four non-mortal wounds.4The lower court thereafter rendered judgment against defendant, as follows:There is no doubt that the insured, Juan S. Biagtan, met his death as a result of the wounds inflicted upon him by the malefactors on the early morning of May 21, 1964 by means of thrusts from sharp-pointed instruments delivered upon his person, and there is likewise no question that the thrusts were made on the occasion of the robbery. However, it is defendants' position that the killing of the insured was intentionally done by the malefactors, who were charged with and convicted of the crime of robbery with homicide by the Court of First Instance of Pangasinan.It must be noted here thatno evidence whatsoever was presented by the parties who submitted the case for resolution upon the stipulation of factspresented by them. Thus,the court does not have before it proofthat the act of receiving thrust(s) from the sharp-pointed instrument of the robbers wasintended to inflict injuriesupon the person of the insured or any other person ormerely to scare away any person so as to ward off any resistance or obstacle that might be offeredin the pursuit of their main objective which was robbery. It was held thatwhere a provision of the policy excludes intentional injury, it is the intention of the person inflicting the injury that is controlling ... and to come within the exception, the act which causes the injury must be wholly intentional, not merely partly.The case at bar has some similarity with the case ofVirginia Calanoc vs. Court of Appeals, et al., L-8151, promulgated December 16, 1965, where the Supreme Court ruled that "the shot (which killed the insured) was merely to scare away the people around for his own protection and not necessarily to kill or hit the victim."In the Calanoc case, one Melencio Basilio, a watchman of a certain company, took out life insurance from the Philippine American Life Insurance Company in the amount of P2,000.00 to which was attached a supplementary contract covering death by accident. Calanoc died of gunshot wounds on the occasion of a robbery committed in the house of a certain Atty. Ojeda in Manila. The insured's widow was paid P2,000.00, the face value of the policy, but when she demanded payment of the additional sum of P2,000.00 representing the value of the supplemental policy, the company refused alleging, as main defense, that the deceased died because he was murdered by a person who took part in the commission of the robbery and while making an arrest as an officer of the law which contingencies were (as in this case) expressly excluded in the contract and have the effect of exempting the company from liability.The facts in the Calanoc case insofar as pertinent to this case are, as found by the Court of Appeals in its decision which findings of fact were adopted by the Supreme Court, as follows:"...that on the way to the Ojeda residence (which was then being robbed by armed men), the policeman and Atty. Ojeda passed by Basilio (the insured) and somehow or other invited the latter to come along; that as the three approached the Ojeda residence and stood in front of the main gate which was covered by galvanized iron, the fence itself being partly concrete and partly adobe stone, a shot was fired; ... that it turned out afterwards that the special watchman Melencio Basilio was hit in the abdomen, the wound causing his instantaneous death ..."The Court of Appeals arrived at the conclusion that the death of Basilio, although unexpected, was not caused by an accident, being a voluntary and intentional act on the part of the one who robbed, or one of those who robbed, the house of Atty. Ojeda.In reversing this conclusion of the Court of Appeals, the Supreme Court said in part:"... Nor can it be said that the killing was intentional for there is the possibility that the malefactors had fired the shot merely to scare away the people around for his own protection and not necessarily to kill or hit the victim. In any event,while the act may not exempt the triggerman from ability for the damage done, the fact remains that the happening was a pure accidentt on the part of the victim."With this ruling of the Supreme Court, and the utter absence of evidence in this case as to the real intention of the malefactorsin making a thrust with their sharp-pointed instrument on any person, the victim in particular, the case falls squarely within the ruling in the Calanoc vs. Court of Appeals case.It is the considered view of this Court that the insureddied because of an accidentwhich happened on the occasion of the robbery being committed in his house.His death was not sought (at least no evidence was presented to show it was), and therefore was fortuitous. "Accident" was defined as that which happens by chance or fortuitously, without intention or design, and which is unexpected, unusual and unforeseen, or that which 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. (29 Am. Jur. 706).There is no question that the defense set up by the defendant company is one of those included among the risks excluded in the supplementary contract.However, there is no evidence here that the thrusts with sharp-pointed instrument(which led to the death of the insured)was "intentional," (sic) so as to exempt the company from liability. It could safely be assumed that it was purely accidentalconsidering that the principal motive of the culprits was robbery, the thrusts being merely intended to scare away persons who might offer resistance or might obstruct them from pursuing their main objective which was robbery.5It is respectfully submitted that the lower court committed no error in law in holding defendant insurance company liable to plaintiffs-beneficiaries under its accidental death benefit clause, by virtue of the following considerations:1. The case ofCalanoccited by the lower court is indeed controlling here.6This Court, there construing a similar clause, squarely ruled that fatal injuries inflicted upon an insured by a malefactor(s) during the latter's commission of a crime are deemed accidental and within the coverage of such accidental death benefit clauses and the burden of proving that the killing was intentional so as to have it fall within the stipulated exception of having resulted from injuries "intentionally inflicted by a third party" must be discharged by the insurance company. This Court there clearly held that in such cases where the killing does not amount to murder, it must be held to be a "pure accident" on the part of the victim, compensable with double-indemnity, even though the malefactor is criminally liable for his act. This Court rejected the insurance-company's contrary claim, thus:Much less can it be pretended that Basilio died in the course of an assault or murder considering the very nature of these crimes. In the first place, there is no proof that the death of Basilio is the result of either crime forthe record is barren of any circumstance showing how the fatal shot was fired. Perhaps this may be clarified in the criminal case now pending in court a regards the incident but before that is done anything that might be said on the point would be a mere conjecture.Nor can it be said that the killing was intentional for there is the possibility that the malefactor had fired the shot merely to scare away the people aroundfor his own protection and not necessarily to kill or hit the victim. In any event,while the act may not exempt the triggerman from liabilityfor the damage done, the fact remains thatthe happening was a pure accident on the part of the victim. The victim could have been either the policeman or Atty. Ojeda for it cannot be pretended that the malefactor aimed at the deceased precisely because he wanted to take his life. 72. Defendant company patently failed to discharge its burden of proving that the fatal injuries were inflicted upon the deceasedintentionally, i.e.deliberately. The lower court correctly held that since the case was submitted upon the parties' stipulation of facts which did not cover the malefactors' intent at all, there was an "utter absence of evidence in this case as to the real intention of the malefactors in making a thrust with their sharp-pointed instrument(s) on any person, the victim in particular." From the undisputed facts,supra,8the robbers had "rushed towards the doors of the second floor room, where they suddenly met a person ... who turned out to be the insured Juan S. Biagtan who received thrusts from their pointed instruments." The thrusts were indeed properly termed "purely accidental" since they seemed to be a reflex action on the robbers' part upon their being surprised by the deceased. To argue, as defendant does, that the robbers' intent to kill must necessarily be deduced from the four mortal wounds inflicted upon the deceased is to beg the question. Defendant must suffer the consequences of its failure to discharge its burden of proving by competent evidence, e.g. the robbers' or eyewitnesses' testimony, that the fatal injuries wereintentionally inflicted upon the insuredso as to exempt itself from liability.3. Furthermore, plaintiffs-appellees properly assert in their brief that the sole error assigned by defendant company, to wit, that the fatal injuries were not accidental as held by the lower court but should be held to have beenintentionally inflicted, raises a question of fact which defendant is now barred from raising, since it expressly limited its appeal to this Court purely "onquestions of law", per its noitice of appeal,9Defendant is therefore confined to "raising only questions of law" and "no other questions" under Rule 42, section 2 of the Rules of Court10and is deemed to have conceded the findings of fact of the trial court, since he thereby waived all questions of facts.114. It has long been an established rule of construction of so-called contracts of adhesion such as insurance contracts, where the insured is handed a printed insurance policy whose fine-print language has long been selected with great care and deliberation by specialists and legal advisers employed by and acting exclusively in the interest of the insurance company, that the terms and phraseology of the policy, particularly of any exception clauses, must be clearly expressed so as to be easily understood by the insured and any "ambiguous, equivocal or uncertain terms" are to be "construed strictly and most strongly against the insurer and liberally in favor of the insured so as to effect the dominant purpose of indemnity or payment to the insured, especially where a forfeiture is involved.The Court so expressly held inCalanocthat:... While as a general rule "the parties may limit the coverage of the policy to certain particular accidents and risks or causes of loss, and may expressly except other risks or causes of loss therefrom" (45 C.J.S. 781-782), however, it is to be desired that the terms and phraseology ofthe exception clause be clearly expressed so as to be within the easy grasp and understanding of the insured, for if the terms are doubtful or obscure the same must of necessity be interpreted or resolved against the one who has caused the obscurity. (Article 1377, new Civil Code) And so it has been generally held that the "terms in an insurance policy, which are ambiguous, equivocal, or uncertain ...are to be construed strictly and most strongly against the insurer, and liberally in favor of the insured so as to effect the dominant purpose of indemnity or payment to the insured, especially where a forfeiture is involved" (29 AM. Jur., 181), and the reason for this rule is thatthe "insured usually has no voice in the selection or arrangement of the words employedand that the language of the contract is selected with great care and deliberation by experts and legal advisers employed by, and acting exclusively in the interest of, the insurance company." (44 C.J.S., p. 1174)Insurance is, in its nature, complex and difficult for the layman to understand.Policies are prepared by expertswho know and can anticipate the bearing and possible complications of every contingency.So long as insurance companies insist upon the use of ambiguous, intricate and technical provisions, which conceal rather than frankly disclose, their own intentions, the courts must, in fairness to those who purchase insurance construe every ambiguity in favor of the insured." (Algoe vs. Pacific Mut. L. Ins. Co., 91 Wash. 324 LRA 1917A, 1237.)"Aninsurershould not be allowed, by the use ofobscure phrases and exceptions, to defeat the very purpose for which the policy was procured." (Moore vs. Aetna Life Insurance Co., LRA 1915D, 164).12The Court has but recently reiterated this doctrine inLandicho vs. GSIS13and again applied the provisions of Article 1377 of our Civil Code that "The interpretation of obscure words or stipulations in a contract shall not favor the party who caused the obscurity."5. The accidental death benefit clause assuring the insured's beneficiaries of double indemnity, upon payment of an extra premium, in the event that the insured meets violent accidental death is contractually stipulated as follows in the policy: "that the death of the insured resulteddirectly from bodily injuryeffectedsolely through external and violent meanssustained in anaccident,"supra. The policy then lists numerous exceptions, which may be classified as follows: Injuries effected throughnon-external meanswhich are excepted: self-destruction, bodily or mental infirmity or disease, poisoning or infection, injuries with novisiblecontusions or exterior wounds (exceptions 1 to 4 of policy clause); Injuriescaused by some act of the insured which is proscribedby the policy, and are therefore similarly exepted: injuries received while on police duty, while travelling in any form of submarine transportation, orin any violation of law by the insured or assault provoked by the insured, or in any aircraft if the insured is a pilot or crew member; [exceptions 5 (a), (c) and (d), and 6 of the policy clause]; and Accidentsexpressly excluded: where death resulted in any riot, civil commotion, insurrection or war or atomic energy explosion. (Exceptions 5[b] and 7 of policy clause).The only exception which isnotsusceptible of classification is that provided in paragraph 5 (e), the very exception herein involved, which would also except injuries "inflicted intentionally by a third party, either with or without provocationon the part of the insured, andwhether or notthe attack or the defense by the third party wascaused by a violation of the law by the insured."This ambiguous clause conflicts with all the other four exceptions in the same paragraph 5 particularly that immediately preceding it in item (d) which excepts injuries received where the insured has violated the law or provoked the injury, while this clause, construed as the insurance company now claims, would seemingly except alsoall other injuries, intentionally inflicted by a third party, regardless of any violation of law or provocation by the insured, and defeat the very purpose of the policy of giving the insured double indemnity in case of accidental death by "external and violent means" in the very language of the policy."It is obvious from the very classification of the exceptions and applying the rule ofnoscitus a sociisthat the double-indemnity policy covers the insured against accidental death, whether caused by fault, negligence or intent of a third party which is unforeseen and unexpected by the insured. All the associated words and concepts in the policy plainly exclude the accidental death from the coverage of the policy only where the injuries are self-inflicted or attended by some proscribed act of the insured or are incurred in some expressly excluded calamity such as riot, war or atomic explosion.Finally, the untenability of herein defendant insurer's claim that the insured's death fell within the exception is further heightened by the stipulated fact that two other insurance companies which likewise covered the insured for which larger sums under similar accidental death benefit clauses promptly paid the benefits thereof to plaintiffs-beneficiaries.I vote accordingly for the affirmancein totoof the appealed decision, with costs against defendant-appellant.Concepcion, C.J. and Reyes, J.B.L., J., concur.

G.R. No. 100970 September 2, 1992FINMAN GENERAL ASSURANCE CORPORATION,petitioner,vs.THE HONORABLE COURT OF APPEALS and JULIA SURPOSA,respondents.Aquino and Associates for petitioner.Public Attorney's Office for private respondent.NOCON,J.:This is a petition forcertiorariwith a prayer for the issuance of a restraining order and preliminary mandatory injunction to annul and set aside the decision of the Court of Appeals dated July 11, 1991,1affirming the decision dated March 20, 1990 of the Insurance Commission2in ordering petitioner Finman General Assurance Corporation to pay private respondent Julia Surposa the proceeds of the personal accident Insurance policy with interest.It appears on record that on October 22, 1986, deceased, Carlie Surposa was insured with petitioner Finman General Assurance Corporation under Finman General Teachers Protection Plan Master Policy No. 2005 and Individual Policy No. 08924 with his parents, spouses Julia and Carlos Surposa, and brothers Christopher, Charles, Chester and Clifton, all surnamed, Surposa, as beneficiaries.3While said insurance policy was in full force and effect, the insured, Carlie Surposa, died on October 18, 1988 as a result of a stab wound inflicted by one of the three (3) unidentified men without provocation and warning on the part of the former as he and his cousin, Winston Surposa, were waiting for a ride on their way home along Rizal-Locsin Streets, Bacolod City after attending the celebration of the "Maskarra Annual Festival."Thereafter, private respondent and the other beneficiaries of said insurance policy filed a written notice of claim with the petitioner insurance company which denied said claim contending that murder and assault are not within the scope of the coverage of the insurance policy.On February 24, 1989, private respondent filed a complaint with the Insurance Commission which subsequently rendered a decision, the pertinent portion of which reads:In the light of the foregoing. we find respondent liable to pay complainant the sum of P15,000.00 representing the proceeds of the policy with interest. As no evidence was submitted to prove the claim for mortuary aid in the sum of P1,000.00, the same cannot be entertained.WHEREFORE, judgment is hereby rendered ordering respondent to pay complainant the sum of P15,000.00 with legal interest from the date of the filing of the complaint until fully satisfied. With costs.4On July 11, 1991, the appellate court affirmed said decision.Hence, petitioner filed this petition alleging grove abuse of discretion on the part of the appellate court in applying the principle of "expresso unius exclusio alterius" in a personal accident insurance policy since death resulting from murder and/or assault are impliedly excluded in said insurance policy considering that the cause of death of the insured was not accidental but rather a deliberate and intentional act of the assailant in killing the former as indicated by the location of the lone stab wound on the insured. Therefore, said death was committed with deliberate intent which, by the very nature of a personal accident insurance policy, cannot be indemnified.We do not agree.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.. . . 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. 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. 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 the policies insuring against death or injury from accident.5As correctly pointed out by the respondent appellate court in its decision:In the case at bar, it cannot be pretended that Carlie Surposa died in the course of an assault or murder as a result of his voluntary act considering the very nature of these crimes. In the first place, the insured and his companion were on their way home from attending a festival. They were confronted by unidentified persons. The record is barren of any circumstance showing how the stab wound was inflicted. Nor can it be pretended that the malefactor aimed at the insured precisely because the killer wanted to take his life. In any event, while the act may not exempt the unknown perpetrator from criminal liability, the fact remains that the happening was a pure accident on the part of the victim. The insured died from an event that took place without his foresight or expectation, an event that proceeded from an unusual effect of a known cause and, therefore, not expected. Neither can it be said that where was a capricious desire on the part of the accused to expose his life to danger considering that he was just going home after attending a festival.6Furthermore, the personal accident insurance policy involved herein specifically enumerated only ten (10) circumstances wherein no liability attaches to petitioner insurance company for any injury, disability or loss suffered by the insured as a result of any of the stimulated causes. The principle of "expresso unius exclusio alterius" the mention of one thing implies the exclusion of another thing is therefore applicable in the instant case since murder and assault, not having been expressly included in the enumeration of the circumstances that would negate liability in said insurance policy cannot be considered by implication to discharge the petitioner insurance company from liability for, any injury, disability or loss suffered by the insured. Thus, the failure of the petitioner insurance company to include death resulting from murder or assault among the prohibited risks leads inevitably to the conclusion that it did not intend to limit or exempt itself from liability for such death.Article 1377 of the Civil Code of the Philippines provides that:The interpretation of obscure words or stipulations in a contract shall not favor the party who caused the obscurity.Moreover,it is well settled that contracts of insurance are to be construed liberally in favor of the insured and strictly against the insurer. Thus ambiguity in the words of an insurance contract should be interpreted in favor of its beneficiary.7WHEREFORE, finding no irreversible error in the decision of the respondent Court of Appeals, the petition forcertiorariwith restraining order and preliminary injunction is hereby DENIED for lack of merit.SO ORDERED.Narvasa, C.J., Padilla, Regalado and Melo, JJ., concur.

G.R. No. 85296 May 14, 1990ZENITH INSURANCE CORPORATION,petitioner,vs.COURT OF APPEALS and LAWRENCE FERNANDEZ,respondents.Vicente R. Layawen for petitioner.Lawrence L. Fernandez & Associates for private respondent.MEDIALDEA,J.:Assailed in this petition is the decision of the Court of Appeals in CA-G.R. C.V. No. 13498 entitled, "Lawrence L. Fernandez, plaintiff-appellee v. Zenith Insurance Corp., defendant-appellant" which affirmedin totothe decision of the Regional Trial Court of Cebu, Branch XX in Civil Case No. CEB-1215 and the denial of petitioner's Motion for Reconsideration.The antecedent facts are as follows:On January 25, 1983, private respondent Lawrence Fernandez insured his car for "own damage" under private car Policy No. 50459 with petitioner Zenith Insurance Corporation. On July 6, 1983, the car figured in an accident and suffered actual damages in the amount of P3,640.00. After allegedly being given a run around by Zenith for two (2) months, Fernandez filed a complaint with the Regional Trial Court of Cebu for sum of money and damages resulting from the refusal of Zenith to pay the amount claimed. The complaint was docketed as Civil Case No. CEB-1215. Aside from actual damages and interests, Fernandez also prayed for moral damages in the amount of P10,000.00, exemplary damages of P5,000.00, attorney's fees of P3,000.00 and litigation expenses of P3,000.00.On September 28, 1983, Zenith filed an answer alleging that it offered to pay the claim of Fernandez pursuant to the terms and conditions of the contract which, the private respondent rejected. After the issues had been joined, the pre-trial was scheduled on October 17, 1983 but the same was moved to November 4, 1983 upon petitioner's motion, allegedly to explore ways to settle the case although at an amount lower than private respondent's claim. On November 14, 1983, the trial court terminated the pre-trial. Subsequently, Fernandez presented his evidence. Petitioner Zenith, however, failed to present its evidence in view of its failure to appear in court, without justifiable reason, on the day scheduled for the purpose. The trial court issued an order on August 23, 1984 submitting the case for decision without Zenith's evidence (pp. 10-11,Rollo). Petitioner filed a petition forcertiorariwith the Court of Appeals assailing the order of the trial court submitting the case for decision without petitioner's evidence. The petition was docketed as C.A.-G.R. No. 04644. However, the petition was denied due course on April 29, 1986 (p. 56,Rollo).On June 4, 1986, a decision was rendered by the trial court in favor of private respondent Fernandez. The dispositive portion of the trial court's decision provides:WHEREFORE, defendant is hereby ordered to pay to the plaintiff:1. The amount of P3,640.00 representing the damage incurred plus interest at the rate of twice the prevailing interest rates;2. The amount of P20,000.00 by way of moral damages;3. The amount of P20,000.00 by way of exemplary damages;4. The amount of P5,000.00 as attorney's fees;5. The amount of P3,000.00 as litigation expenses; and6. Costs. (p. 9,Rollo)Upon motion of Fernandez and before the expiration of the period to appeal, the trial court, on June 20, 1986, ordered the execution of the decision pending appeal. The order was assailed by petitioner in a petition forcertiorariwith the Court of Appeals on October 23, 1986 in C.A. G.R. No. 10420 but which petition was also dismissed on December 24, 1986 (p. 69,Rollo).On June 10, 1986, petitioner filed a notice of appeal before the trial court. The notice of appeal was granted in the same order granting private respondent's motion for execution pending appeal. The appeal to respondent court assigned the following errors:I. The lower court erred in denying defendant appellant to adduce evidence in its behalf.II. The lower court erred in ordering Zenith Insurance Corporation to pay the amount of P3,640.00 in its decision.III. The lower court erred in awarding moral damages, attorneys fees and exemplary damages, the worst is that, the court awarded damages more than what are prayed for in the complaint. (p. 12,Rollo)On August 17, 1988, the Court of Appeals rendered its decision affirmingin totothe decision of the trial court. It also ruled that the matter of the trial court's denial of Fernandez's right to adduce evidence is a closed matter in view of its (CA) ruling in AC-G.R. 04644 wherein Zenith's petition questioning the trial court's order submitting the case for decision without Zenith's evidence, was dismissed.The Motion for Reconsideration of the decision of the Court of Appeals dated August 17, 1988 was denied on September 29, 1988, for lack of merit. Hence, the instant petition was filed by Zenith on October 18, 1988 on the allegation that respondent Court of Appeals' decision and resolution ran counter to applicable decisions of this Court and that they were rendered without or in excess of jurisdiction. The issues raised by petitioners in this petition are:a) The legal basis of respondent Court of Appeals in awarding moral damages, exemplary damages and attomey's fees in an amount more than that prayed for in the complaint.b) The award of actual damages of P3,460.00 instead of only P1,927.50 which was arrived at after deducting P250.00 and P274.00 as deductible franchise and 20% depreciation on parts as agreed upon in the contract of insurance.Petitioner contends that while the complaint of private respondent prayed for P10,000.00 moral damages, the lower court awarded twice the amount, or P20,000.00 without factual or legal basis; while private respondent prayed for P5,000.00 exemplary damages, the trial court awarded P20,000.00; and while private respondent prayed for P3,000.00 attorney's fees, the trial court awarded P5,000.00.The propriety of the award of moral damages, exemplary damages and attorney's fees is the main issue raised herein by petitioner.The award of damages in case of unreasonable delay in the payment of insurance claims is governed by the Philippine Insurance Code, which provides:Sec. 244. In case of any litigation for the enforcement of any policy or contract of insurance, it shall be the duty of the Commissioner or the Court, as the case may be, to make a finding as to whether the payment of the claim of the insured has been unreasonably denied or withheld; and in the affirmative case, the insurance company shall be adjudged to pay damages which shall consist of attomey's fees and other expenses incurred by the insured person by reason of such unreasonable denial or withholding of payment plus interest of twice the ceiling prescribed by the Monetary Board of the amount of the claim due the insured, from the date following the time prescribed in section two hundred forty-two or in section two hundred forty-three, as the case may be, until the claim is fully satisfied;Provided, That the failure to pay any such claim within the time prescribed in said sections shall be consideredprima facieevidence of unreasonable delay in payment.It is clear that under the Insurance Code, in case of unreasonable delay in the payment of the proceeds of an insurance policy, the damages that may be awarded are: 1) attorney's fees; 2) other expenses incurred by the insured person by reason of such unreasonable denial or withholding of payment; 3) interest at twice the ceiling prescribed by the Monetary Board of the amount of the claim due the injured; and 4) the amount of the claim.As regards the award of moral and exemplary damages, the rules under the Civil Code of the Philippines shall govern."The purpose of moral damages is essentially indemnity or reparation, not punishment or correction. Moral damages are emphatically not intended to enrich a complainant at the expense of a defendant, they are awarded only to enable the injured party to obtain means, diversions or amusements that will serve to alleviate the moral suffering he has undergone by reason of the defendant's culpable action." (J. Cezar S. Sangco, Philippine Law on Torts and Damages, Revised Edition, p. 539) (See also R and B Surety & Insurance Co., Inc. v. IAC, G.R. No. 64515, June 22, 1984; 129 SCRA 745). While it is true that no proof of pecuniary loss is necessary in order that moral damages may be adjudicated, the assessment of which is left to the discretion of the court according to the circumstances of each case (Art. 2216, New Civil Code), it is equally true that in awarding moral damages in case of breach of contract, there must be a showing that the breach was wanton and deliberately injurious or the one responsible acted fraudently or in bad faith (Perez v. Court of Appeals, G.R. No. L-20238, January 30,1965; 13 SCRA 137; Solis v. Salvador, G.R. No. L-17022, August 14, 1965; 14 SCRA 887). In the instant case, there was a finding that private respondent was given a "run-around" for two months, which is the basis for the award of the damages granted under the Insurance Code for unreasonable delay in the payment of the claim. However, the act of petitioner of delaying payment for two months cannot be considered as so wanton or malevolent to justify an award of P20,000.00 as moral damages, taking into consideration also the fact that the actual damage on the car was only P3,460. In the pre-trial of the case, it was shown that there was no total disclaimer by respondent. The reason for petitioner's failure to indemnify private respondent within the two-month period was that the parties could not come to an agreement as regards the amount of the actual damage on the car. The amount of P10,000.00 prayed for by private respondent as moral damages is equitable.On the other hand, exemplary or corrective damages are imposed by way of example or correction for the public good (Art. 2229, New Civil Code of the Philippines). In the case ofNoda v. Cruz-Arnaldo,G.R. No. 57322, June 22,1987; 151 SCRA 227, exemplary damages were not awarded as the insurance company had not acted in wanton, oppressive or malevolent manner. The same is true in the case at bar.The amount of P5,000.00 awarded as attomey's fees is justified under the circumstances of this case considering that there were other petitions filed and defended by private respondent in connection with this case.As regards the actual damages incurred by private respondent, the amount of P3,640.00 had been established before the trial court and affirmed by the appellate court. Respondent appellate court correctly ruled that the deductions of P250.00 and P274.00 as deductible franchise and 20% depreciation on parts, respectively claimed by petitioners as agreed upon in the contract, had no basis. Respondent court ruled:Under its second assigned error, defendant-appellant puts forward two arguments, both of which are entirely without merit. It is contented that the amount recoverable under the insurance policy defendant-appellant issued over the car of plaintiff-appellee is subject to deductible franchise, and . . . .The policy (Exhibit G, pp. 4-9, Record),does not mntion any deductible franchise,. . . (p. 13,Rollo)Therefore, the award of moral damages is reduced to P10,000.00 and the award of exemplary damages is hereby deleted. The awards due to private respondent Fernandez are as follows:1) P3,640.00 as actual claim plus interest of twice the ceiling prescribed by the Monetary Board computed from the time of submission of proof of loss;2) P10,000.00 as moral damages;3) P5,000.00 as attorney's fees;4) P3,000.00 as litigation expenses; and5) Costs.ACCORDINGLY, the appealed decision is MODIFIED as above stated.SO ORDERED.Narvasa, Cruz and Grio-Aquino, JJ., concur.Gancayco, J., is on leave.

G.R. No. 92383 July 17, 1992SUN INSURANCE OFFICE, LTD.,petitioner,vs.THE HON. COURT OF APPEALS and NERISSA LIM,respondents.CRUZ,J.: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 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 he loaded. He assured her it was not and then pointed it to his temple. The next moment there was an explosion and Lim slumped to the floor. He was dead before he fell.1The widow sued the petitioner in the Regional Trial Court of Zamboanga City and was sustained.2The 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