2001, 361 SCRA 514

FACTS:

Private respondent obtained a fire insurance policy from petitioner under the name Summa Insurance Corp.) covering certain properties. Under the policy issued to private respondent, petitioner undertook to indemnify private respondent for any damage to or loss of said properties arising from fire. Sometime in 1982 private respondent filed with petitioner an insurance claim for the loss of the insured properties due to fire.
Petitioner appointed an adjuster to undertake the valuation and adjustment of the loss. Private respondent submitted its sworn statement of loss and formal claim. Despite repeated demands by private respondent, petitioner refused to pay the insurance claim. Thus, private respondent was constrained to file a complaint against petitioner for the unpaid insurance claim. In its answer, petitioner maintained that the claim of private respondent could not be allowed because it failed to comply with the policy condition regarding the submission of certain documents to prove the loss.
Trial ensued. The trial court rendered judgment in favor of private respondent. On appeal, the CA substantially affirmed the decision of the trial court. Petitioner appealed to the SC assailing the decision of the appellate court.

ISSUE :

Whether or not the insurer is liable for the payment of the insurance claim.

HELD:

Yes, well-settled is the rule that factual findings and conclusions of the trial court and the CA are entitled to great weight and respect, and will not be disturbed on appeal in the absence of clear showing that the trial court overlooked certain facts or circumstances which would substantially affect the disposition of the case.
Both the trial court and the CA concur in holding that private respondent had substantially complied with the policy no. 13 regarding the submission of the certain documents to prove the loss. As perusal of the records shows that private respondent, after the occurrence of the fire, immediately notified petitioner thereof following the submission of the documents. Petitioner itself acknowledged its liability when through its Finance Manager signed the documents indicating that the amount due to private respondent and as held correctly by the appellate court.
Under Sec. 243. The amount of any loss or damage for which an insurer may be liable, under any policy other life insurance policy, shall be paid within 30days after the proof of the loss is received by the insurer and ascertainment of the loss or damage is made either by agreement of between the insured and the insurer or by arbitration; but if such ascertainment is not had or made within 60days after such receipt by the insurer of the proof of loss, then the loss or damage shall be paid within 90days after such receipt.
The policy itself obliges petitioner to pay the insurance claim within 30days after proof of loss and ascertainment of the loss made in an agreement between private respondent and petitioner. For its failure to do so, the CA and the trial court rightfully directed petitioner to pay 24 % interest per annum.

*Case digest by AG Himang , LLB-IV, Andres Bonifacio College Law School, SY 2018-2019