Insurance company, ‘di maaaring tanggihan ang claim sa life insurance policy pagkalipas ng 2 taon

ni Atty. Persida Rueda-Acosta @Magtanong Kay Attorney | October 20, 2025

Dear Chief Acosta,

Ang aking asawa ay kumuha ng life insurance noong Hunyo 2021 at ginawa akong beneficiary. Makalipas ang isang buwan matapos mabayaran ang premium, nakuha na rin namin ang kopya ng insurance policy. Sa kasamaang palad, yumao ang aking asawa dahil sa sakit, ngayong taon lamang. Ako ay nagsadya sa insurance company upang makuha ko ang mga death benefits na nakasaad sa kanyang life insurance policy. Nagulat ako nang sabihin ng insurance company na isasauli na lamang nila ang mga premiums na binayaran ng aking asawa sa kadahilanang itinago diumano ng aking asawa ang kanyang sakit. Hanggang sa ngayon ay wala pa rin akong nakukuha. Wala ba talaga akong makukuha na death benefits alinsunod sa life insurance policy ng aking asawa? Aantayin ko po ang inyong kasagutan. Maraming salamat. -- Brenda

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Dear Brenda,

Para sa iyong kaalaman, ang batas na sumasaklaw sa sitwasyon na iyong inilahad ay ang Section 48 ng Amended Insurance Code of the Philippines (Republic Act No. 10607).  Ayon sa nasabing batas:

“Section 48. Whenever a right to rescind a contract of insurance is given to the insurer by any provision of this chapter, such right must be exercised previous to the commencement of an action on the contract. After a policy of life insurance made payable on the death of the insured shall have been in force during the lifetime of the insured for a period of two (2) years from the date of its issue or of its last reinstatement, the insurer cannot prove that the policy is void ab initio or is rescindable by reason of the fraudulent concealment or misrepresentation of the insured or his agent.” 

Paliwanag din ng ating Korte Suprema, sa kasong Manila Bankers Life Insurance Corporation vs. Aban (G.R. No. 175666, 29 July 2013, Ponente: Kagalang-galang na Mahistrado Mariano C. Del Castillo), na nagbibigay-kahulugan sa parehong probisyon sa dating Insurance Code of the Philippines: 

“Section 48 serves a noble purpose, as it regulates the actions of both the insurer and the insured. Under the provision, an insurer is given two years – from the effectivity of a life insurance contract and while the insured is alive – to discover or prove that the policy is void ab initio or is rescindible by reason of the fraudulent concealment or misrepresentation of the insured or his agent. After the two-year period lapses, or when the insured dies within the period, the insurer must make good on the policy, even though the policy was obtained by fraud, concealment, or misrepresentation. This is not to say that insurance fraud must be rewarded, but that insurers who recklessly and indiscriminately solicit and obtain business must be penalized, for such recklessness and lack of discrimination ultimately work to the detriment of bona fide takers of insurance and the public in general.

Section 48 regulates both the actions of the insurers and prospective takers of life insurance. It gives insurers enough time to inquire whether the policy was obtained by fraud, concealment, or misrepresentation; on the other hand, it forewarns scheming individuals that their attempts at insurance fraud would be timely uncovered – thus deterring them from venturing into such nefarious enterprise. At the same time, legitimate policy holders are absolutely protected from unwarranted denial of their claims or delay in the collection of insurance proceeds occasioned by allegations of fraud, concealment, or misrepresentation by insurers, claims which may no longer be set up after the two-year period expires as ordained under the law.”

Malinaw na nakasaad sa ating batas na ang insurance company ay binibigyan ng dalawang taon mula sa pagsisimula ng kontrata ng life insurance at habang buhay pa ang insured, upang siyasatin o patunayan kung ang polisiya ay walang bisa sa simula (void ab initio) o maaaring bawiin dahil sa panlilinlang, pagtatago ng impormasyon, o maling pahayag ng insured o ng kanyang ahente.

Samakatwid, sa iyong sitwasyon, ikaw ay may karapatang makuha ang death benefits na nakasaad sa life insurance policy ng iyong asawa at hindi na maaaring tanggihan ng insurance company ang iyong claim o kaya sabihin na walang bisa ang polisiya na nakuha pa ng iyong asawa noong taong 2021. 

Sana ay nabigyan namin ng linaw ang iyong katanungan. Ang payong aming ibinigay ay base lamang sa mga impormasyon na iyong inilahad at maaaring magbago kung mababawasan o madaragdagan ang mga detalye ng iyong salaysay.

Maraming salamat sa iyong patuloy na pagtitiwala.