Double Insurance; Overinsurance | INSURANCE

Double Insurance and Overinsurance in Philippine Insurance Law

Under Philippine law, the concepts of double insurance and overinsurance are governed primarily by the Insurance Code of the Philippines (Presidential Decree No. 612, as amended by Republic Act No. 10607). These doctrines play a crucial role in the proper functioning of insurance law, ensuring fairness and preventing unjust enrichment of insured parties.

I. Double Insurance

Definition of Double Insurance Double insurance occurs when a person, also known as the insured, holds multiple insurance policies from different insurers for the same subject matter, covering the same peril, and providing an aggregate coverage that exceeds the actual value or potential loss related to the insured interest. Double insurance is allowed under Philippine law, but it must be approached cautiously to avoid overinsurance.

Legal Basis and Purpose Section 93 of the Insurance Code provides the basis for double insurance, and Sections 94-98 further elucidate its regulation. The purpose of allowing double insurance is to give flexibility to insured parties, allowing them to procure additional insurance coverage when necessary. However, the insured should not profit from multiple policies, as the purpose of insurance is indemnification, not profit.

Elements of Double Insurance For an insurance arrangement to be considered "double insurance," the following elements must be present:

  1. Two or more insurance policies issued by different insurers.
  2. Same subject matter is covered under each policy.
  3. Same interest in the subject matter of the insurance.
  4. Same risk or peril insured against.
  5. Total sum insured exceeds the value of the insurable interest or the potential amount of loss.

If these elements are not met, the situation may not legally qualify as double insurance.

Rights and Obligations in Double Insurance The existence of double insurance grants the insured the following rights and obligations:

  • Right to Indemnity, not Profits: The insured is entitled to indemnification but cannot receive compensation that exceeds the actual loss. This principle maintains the indemnity nature of insurance and prevents the insured from profiting.
  • Contribution Among Insurers: If multiple insurers are liable for the same loss, the insured can only recover the full amount of the loss once. If one insurer pays the entire claim, it may seek proportionate contribution from the other insurers (Section 94, Insurance Code).
  • Right of Subrogation: Once the insured has received full indemnification for a loss, the insurers have the right of subrogation, enabling them to step into the insured’s position to recover from third parties responsible for the loss.

II. Overinsurance

Definition of Overinsurance Overinsurance occurs when the total sum insured under multiple insurance policies exceeds the actual value of the insured interest or the potential loss the insured might incur. Overinsurance is not encouraged because it goes against the principle of indemnity and creates a moral hazard by giving the insured an incentive to cause or inflate a loss.

Causes of Overinsurance Overinsurance can arise under various circumstances:

  1. Misvaluation of the Insurable Interest: When the insured overestimates the value of the property or interest.
  2. Multiple Insurance Policies: When the insured procures additional policies, possibly without fully understanding the aggregate limit, leading to excessive coverage.
  3. Change in Value: When the value of the insured interest diminishes, and the insured does not adjust the insurance coverage accordingly.

Legal Implications of Overinsurance Under Philippine insurance law, overinsurance has the following implications:

  • Moral Hazard: Overinsurance introduces a moral hazard as it may incentivize fraudulent claims. Insurers may therefore insert anti-fraud clauses and other protective measures in their policies to guard against intentional or exaggerated losses.
  • Pro Rata Limitation on Indemnity: In cases of overinsurance, Section 94 of the Insurance Code requires that the liability of each insurer is proportionate to the insured sum in each policy relative to the total amount insured across all policies. This principle restricts the insured from recovering beyond the actual value of the insured interest.
  • Voidable Policies Due to Non-Disclosure: Insured individuals are required to disclose the existence of all other insurance policies they hold on the same interest and risk. Non-disclosure of other policies constitutes a material concealment, allowing insurers to potentially void the contract under Section 48 of the Insurance Code.

Application of Pro Rata Clause Where multiple policies cover the same risk, the insurers are responsible for indemnifying the insured on a pro-rata basis. This means that each insurer’s liability is calculated based on the proportion of the insured amount under their policy to the total insurance coverage.

For example: If the insured has two policies for Php 1,000,000 each, covering the same interest valued at Php 1,000,000, the liability of each insurer would be limited to a proportional share (typically 50% each, assuming equal policies) based on the amount of loss.

III. Legal Remedies and Rights of Insurers

In cases involving double insurance and overinsurance, insurers have specific remedies to protect against unjust claims:

  • Right to Rescind: Insurers may rescind an insurance contract if the insured failed to disclose other insurance policies or other relevant facts, as per Section 48.
  • Right to Contribution: Insurers have a right of contribution against each other to ensure that liability is shared proportionately among them, as per Section 94.
  • Right to Proportionate Reduction: If the aggregate coverage exceeds the value of the insured interest, insurers are allowed to proportionately reduce the amount payable to avoid overpayment.

IV. Public Policy and Principles Governing Double Insurance and Overinsurance

The principle of utmost good faith (uberrimae fidei) requires that both insurers and insureds act with transparency and honesty in disclosing all relevant information. This includes the insured’s obligation to inform all insurers of any other existing policies covering the same risk. Additionally:

  • Indemnity Principle: Insurance serves to indemnify or restore the insured to their previous financial position. Recoveries that exceed actual loss violate the indemnity principle.
  • Anti-Profiteering Principle: Double insurance should not create an opportunity for the insured to profit from the coverage by collecting multiple payouts for a single loss. This aligns with the doctrine of indemnity and prevents insurance fraud.

V. Practical Considerations

Avoiding Double Insurance and Overinsurance

  1. Accurate Valuation: Insurers and insureds should ensure accurate assessment and valuation of the insurable interest.
  2. Disclosure of Existing Policies: Insureds must disclose all existing insurance policies to each insurer to maintain transparency and avoid grounds for policy rescission.
  3. Adjusting Coverage: Insureds should regularly assess their coverage levels, especially after any change in the value of the insured interest.

Managing Claims in Double Insurance In the event of a claim, the insured must notify all insurers involved and claim indemnity based on each policy’s pro-rata share. Insurers are entitled to verify the value of the loss and may reduce payments to avoid overcompensating the insured.

VI. Case Law and Jurisprudence

Philippine courts have upheld these principles through case law, affirming that:

  1. Right to Indemnity Only: Insureds cannot profit from insurance; they are entitled only to actual losses sustained (indemnity principle).
  2. Importance of Disclosure: Courts emphasize the duty of insureds to disclose all material facts, including the existence of other insurance policies covering the same risk.
  3. Pro Rata Contribution: Courts support the pro-rata contribution among insurers, emphasizing that each insurer’s liability is limited by the insured’s actual loss and each insurer’s proportional coverage.

In conclusion, double insurance and overinsurance under Philippine law allow flexibility in coverage while adhering strictly to principles of indemnity and fair contribution among insurers. Proper disclosure, valuation, and adherence to the pro-rata rule ensure that insurance maintains its primary role of indemnifying losses rather than serving as a profit mechanism for insured parties.