No. L-21574 – SIMON DE LA CRUZ, plaintiff and appellee, vs. THE CAPITAL INSURANCE & SURETY Co., lNC., defendant and appellant.
BARRERA, J.
Rule Synopsis
“Accident,” “accidental,” and “accidental means” has an acquired technical meaning in insurance parlance. They must be taken in the ordinary sense, i.e. something unintentional or unforeseen.
Facts
Eduardo de la Cruz, a non-professional boxer, had an accident insurance policy with Capital Insurance, with his father Simon, as the beneficiary. For the New Year’s celebration, he joined a boxing contest. In the course of the match, Eduardo unintentionally slipped and was hit by his opponent on the left part of the back of the head, causing Eduardo to fall, with his head hitting the rope of the ring. He died because of cranial injury sustained. Simon filed a claim with Capital insurance but the latter refused on the ground that Eduardo’s death was not by “accidental means,” as Eduardo voluntarily joined the boxing contest, and that such participation was the “means” contemplated under the policy for which he was insured “against death or disability caused by accidental means.”
Simon filed an action for specific performance with the CFI.
The CFI ruled in favor of de la Cruz. The SC affirmed.
Issue
Should Capital Insurance be exempted from liability under the policy on the ground that Eduardo’s death was not by “accidental means”?
Ruling and Discussion
No. Capital Insurance should not be exempted from liability.
“Accident” and “accidental” mean that which happen by chance or fortuitously, without intention and design, and which is unexpected, unusual, and unforeseen. As used in insurance policies, the trend is to consider these terms legally synonymous with “accidental means.” The insurer is liable where the death or injury is a natural or probable result of the insured’s voluntary act, or if something unforeseen occurs in the doing of the act which produces the injury, the resulting death is within the protection of policies insuring against death or injury from accident.
In this case, while Eduardo voluntarily joined the boxing contest, the injury was sustained when he slid, giving occasion to the infliction by his opponent of the blow that threw him to the ropes of the ring. This unintentional slipping was described by the Court as an “unfortunate incident.” The Court also noted that is physically demanding sports as boxing, death is not ordinarily expected as a result unless some accident or unforeseen event intervened.
Furthermore, the policy involved herein specifically excluded from its coverage—
(e) Death or disablement consequent upon the Insured engaging in football, hunting, pigsticking, steeplechasing, poloplaying, racing of any kind, mountaineering, or motorcycling.”
Death or disablement resulting from engagement in boxing contests was not declared outside of the protection of the insurance contract. Failure of Capital Insurance to include death resulting from a boxing match or other sports among the prohibitive risks leads inevitably to the conclusion that it did not intend to limit or exempt itself from liability for such death.
Dispositive
Judgment affirmed.