Source: http://lawlibrary.chanrobles.com/index.php?option=com_content&amp;view=article&amp;id=50700:gr-169737-2008&amp;catid=1502&amp;Itemid=566
Timestamp: 2019-04-26 04:09:38+00:00

Document:
BLUE CROSS HEALTH CARE, INC., Petitioner, v. NEOMI* and DANILO OLIVARES, Respondents.
She was discharged from the hospital on December 3, 2002. On December 5, 2002, she demanded that petitioner pay her medical bill. When petitioner still refused, she and her husband, respondent Danilo Olivares, were constrained to settle the bill.10 They thereafter filed a complaint for collection of sum of money against petitioner in the MeTC on January 8, 2003.11 In its answer dated January 24, 2003, petitioner maintained that it had not yet denied respondents' claim as it was still awaiting Dr. Saniel's report.
This is in response to your letter dated February 13, 2003. [Respondent] Neomi T. Olivares called by phone on January 29, 2003. She stated that she is invoking patient-physician confidentiality. That she no longer has any relationship with [petitioner]. And that I should not release any medical information concerning her neurologic status to anyone without her approval. Hence, the same day I instructed my secretary to inform your office thru Ms. Bernie regarding [respondent's] wishes.
Aggrieved, petitioner filed a Petition for Review under Rule 42 of the Rules of Court in the CA. In a decision promulgated on July 29, 2005, the CA affirmed the decision of the RTC. It denied reconsideration in a resolution promulgated on September 21, 2005. Hence this petition which raises the following issues: (1) whether petitioner was able to prove that respondent Neomi's stroke was caused by a pre-existing condition and therefore was excluded from the coverage of the health care agreement and (2) whether it was liable for moral and exemplary damages and attorney's fees.
Under this provision, disabilities which existed before the commencement of the agreement are excluded from its coverage if they become manifest within one year from its effectivity. Stated otherwise, petitioner is not liable for pre-existing conditions if they occur within one year from the time the agreement takes effect.
Petitioner never presented any evidence to prove that respondent Neomi's stroke was due to a pre-existing condition. It merely speculated that Dr. Saniel's report would be adverse to Neomi, based on her invocation of the doctor-patient privilege. This was a disputable presumption at best.
(e) That evidence willfully suppressed would be adverse if produced.
Suffice it to say that this presumption does not apply if (a) the evidence is at the disposal of both parties; (b) the suppression was not willful; (c) it is merely corroborative or cumulative and (d) the suppression is an exercise of a privilege.22 Here, respondents' refusal to present or allow the presentation of Dr. Saniel's report was justified. It was privileged communication between physician and patient.
Furthermore, as already stated, limitations of liability on the part of the insurer or health care provider must be construed in such a way as to preclude it from evading its obligations. Accordingly, they should be scrutinized by the courts with "extreme jealousy"23 and "care" and with a "jaundiced eye."24 Since petitioner had the burden of proving exception to liability, it should have made its own assessment of whether respondent Neomi had a pre-existing condition when it failed to obtain the attending physician's report. It could not just passively wait for Dr. Saniel's report to bail it out. The mere reliance on a disputable presumption does not meet the strict standard required under our jurisprudence.
This is a factual matter binding and conclusive on this Court.26 We see no reason to disturb these findings.
WHEREFORE, the petition is hereby DENIED. The July 29, 2005 decision and September 21, 2005 resolution of the Court of Appeals in CA-G.R. SP No. 84163 are AFFIRMED.
* The petition spelled the name of respondent as Noemi Olivares but in the decision of the Court of Appeals, Neomi was used since she signed as such in the verification and certificate of non-forum shopping attached to her complaint.
2 Penned by Associate Justice Japar B. Dimaampao and concurred in by Associate Justices Martin S. Villarama, Jr. and Edgardo F. Sundiam of the Former Fifteenth Division of the Court of Appeals; rollo, pp. 17-25.
4 Penned by Judge Romeo F. Barza; id., pp. 38-43.
5 Penned by Judge Perpetua Atal-PaÃ±o; id., pp. 44-47.
21 Id., pp. 93-94, citations omitted.
22 People v. Andal, 344 Phil. 889, 912 (1997), citing People v. Ducay, G.R. No. 86939, 2 August 1993, 225 SCRA 1 and People v. Navaja, G.R. No. 104044, 30 March 1993, 220 SCRA 624, 633.
23 DBP Pool of Accredited Insurance Companies v. Radio Mindanao Network, Inc., G.R. No. 147039, 27 January 2006, 480 SCRA 314, 322, citing Malayan Insurance Corporation v. Court of Appeals, 336 Phil. 977, 989 (1997).
24 Western Guaranty Corporation v. Court of Appeals, G.R. No. 91666, 20 July 1990, 187 SCRA 652, 659-660, citing Taurus Taxi Co., Inc. v. The Capital Ins. & Surety Co., Inc., G.R. No. L-23491, 31 July 1968, 24 SCRA 454 and Eagle Star Insurance, Ltd. v. Chia Yu, 96 Phil. 696 (1955).
26 PAL, Inc. v. CA, 326 Phil. 824, 835 (1996), citations omitted.

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