Valle v. Heirs of Wiscovitch
Valle v. Heirs of Wiscovitch
Opinion of the Court
delivered the opinion of the Court.
The Globe Indemnity Co. issued an insurance policy of public liability in favor of Julio Wiscovitch. It covered the damages caused in the operation of a Chevrolet pick-up 1955 model by said insured or by any other person driving it with his consent. The limit of liability for the damages caused as established was $10,000 per person and $20,000 per accident.
The insured Julio Wiscovitch died in the accident.- At that time he was with his brother Waldemar and a friend surnamed Valle. Both suffered serious injuries. The accident took place on August 20, 1956. On October 10 following Valle filed a complaint in an action for damages against the heirs of Julio Wiscovitch,
Within the suit filed by Valle the insurance company filed a third-party complaint against the owner and driver of the jeep. The latter answered and counterclaimed.
Both suits were consolidated and heard jointly. The complaint filed by Waldemar against Valle and the Globe was dismissed. The complaint filed by Valle against Globe was granted. The counterclaim was dismissed but the court made no other pronouncement.
The Globe has requested us to review the judgment of the trial court. We agreed. Five errors are assigned in support of its petition.
We shall first consider the assignment which if it should prevail, shall cause the reversal of the judgment appealed from. The insurance company maintains that the trial court “committed a clear and manifest error of law in not giving validity to the provisions of the policy agreed by the parties
The purpose of the cooperation clauses in the insurance policies is to protect the insurer of a possible collusion between the insured and the prejudiced party to defraud the company. Its breach alone, however, does not relieve the insurer from liability. What constitutes in some cases a lack of cooperation may be irrelevant in other cases. Levy v. Indemnity Ins. Co. of North America, 8 So.2d 774 (La. 1942). An example of this is that it has been maintained that the' fact that it is reported that a person is driving a vehicle when actually another person was driving it does not necessarily imply lack of cooperation. Commercial Standard Ins. Co. v. Readnour, 241 F.2d 14 (10th Cir. 1956); Ford v. Providence Washington Ins. Co., 311 P.2d 930 (Cal. 1957).
Thus, as a substantive requirement, it is necessary that the lack of cooperation on the part of the insured should cause prejudice to the insurer. For this reason in Cuebas v. P.R. & American Ins. Co., 85 P.R.R. 601 (1962) we stated that: “In order that the lack of cooperation of the insured may relieve the insurer from liability, it must be in some material and substantial aspect which may cause him prejudice.”
Likewise, and as a procedural requisite, the lack of cooperation constitutes a defense that should be alleged affirmatively. It is clearly included in the final clause of Rule No. 6.3 of the Rules of Civil Procedure of 1958,
However, this defense should be alleged affirmatively when answering the complaint. It is considered alleged if clear and unequivocal evidence is presented, without objection, that there was lack of cooperation and on that ground the insurer should be excused of liability, even though it has not specifically alleged it in the answer to the complaint. In that case the allegations are considered amended to conform to the evidence, as provided by Rule 13.2 of the Rules of Civil Procedure. In 2 Moore, Federal Practice 1853, § 8.27, it is said:
“If an affirmative defense is not pleaded it is waived to the extent that the party who should have pleaded the affirmative defense may not introduce evidence in support thereof, unless*89 the adverse party makes no objection in which case the issues are enlarged, or unless an amendment to set forth the affirmative defense is properly made.
“Failure to plead matter which constitutes an affirmative defense does not, however, preclude a party from taking advantage of the opposing party’s proof, if such proof establishes the defense.”
Cf. Sec. of Labor v. Vélez, 86 P.R.R. 555 (1962).
In the present case the lack of cooperation on the part of the insured was not established as an affirmative defense. It was not expressly alleged. The allegation appearing in the answer to the effect that the policy “was subject to the clauses and restrictions appearing therein” can in nowise be considered an expression of an affirmative defense. Likewise an examination of the evidence does not disclose that the trial court had before it any basis to make a finding to that effect. From the incidents set forth by the defendant as demonstrative that said defense was raised in the trial court, the only relevant point is that in passing it made reference to the fact that a report of the accident had not been filed,
Since lack of cooperation was not alleged as a special defense and there was no preponderant evidence in the record to establish it, it is obvious that the plaintiff did not confront the defense with an opportunity to contradict it. And since the question was not raised, the court did not err in making no finding on the matter.
The trial court made a finding to the effect that the driver of the insured vehicle was an agent of its owner. This is not supported by the evidence, but the error is harim less, because the policy covered any person who might drive the vehicle with the consent of the insured. And in this case said consent obviously existed because the insured was also traveling in the vehicle.
The appellee consents to a reduction of the judgment to $10,000 which is the limit of liability of the policy. The compensations granted to plaintiff’s parents are therefore eliminated. The award of attorney’s fees is also eliminated. Certainly the defendant was not obstinate in .defending itself considering the attendant circumstances.
The judgment appealed from will be modified, and as thus modified it will be affirmed.
At the trial of the case the claim against the heirs was abandoned.
Rule 6.3 provides thus:
“In pleading to a preceding pleading, the following defenses must be set forth affirmatively: compromise and settlement, accord and satisfaction, arbitration and award, assumption of risk, negligence, discharge in bankruptcy, duress, estoppel, failure of consideration, fraud, illegality, laches, license, payment, release, res judicata, statute of limitations, waiver, and any other matter constituting an avoidance or affirmative defense.” ■
Although none of the plaintiffs herein did it, the widow of the insured Julio Wiscovitch had already sent the report to the insurance company.
Case-law data current through December 31, 2025. Source: CourtListener bulk data.