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(영문) 대법원 1986. 5. 27. 선고 85누879 판결

[요양결정처분취소][공1986.7.1.(779),824]

Main Issues

(a) Whether an industrial accident insurance policyholder can institute an administrative litigation against the determination on medical care;

(b) Summary procedure to be passed through an administrative litigation against a decision on insurance benefits under the Industrial Accident Compensation Insurance Act; and

Summary of Judgment

A. Article 3(1) of the Industrial Accident Compensation Insurance Business and Examination Act provides that a person who has an objection to the insurance benefits under the Industrial Accident Compensation Insurance Act may institute an administrative litigation through an examination and a ruling by the Industrial Accident Compensation Insurance Review Committee and the Industrial Accident Compensation Insurance Review Committee. Therefore, even if the damaged worker is not the direct counterpart worker such as the insurance benefits, etc. arising from the decision on medical care, if there is a legal interest in disputing the legality of the disposition, an

(b) Article 3 of the Industrial Accident Compensation Insurance Business and Examination Act provides for the method of appeal against a decision on medical care immediately. Thus, an administrative litigation against insurance benefits, etc. shall not be filed unless it has passed all the examination and reexamination procedures prescribed in Article 3 of the same Act as a pre-determination requirement.

[Reference Provisions]

(a) Article 12 of the Administrative Litigation Act;

Reference Cases

Supreme Court Decision 81Nu344 Decided December 23, 1983, Supreme Court Decision 84Nu48 Decided November 12, 1985

Plaintiff-Appellant

[Defendant-Appellee] Korea Coal Corporation (Attorney Lee Jong-soo, Counsel for defendant-appellee)

Defendant-Appellee

The head of the office of the Ministry of Labor

Judgment of the lower court

Seoul High Court Decision 85Gu7 delivered on October 10, 1985

Text

The appeal is dismissed.

Litigation costs shall be borne by the plaintiff.

Reasons

1. The grounds of appeal are examined.

According to the reasoning of the judgment below, the court below rejected the plaintiff's lawsuit of this case, on the ground that the person who can seek the revocation or change of a disposition made by an administrative agency under the Administrative Litigation Act is the non-party who is subject to the disposition of this case's medical care decision, and therefore, the legal relationship of medical care benefits, etc. arising from the disposition is only between the above non-party and the defendant, and the plaintiff does not have any direct infringement of rights or legal rights and obligations. Therefore, the plaintiff has an anti-private interest, such as the plaintiff's burden of conducting a series of affairs according to the medical care decision of this case, and the plaintiff can not immediately bring a lawsuit of this case to the plaintiff. Further, since the plaintiff's insurance premium is paid as the policyholder and the insurance premium is determined according to the premium rate based on the disaster rate applied to the same kind of business, the accident of this case can cause an increase in the insurance premium for all the same kind of business. However, this probability alone can not be viewed as a legal interest in all the same kind of business including the plaintiff.

However, under Article 3 (1) of the Industrial Accident Compensation Insurance Business and Examination Act, a person who has an objection to insurance benefits under the Industrial Accident Compensation Insurance Act may institute an administrative litigation after the Industrial Accident Compensation Insurance Review Committee and the Industrial Accident Compensation Insurance Review Committee's review and reexamination. Thus, even if the person who is the other party to the insurance benefits, etc. arising from the disposition of this case is not a worker directly engaged in the insurance benefits, he may institute an administrative litigation if he has a legitimate interest in disputing the legality of the disposition thereof. In light of the provisions of Articles 19 through 22 of the Industrial Accident Compensation Insurance Act and Articles 49 and 50 of the Enforcement Decree of the same Act, the Minister of Labor collects insurance premiums from the insured to cover the costs of the insurance business (Article 19 of the same Act), and the insurance premium rate shall be the amount obtained by taking over the insurance premium rate of the same kind of insurance benefits as the total amount of the insurance benefits to be paid by the insured (Article 20 of the same Act) for the next 30 years, the rate of increase or decrease in the insurance premium rate shall be determined by 10.

Ultimately, the court below erred in the misapprehension of legal principles as to the interest of a lawsuit in an administrative litigation, and there are reasonable grounds to point this out.

2. However, according to Article 3 of the Industrial Accident Compensation Insurance Act, a person who has an objection to insurance benefits under the Industrial Accident Compensation Insurance Act shall file a request for review with the Industrial Accident Compensation Insurance Review Committee, and a person who has an objection to such decision may file a request for review with the Industrial Accident Compensation Insurance Committee, and a person who has an objection to such decision may file an administrative litigation, and a request for review and reexamination, and an administrative litigation is filed within 60 days from the date of receiving a written ruling on the insurance benefits notice, request for review, and request for review, respectively.

Article 3 of the Industrial Accident Compensation Insurance Business and Examination Act provides for the method of appeal against the decision of medical care immediately. Therefore, an administrative litigation on protection benefits, etc. cannot be filed unless it has gone through all the procedures for examination and reexamination as prescribed in Article 3 of the above Act as a pre-determination requirement (see Supreme Court Decision 84Nu48 delivered on Nov. 12, 85; 85Nu400 delivered on Nov. 12, 85).

According to the records (written complaint, written request for examination, and written ruling), the plaintiff submitted a written request for review to the above non-party on October 17, 1984 regarding the medical care approval decision of the above non-party to the above non-party to the industrial accident review committee on November 1, 1984, and the Minister of Labor made a ruling of rejection on December 3, 1984 by deeming it as the source of lawsuit, and the plaintiff received the written ruling on December 8, 1985, and filed an administrative lawsuit of this case on January 5, 1985. As to the above written request for review, it cannot be deemed that the decision of the industrial accident review committee under Article 3 of the above Act was made by the Minister of Labor by deeming it as a source of lawsuit under the original law and by deeming it as a source of lawsuit by the industrial accident review committee. In addition, the plaintiff's lawsuit of this case cannot be viewed as an unlawful lawsuit without going through legitimate procedure of the industrial accident review committee.

3. Therefore, the court below's decision that dismissed the lawsuit of this case on account of its illegality is erroneous, but it is reasonable in its reasoning, and therefore, the plaintiff's appeal is dismissed. The costs of appeal are assessed against the losing party. It is so decided as per Disposition by the assent of all participating Justices on the bench.

Justices Lee Byung-su (Presiding Justice)

심급 사건
-서울고등법원 1985.10.10선고 85구7
본문참조조문