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(영문) 대구지방법원 2015.2.6.선고 2013가합204533 판결

보험계약무효확인및보험금반환

Cases

2013AD 204533 Nullification of the insurance contract and return of the insurance proceeds

Plaintiff

DooDO ○ Company

Law Firm Man-han, Counsel for the defendant-appellant

Attorney Lee Chang-ho, and Oi-tae

Conclusion of Pleadings

January 14, 2015

Imposition of Judgment

February 6, 2015

Text

1. The insurance contract entered in the separate sheet between the Plaintiff and the Defendant is invalid. 2. The Defendant shall pay to the Plaintiff 10,790,000 won with 5% interest per annum from January 14, 2014 to April 7, 2014, and 20% interest per annum from the next day to the day of full payment.

3. The costs of lawsuit shall be borne by the defendant.

4. Paragraph 2 can be provisionally executed.

Purport of claim

The same shall apply to the order.

Reasons

1. Basic facts

A. Conclusion of the instant insurance contract

On November 19, 2010, the Plaintiff entered into an insurance contract with the Defendant listed in the separate insurance list (hereinafter referred to as “instant insurance contract”). The main contents of the instant insurance contract include: (a) 30,000 won per day of hospitalization within the limit of 180 days from the date of the accident when the insured was hospitalized due to a general injury or disease; and (b) 2,00,000 won per day of hospitalization only once when the diagnosis is confirmed as a upper cancer, boundaryal pattern, other skin cancer, and sampling cancer.

B. The Defendant’s hospitalization treatment and the Plaintiff’s insurance payment

The Defendant alleged that he/she was suffering from injury, such as galap, etc., on or around January 17, 201 because he/she gets out of a bicycle and suffered from injury, such as galap, etc., for 21 days from January 19, 201 to February 8, 2011, including that he/she was hospitalized in the East Korean Medical Hospital from January 19, 2011, to February 11, 201, as indicated in the following table, was hospitalized for 297 days from January 19, 201 to January 11, 2014, was hospitalized for 10,790,000 won as the insurance money from the Plaintiff according to the insurance contract of this case, and received KRW 10,790,00 as the insurance money from the Plaintiff under the insurance contract of this case (the end 2, the claim of injury caused by traffic accident, No. 3 is the remainder of the injury caused by injury, including March 31, 2012012).

A person shall be appointed.

A person shall be appointed.

C. Of the insurance contracts concluded by the Defendant as the insured, the current status of the conclusion of each of the instant insurance contracts, and the insurance contracts maintained at the time of the conclusion of the instant insurance contracts, or concluded after the instant insurance contracts, which are similar to the content and nature of the instant insurance contracts, are as listed in the following table. The Defendant received insurance proceeds of KRW 60,833,733 from each insurance company from February 2, 2011 to January 2014.

A person shall be appointed.

D. There was no fact that the Defendant reported or paid global income or earned income from 2008 to 2012, including the Defendant’s property and income, and there was no details of imposition of property tax.

[Ground of recognition] The facts without dispute; Gap evidence Nos. 1 through 10 (if there are numbers, including each number; hereinafter the same shall apply); the court's lot accident insurance company; MG damage insurance company; Samsung Fire and Marine Insurance Co., Ltd.; AIA bio-life insurance company; Qzz marine insurance company; El branch accident insurance company; El branch accident insurance company; interesting marine insurance company; Hyundai Marine Fire and Fire Insurance Co., Ltd.; the result of each inquiry into the fact-finding against the East Daegu District Fire Insurance Co., Ltd.; the purport of this court's response to the order to submit tax

2. Determination on the claim to nullify the invalidity of the insurance contract of this case

A. Relevant legal principles

Where a policyholder concludes an insurance contract for the purpose of unfairly acquiring insurance proceeds through a large number of insurance contracts, requiring the payment of insurance proceeds based on the insurance contract concluded for such purpose would go beyond the social reasonableness by encouraging speculative spirit to gain unjust benefits through abuse of insurance contracts, as well as hindering the purpose of the insurance system, destroying the contingentness of risk occurrence, and causing the sacrifice of the large number of subscribers, thereby impairing the foundation of the insurance system. Such insurance contract is null and void against the good morals and other social order under Article 103 of the Civil Act. In addition, as to whether a policyholder concludes a large number of insurance contracts for the purpose of unfairly acquiring insurance proceeds, such purpose may be ratified based on all the circumstances, including occupation and financial status of the policyholder, the timing and background of concluding a large number of insurance contracts, the scale and nature of the insurance contracts, and circumstances after concluding the insurance contract (see Supreme Court Decision 209Da12115, May 28, 2009).

In particular, the circumstance that an insurance policyholder concluded an excessive insurance contract to pay a large amount of insurance premium on a regular basis to the extent difficult to be borne by him/her in light of economic circumstances, such as his/her own income, the circumstance that a large number of insurance have been collectively subscribed despite the absence of reasonable grounds to subscribe to a large number of insurance contracts in the short period, and that he/she actively concluded an excessive insurance contract by himself/herself, unlike the circumstance of entering into an insurance contract, such as solicitation by an insurance solicitor, etc., the circumstance that he/she actively purchased a large number of insurance contracts with a strong security character, and that considerable amount of income was paid as the relevant insurance premium; or that there were indirect facts such as the existence of other insurance contracts of the same type of insurance contract at the time of entering into an insurance contract, and the circumstance that he/she received an intensive claim for insurance premium on account of an occurrence of an insurance accident at a long time after the conclusion of a large number of insurance contracts, such indirect materials can be deemed as significant evidence which can confirm the purpose of the wrongful acquisition of insurance proceeds

B. Determination

1) Examining the following circumstances in light of the aforementioned legal principles, it is difficult to view that the Defendant’s conclusion of the instant insurance contract is aimed at preparation for a pure risk to life, body, etc., and rather, it is reasonable to deem that the Defendant concluded the instant insurance contract with the intent to illegally acquire the insurance proceeds by undermining the insurance accident.

① From November 10, 201 to November 4, 2011, the Defendant concluded ten same type of insurance contracts, including the instant insurance contracts, for a short period of less than one year. In particular, on November 19, 2010, the Defendant concluded six insurance contracts with six insurance companies a day, and concluded ten contracts with six companies on November 19, 201 during the month of November 201. However, the Defendant did not have any reasonable reason or circumstance to conclude multiple insurance contracts within a short period.

② The Defendant stated at the date of the second pleading that “from the line running the telecom with the telecom in the vicinity of the Eastern Zone from 2007 to 2011, it was not certain that it would have been receiving a monthly wage of 2 million to 3 million won per month.” However, there is no evidence to acknowledge it, and there is no evidence to deem that there was no fact that there was no wage and salary tax and global income tax from 2008 to 2012, and there is no evidence to deem that the Defendant was receiving income even after 2012. In addition, in light of the fact that the Defendant acknowledges that there was no particular property, and that there is no evidence to deem that there is no evidence to deem that there was a lack of property, as well as that the Defendant stated that there is a lot of inconvenience at present, the sum of 12 insurance premiums including the instant insurance contract, the monthly amount of KRW 806,700, which is an excessive amount of income to be borne by the Defendant at the time.

③ Most of the above insurance policies subscribed by the Defendant are not the insurance of a savings nature, but mainly the injury or disease is the insurance of a guaranteed nature, which has a strong nature of compensating for actual expenses for hospitalization. In particular, there is no reasonable ground that the Defendant, who appears to have no particular occupation and income, should buy many insurance of the guaranteed nature as above.

④ On February 25, 2011, on the ground that the Defendant was hospitalized on January 17, 201 due to an accident occurred on January 17, 201, which occurred two months after the date of the conclusion of the instant insurance contract, the Defendant received KRW 630,00 from the Plaintiff on February 25, 2011, and continued hospitalization and discharge, etc., and received the insurance money accordingly repeatedly. Accordingly, the Defendant received hospital treatment for 297 days from January 19, 201 to January 11, 2014, and received KRW 10,790,000 in total from the Plaintiff. Considering the insurance contract other than the instant insurance contract, the Defendant received excessive insurance money from the insurance company in light of the amount of insurance premium paid by the Defendant.

⑤ In light of the contents of the insurance accident alleged by the Defendant, it is difficult to view that there is no need for long-term hospitalization by the Defendant, even if there is no need for medical examination or treatment, in light of the following: (a) there is a limited-term illness where the actual accident occurred; (b) it is merely a temporary disease that does not need hospital treatment; (c) it is merely a temporary disease that does not actually need hospital treatment; (d) it is merely a serious change in the conditions of hospital treatment; and (e) it is hard to say that the disease or urine disease was caused by a traffic accident; and (e) it is hard to say that the disease or urine disease was caused by a serious change in the conditions of hospital treatment; and (e) it is hard to say that there was no need for medical examination or treatment by the Defendant, even if the disease or urine was actually repeated by the Defendant, as the disease was caused by an inevitable change in the conditions of hospital treatment; and (e) it seems that there was no need for medical treatment.

(6) Since the Defendant subscribed to an insurance policy that provides compensation for a disease within a maximum of 180 days from the date of hospitalization, the Defendant transferred the hospital to most of the period of hospitalization, and where it is possible to rehospitalize a disease for treatment of a disease after the lapse of 180 days from the date of discharge of the disease, the Defendant appears to repeat the hospitalization and treatment due to a disease from January 1, 201 to January 201, such as re-hospitalize a person under the pretext of providing treatment of a disease.

2) Therefore, the instant insurance contract is null and void as it is contrary to the good morals and social order stipulated in Article 103 of the Civil Act, and as long as the Defendant contests this, there is a benefit to seek confirmation.

3. Determination on the claim for return of unjust enrichment

As seen earlier, as long as the insurance contract of this case is null and void pursuant to Article 103 of the Civil Act, the defendant is a malicious beneficiary who received insurance money from the plaintiff without any legal cause. As such, the defendant is obligated to pay to the plaintiff the total amount of KRW 10,790,000, which was paid by the plaintiff based on the insurance contract of this case, as the return of unjust enrichment, and damages for delay calculated at each rate of 20% per annum as stipulated in the Civil Act, from January 14, 2014 to April 2, 2014, as claimed by the plaintiff, on the record that it is clear that the delivery date of the claim and the application for modification of the cause of the claim is the delivery date of the claim, as the return of unjust enrichment to the plaintiff.

4. Conclusion

Therefore, the plaintiff's claim of this case is justified, and all of them are accepted, and it is so decided as per Disposition.

Judges

The presiding judge, judge and clerk;

Judges Lee Dong-ho

Judges Kim Gin-un

Note tin

1) As a result of the Defendant’s reply to an order to submit financial transaction information to a lot damage insurance company on the ground of acute organ salt 780

Although it is stated that only KRW 780,000 is paid as insurance money, it seems that it is 780,000 won.