[보험금][미간행]
[Defendant-Appellee] Plaintiff 1 and 1 others
Future Life Insurance Co., Ltd. (Attorney Lee Byung-soo et al., Counsel for the defendant-appellant)
April 29, 2010
1. The defendant shall pay to the plaintiff 214,779,708 won with 6% interest per annum from April 20, 2010 to June 10, 2010, and 20% interest per annum from the next day to the day of full payment.
2. The plaintiff's remaining claims are dismissed.
3. Of the costs of lawsuit, 2/5 shall be borne by the Plaintiff, and the remainder by the Defendant, respectively.
4. Paragraph 1 can be provisionally executed.
The defendant shall pay to the plaintiff 35,00,000 won with 20% interest per annum from April 20, 2010 to the day of complete payment.
1. Basic facts
A. On June 30, 2000, the defendant (the trade name before the registration of the change of trade name was made on June 27, 2005) was merged with the non-party Han Young Life Insurance Co., Ltd., a company operating the insurance business, etc.
B. On March 11, 1999, the Plaintiff entered into a contract between the Korea Life Insurance Co., Ltd. and the insured Nonparty 1, the Plaintiff’s children’s children’s children’s children’s children’s children’s children’s children’s children’s children’s children’s children’s children’s children’s children’s children’s children’s insurance period from March 11, 1999 to March 11, 2014 (hereinafter “instant 1 insurance”). The content of the contract related to the instant case is as set forth in attached Table 1.
C. On November 10, 200, the Plaintiff entered into a contract between the Plaintiff, the beneficiary of Nonparty 1, the Plaintiff, and the insurance period from November 10, 200 to November 10, 2020, under which the Plaintiff entered into a non-party 1, the beneficiary of the Plaintiff, and the non-party 1’s insurance period (hereinafter “instant non-party 2 insurance”). The content of the contract related to the instant case is as set forth in attached Form 2.
D. Meanwhile, at around 18:30 on October 206, Nonparty 1 was an accident that was caused by a motor vehicle (vehicle number omitted) driven by Nonparty 2 (hereinafter “the instant accident”) while driving a bicycle on the road in the Slong-si emul ebbbb, e.g., on the other hand, Nonparty 1 was injured, such as brain, bovine spongiformiformiformiform encephalopathy, and cerebriformiformiform encephalopathy, etc., and on October 20, 2006, Nonparty 1 was injured, due to the instant accident.
E. Due to the instant accident, Nonparty 1 was judged to be “when Nonparty 1 needs to receive occasional nursing because he left a serious obstacle in the middle, old boundaries or spirit” under class 1 of the disability grade classification table of each of the instant insurance terms and conditions.
F. On March 21, 2008, the Plaintiff claimed the Defendant for the payment of the insurance money under each of the instant insurance contracts, but the Defendant rejected the payment of the insurance money.
[Ground of recognition] In the absence of dispute, Gap's evidence 1 through 5, 7, 8, 9-2, 9, 10, Eul's evidence 1-1, 2, 2, 3, and 4-1, 2, 3, 5, 6, 7, 7-1 through 3, 9-2, each statement of evidence Nos. 1 through 3, 9-1, and 2, the result of physical entrustment to the Chief of Seoul National University Hospital Hospital, the purport of the whole pleadings
2. The parties' assertion
A. The plaintiff's assertion
The plaintiff asserts that since the non-party 1 suffered from the accident of this case is "when the insured becomes a disability of grade II in the disability classification table due to traffic disasters or general disasters other than school life" under Article 19 (1) 5 of the Clause 1 of this case and Article 9 (1) 5 of the Clause 2 of the Clause 2 of this case, "when the insured becomes a disability of grade II due to the direct cause of traffic disasters" under subparagraph 6 of Article 9 of the Clause 2 of the Clause 6 of this case, "when the insured becomes a disability of grade II due to the direct cause of traffic disasters other than the traffic disasters," the defendant is liable to pay 70 million won,00,000 won, special education expenses for traffic disasters under Article 19 subparagraph 5 of the Clause 1 of this case, which are the beneficiary of each insurance contract of this case, and special education expenses for general disasters under Article 35,000,000 won, and general income loss of class II, 300,000 won, 000.
B. Defendant’s assertion
On this issue, the defendant asserts as follows.
① The instant second insurance contract is an insurance contract that covers the death of the insured as an insured accident. At the time of entering into the instant second insurance contract, Nonparty 1, the insured, was a person under the age of 15, and thus, the instant second insurance contract is null and void in violation of Article 732 of the Commercial Act, and thus, the Defendant is not liable
② Under Article 909 of the Civil Act, parental authority over a minor shall be jointly exercised by the parents. In doing so, at the time of entering into each of the instant insurance contracts, Nonparty 1, the legal representative, the Plaintiff and Nonparty 3 did not jointly consent. Therefore, each of the instant insurance contracts is null and void.
③ Even if each of the instant insurance contracts is effective, the Plaintiff can only claim the Defendant for special education expenses due to the traffic disaster under the instant 1 insurance contract and the subsidies for the loss of income from the traffic disaster under the instant 2 insurance contract.
④ Nonparty 1, even prior to the occurrence of the instant accident, has an obstacle under class 4 subparag. 3 under each of the instant insurance policies, and thus, Article 20(7) of the instant 1 Insurance Terms and Conditions and Article 20(8) of the instant 2 Insurance Terms and Conditions and Article 9(8) and Article 9(9) of the instant 2 Insurance Terms and Conditions, in granting special education expenses and subsidies for loss of income from traffic disasters, he/she should deduct the insurance proceeds paid when he/she becomes a obstacle to class 4 from the insurance proceeds paid when he/she becomes a obstacle to class 2.
3. Judgment on each of the defendant's arguments
A. Judgment on the Defendant’s assertion ①
On November 10, 200, the second insurance contract of this case was concluded with the policyholder and the non-party 1 of the insured on November 10, 200. The non-party 1, the insured, at the time, was under 15 years of age. The contents of the second insurance contract of this case include the insured's KRW 20,000 per day as insurance money upon the death of non-party 1 due to traffic accident, KRW 40,000 on holidays (transport accident death insurance money) and the insured's payment of KRW 10,00,00 per day as insurance money upon the death of non-party 1 due to traffic accident other than traffic accident (general accident death insurance money). The plaintiff's claim for death insurance money and general accident insurance money of this case did not constitute the non-party 2 insurance contract of this case for the reason of non-party 1's death accident under the provision of Article 732 of the Commercial Act, and thus, the plaintiff's claim for death insurance money of this case cannot be justified.
B. Judgment on the Defendant’s assertion
On the other hand, according to Article 909 of the Civil Code, parents shall jointly exercise parental authority, but it is necessary that the exercise of parental authority is based on the parents' common intent, not on the part of both parents. In full view of the entries and arguments in the evidence Nos. 5, 9-1, 2, the Plaintiff stated in the contractor column as Nonparty 1 at the time of entering into each insurance contract of this case. Nonparty 3, the father of Nonparty 1, as the father of this case, was the disabled of the third degree in the mental retardation and did not raise any objection after entering into each insurance contract of this case. According to the above facts of recognition, it is reasonable to deem that the Plaintiff as the person with parental authority, as the mother of Nonparty 1, was signing each insurance contract of this case on behalf of the non-party 1 with the explicit or implied consent of the non-party 3, and thus, it is not reasonable to deem that the Plaintiff, the legal representative of the Plaintiff, and the non-party 3, as the insured, signed each of the above insurance contracts of this case on behalf of the defendant.
C. Judgment on the Defendant’s assertion
In light of the above facts, Article 19 subparagraph 5 of the 1 insurance contract of this case provides that "when the insured is in a state of disability of Grades II through VI in the table of disability classification due to a traffic accident other than school life or general traffic accident, special education expenses shall be paid to the insured" under Article 19 subparagraph 4 of the 2 insurance contract of this case. Article 9 subparagraph 5 of the 2 insurance contract of this case provides that "when the insured is in a state of disability of Grades II through VI in the table of disability classification" under Article 19 subparagraph 5 of the 2 insurance contract of this case, the insured is clearly entitled to receive traffic accident insurance contracts of Grades I through VI in the attached Table B (grade of disability grade table) due to the direct cause of traffic accident of the non-party 2, and Article 9 subparagraph 6 of the 2 insurance contract of this case provides that the insured is clearly entitled to traffic accident of the above case due to a traffic accident of Grades I through VI in the attached Table 1 insurance contract of this case."
D. Judgment on the Defendant’s argument
Comprehensively taking account of the overall purport of statements and arguments by evidence Nos. 2, 3, 5, 6, and 7-2 of each insurance policy of this case, class 4 subparag. 3 of each of the insurance policy of this case provides that "where a person becomes subject to restrictions on basic daily life activities because he/she has left his/her grave boundary or mind," and the limitation on basic daily life as defined in the [Attachment Table G] of the insurance policy of this case is one or more of the basic action for maintaining life (such as mobile movement, taking-off of food, taking-off of clothes, taking-off of clothes, taking-off of clothes, or subsequent treatment thereof), it is difficult to recognize that there was no other person's mental disability or auxiliary equipment (such as wheelchairss, wheelers, etc.) prior to the occurrence of the foregoing time, it is difficult to find that there was no other person's mental disability in the above-mentioned 10th grade or lower, it is difficult to recognize that there was a serious inconvenience in daily life by Nonparty 1 alone due to the formation of basic mental disability rating, etc.
E. Sub-committee
Ultimately, pursuant to Article 19 subparagraph 5 of the Clause of this case, the Defendant is obligated to pay the Plaintiff, as an insurance beneficiary, special education expenses for Nonparty 1, the insured during the insurance period, on the ground that Nonparty 1 was in a state of disability of Grade II due to traffic accidents other than school life. According to Article 9 (1) subparagraph 5 of the Clause of this case, Nonparty 1, the insured during the insurance period, was in a state of disability of class II due to traffic accidents of class II.
4. Determination on the scope of insurance money payment
The defendant shall pay 7,00,00 won as expenses for special education when the insured becomes disabled at the second degree due to a traffic accident other than school life under the insurance contract of this case. The fact that the insured shall pay 15,00,000 won as subsidies for loss of traffic accidents when they become disabled at the second grade during the insurance period under the insurance contract of this case. The fact that the insured shall pay 10,000 won as subsidies for loss of traffic accidents for 10 years is recognized as above. In full view of the entries and arguments in the second and third evidence of this case, Article 20 (18) of the 1 insurance contract of this case provides that the insured shall be paid at the rate of 10,000 won per annum from the day after the date of payment of insurance money of this case. The defendant may not pay the plaintiff at the rate of 20,000 won per annum from the day after the date of payment of insurance money of this case.
Ultimately, pursuant to the instant insurance contract, the insurance money that the Defendant is obliged to pay to the Plaintiff is KRW 6,383,223,00,00, plus KRW 8,086,080,00,00 for special education expenses incurred from traffic accidents other than school life under the instant insurance contract (i.e., KRW 58,297,143 + KRW 8,086,080) and KRW 124,922,449, plus KRW 23,043,980,000, plus KRW 430,056,000 (= KRW 124,922,449, + KRW 23,043,980 + KRW 430,056). Thus, the Defendant’s assertion that the above insurance money and KRW 23,083,056,00 should not be viewed as being subject to the income tax under the instant insurance contract (i.e., the Defendant’s assertion that the above insurance money and KRW 23637,7,78363638.
5. Conclusion
Therefore, the defendant is obligated to pay to the plaintiff 214,779,708 won and damages for delay calculated at the rate of 6% per annum under the Commercial Act from April 20, 2010 to June 10, 2010, which is the date of this decision, and 20% per annum under the Act on Special Cases concerning Expedition, etc. of Legal Proceedings from the next day to the date of full payment.
Therefore, the plaintiff's claim of this case is justified within the scope of the above recognition, and the remaining claim is dismissed as it is without merit. It is so decided as per Disposition.
[Attachment]
Judge Kim Dae-sung (Presiding Judge) Notice
1) When the cause for the payment of special medical expenses, special medical expenses, special education expenses or special education expenses as provided in Article 20 (7) (6) of the Act on the Payment of Insurance Money) occurs not less than twice directly due to other disasters, each time the cause for the payment of the special medical expenses, special medical expenses, special education expenses or special education expenses corresponding thereto shall be paid to beneficiaries: Provided, That if the disability has already been paid, the special treatment expenses, special education expenses or special education expenses corresponding to the newly incurred disability, special treatment expenses corresponding to the newly incurred disability, special education expenses or special education expenses corresponding to the school life, special education expenses or special education expenses. (8) In paragraph (6) of the Article 20 of the Act on the Payment of Insurance Money, if one of the following cases has already occurred again on the same part of the body of the insured who had already been a disability as provided in paragraph (7) of the same Article, the expenses for special treatment, special education or special education shall be considered to have already been paid to one of the following cases, and the provisions of the latter part of paragraph (7) of the Act shall not apply or before the commencement of the insurance.
2) Article 9 (Grounds for Payment of Insurance Money) (8) If the cause for payment of the income loss subsidy prescribed in paragraph (7) occurs not less than twice directly due to any other disaster, the income loss subsidy corresponding thereto shall be set off to the beneficiary at each time. However, if the disability is an aggravated disability in the same part that has already been paid the income loss subsidy, the difference obtained by subtracting the income loss subsidy already paid from the income loss subsidy corresponding to the newly incurred disability shall be set aside. (9) In paragraph (7) of this Article, if the insured who had already been a disability in one of the following cases before the accident occurs again on the same part of the body and again becomes a disability as prescribed in paragraph (8), the income loss subsidy shall be deemed already paid to the insured, and the latter part of paragraph (8) shall be applied.