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(영문) 대법원 2020.11.05 2020다211832

보험에관한 소송

Text

The appeal is dismissed.

The costs of appeal are assessed against the defendant.

Reasons

The grounds of appeal are examined (to the extent of supplement in case of supplemental appellate briefs not timely filed).

1. As to the ground of appeal on the claim for termination of insurance contract

A. Insurance contracts have to have a strong fiduciary relationship between the parties as well as continuous contracts that continue to exist during the insurance period, and as there is a risk of moral hazard.

Therefore, when the trust relationship, which forms the basis of the contract, is destroyed due to unfair acts of one of the parties during the existence of the contract, and the other party is unable to expect the continued existence of the contract, the other party can terminate the contract by terminating it to the future.

In a case where the policyholder claimed or paid the insurance money for the cause of the payment of the hospitalized treatment, but it is found that the whole or part of the hospitalized treatment is unnecessary, the insurer may terminate the insurance contract if it is deemed that there is a serious reason for the policyholder to expect the existence of the insurance contract due to the loss of trust relationship, which serves as the basis of the insurance contract due to the policyholder’s unreasonable claim or receipt of the insurance money or other insurance contract to which the policyholder has joined, comprehensively taking into account such various circumstances as the background leading up to the hospitalized treatment, whether the hospitalized was hospitalized with knowledge that there was no need for the hospitalized treatment for the purpose of unjust acquisition of the insurance money, the number of days of hospitalization without the necessity of the hospitalized treatment, claim or receipt of the insurance money

On the other hand, this right of termination is based on Article 2 of the Civil Code which provides the principle of good faith and is naturally premised on the relationship of insurance contract.

The insurer's exercise of the right to terminate the contract is Article 663 of the Commercial Code.