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(영문) 대법원 2019. 4. 25. 선고 2015두39897 판결

[장해급여부지급처분취소][공2019상,1181]

Main Issues

[1] The method of recognizing an obligation, which is a cause interrupting extinctive prescription / In order to establish the recognition of an obligation, whether the obligor is aware of the legal nature of the right, etc. or must specify the cause of the right, etc. (negative); and

[2] Whether Article 113 of the Industrial Accident Compensation Insurance Act provides for a claim for insurance benefits under Article 36 (2) of the same Act as a separate cause for interruption of prescription, which is separate from the cause for interruption of prescription under the Civil Act (affirmative), and whether the interruption of prescription following the claim for the above insurance benefits is whether the cause for interruption is terminated at the time when the Korea Workers' Compensation and Welfare Service determines

[3] Whether the interruption of prescription following a claim for insurance benefits, which is an inherent cause for interruption of prescription under the Industrial Accident Compensation Insurance Act, continues to exist separately from the effect of interruption of prescription following a request for examination or reexamination, which is a procedure for voluntary objection against a decision

Summary of Judgment

[1] Approval of an obligation, which is a ground for interruption of extinctive prescription, is established by indicating that an obligor, who is a party to the act in question, becomes aware of the other party’s right or his/her agent, who will lose the claim due to the completion of the extinctive prescription period, and the method of indication is neither implicitly nor explicitly nor explicitly superior. In addition, approval is not necessary to confirm specific matters concerning the cause, content, scope, etc. of the right of the other party, and it does not require the obligor to know of the legal nature of the right, etc. nor specify the cause of the right, etc. of the act in question, by comprehensively taking into account the content and motive of the act in question, the purpose and genuine intent of the said party to achieve through the said act, etc., and should be objectively and reasonably determined in accordance with logical and empirical rules, common sense, and social common sense.

[2] The Industrial Accident Compensation Insurance Act (hereinafter “Industrial Accident Insurance Act”) provides that, if the right to receive insurance benefits under the Industrial Accident Insurance Act is not exercised for three years, it shall be extinguished by the extinctive prescription if it is not exercised for three years (Article 112(1)1). The extinctive prescription under Article 112 of the Industrial Accident Insurance Act shall be interrupted by a beneficiary’s claim for insurance benefits under Article 36(2) of the Industrial Accident Insurance Act (Article 113). In light of the language and purport of such provision, legislative purport, and the nature of the claim for insurance benefits under the Industrial Accident Insurance Act, Article 113 of the Industrial Accident Insurance Act can be deemed as a separate ground for interruption of extinctive prescription from that under the Civil Act.

Article 112(2) of the Industrial Accident Insurance Act provides, “The extinctive prescription under the Industrial Accident Insurance Act shall be governed by the Civil Act, except as otherwise provided for in the Industrial Accident Insurance Act.” Article 178(1) of the Civil Act provides, “When the prescription has been interrupted, the period of prescription that has lapsed until the interruption thereof shall not be included, but shall newly run from the time when the cause for interruption ends.” This provision also applies to the extinctive prescription under the Industrial Accident Insurance Act.

In light of the purport of the interruption of prescription system, the claim ought to be deemed to continue until the Korea Labor Welfare Corporation renders a decision on an insurance benefit claim, which is a cause interrupting prescription. Therefore, the interruption of prescription following an insurance benefit claim is terminated at the time when the Korea Labor Welfare Corporation renders a decision on

[3] Article 111 of the Industrial Accident Compensation Insurance Act (hereinafter “Industrial Accident Compensation Insurance Act”) provides that “The filing of a request for examination and reexamination under Articles 103 and 106 shall be deemed a judicial claim as to the interruption of prescription pursuant to Article 168 of the Civil Act with respect to the interruption of prescription.” In addition, Article 170 of the Civil Act provides that “In the case of dismissal, dismissal or withdrawal of a lawsuit, the interruption of prescription shall not be effective.” Article 170(1) of the Civil Act provides that “In the case of paragraph (1), where a judicial claim, intervention in bankruptcy proceedings, seizure or provisional seizure or provisional disposition is made within six months, the period of prescription shall be deemed to have been interrupted due to the first judicial claim.”

However, given that the Industrial Accident Insurance Act does not provide that a claim for insurance benefits shall be deemed a judicial claim, and that the interruption of prescription resulting from a claim for insurance benefits shall be deemed extinguished by a claim for examination, which is a voluntary objection procedure against a decision on insurance benefits, there is no ground to deem that the interruption of prescription resulting from a claim for insurance benefits, which is a cause of interruption of prescription inherent under the Industrial Accident Insurance Act, shall continue to exist separately from the effect of interruption of prescription resulting from a request for examination or reexamination. Therefore, even if the interruption of prescription resulting from a request for examination, etc. is not recognized as having no judicial claim again within six months following the dismissal

[Reference Provisions]

[1] Article 168 of the Civil Code / [2] Articles 36(2), 112, and 113 of the Industrial Accident Compensation Insurance Act; Article 178(1) of the Civil Code / [3] Articles 36(2), 103, 106, 111, 112, and 113 of the Industrial Accident Compensation Insurance Act; Article 170 of the Civil Code

Reference Cases

[1] Supreme Court Decision 2008Da25299 Decided July 24, 2008 (Gong2008Ha, 1239), Supreme Court Decision 2012Da45566 Decided October 25, 2012 (Gong2012Ha, 1921) / [2] Supreme Court Decision 94Da2436 Decided May 12, 1995 (Gong195Sang, 2101), Supreme Court Decision 2005Da25632 Decided June 16, 2006 (Gong2006Ha, 1327) (Gong2019 Decided June 15, 2018)

Plaintiff-Appellant

Plaintiff (Attorney Name-ho et al., Counsel for the plaintiff-appellant)

Defendant-Appellee

Korea Labor Welfare Corporation

Judgment of the lower court

Daegu High Court Decision 2014Nu5973 decided February 13, 2015

Text

The judgment below is reversed, and the case is remanded to the Daegu High Court.

Reasons

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

1. A. Approval of an obligation, which is the cause of interruption of extinctive prescription, is established by expressing to the other party or his/her agent, who is a party to the extinctive prescription benefit, the purport that the obligor is aware of the other party’s right or his/her obligation due to the completion of the extinctive prescription period, and the method of indication is neither implied nor explicit. In addition, approval is an unilateral act that recognizes the existence of the other party’s right, etc., and does not require confirmation of specific matters concerning the cause, content, scope, etc. of the right, but does not require the obligor to know of the legal nature of the right, etc. or specify the cause of the right, etc. In addition, the existence of such approval should be objectively and reasonably conducted in accordance with logical and empirical rules, law of experience, and common sense (see, e.g., Supreme Court Decisions 2008Da25299, Jul. 24, 2008; 206Da4265, Oct. 26, 2012).

B. (1) The Industrial Accident Compensation Insurance Act (hereinafter “Industrial Accident Insurance Act”) provides that the right to receive insurance benefits under the Industrial Accident Insurance Act (hereinafter “Industrial Accident Insurance Act”) shall be extinguished by the extinctive prescription if it is not exercised for three years (Article 112(1)1). The extinctive prescription under Article 112 of the Industrial Accident Insurance Act shall be interrupted by a beneficiary’s claim for insurance benefits under Article 36(2) of the Industrial Accident Insurance Act (Article 113). In light of the language and legislative purport of such provision, the nature of the claim for insurance benefits under the Industrial Accident Insurance Act, etc., Article 113 of the Industrial Accident Insurance Act may be deemed to have provided that the grounds for interrupting prescription under Article 36(2) of the Industrial Accident Insurance Act separately from the grounds for interrupting prescription under the Civil Act (see Supreme Court Decision 2017Du49119, Jun. 15, 2018).

Article 112(2) of the Industrial Accident Insurance Act provides, “The extinctive prescription under the Industrial Accident Insurance Act shall be governed by the Civil Act, except as otherwise provided for in the Industrial Accident Insurance Act.” Article 178(1) of the Civil Act provides, “When the prescription has been interrupted, the period of prescription that has lapsed until the interruption thereof shall not be included, but shall newly run from the time when the cause for interruption ceases to exist.” This provision also applies to the extinctive prescription under the Industrial Accident Insurance Act.

(2) In light of the purport of the interruption of prescription system, a claim ought to be deemed to continue until the Korea Labor Welfare Corporation renders a decision on an insurance benefit claim, which is the cause of interruption of prescription (see, e.g., Supreme Court Decisions 94Da24336, May 12, 1995; 2005Da25632, Jun. 16, 2006). Therefore, the interruption of prescription following a claim for insurance benefits, as the cause of interruption of prescription terminates when the Korea Labor Welfare Corporation renders a decision, and the period of prescription for three

(3) Article 111 of the Industrial Accident Insurance Act provides, “The filing of a request for examination and reexamination under Articles 103 and 106 shall be deemed a judicial claim under Article 168 of the Civil Act with respect to the interruption of prescription.” In addition, Article 170 of the Civil Act provides, “A request for judgment shall not have the effect of interrupting prescription in the case of dismissal, dismissal or withdrawal of a lawsuit,” and Article 111(2) provides, “In the case of the preceding paragraph, where a judicial claim, intervention in bankruptcy proceedings, seizure or provisional seizure or provisional disposition has been made within six months, the period of prescription shall be deemed to have been interrupted by the first judicial claim.”

However, given that the Industrial Accident Insurance Act does not provide that a claim for insurance benefits shall be deemed a judicial claim, and that the interruption of prescription resulting from a claim for insurance benefits shall be deemed extinguished by a claim for examination, which is a voluntary objection procedure against a decision on insurance benefits, there is no ground to deem that the interruption of prescription resulting from a claim for insurance benefits, which is a cause of interruption of prescription inherent under the Industrial Accident Insurance Act, shall continue to exist separately from the effect of interruption of prescription resulting from a request for examination or reexamination. Therefore, even if the interruption of prescription resulting from a request for examination, etc. is not recognized as having no judicial claim again within six months following the dismissal of

2. According to the reasoning of the lower judgment, the following circumstances are revealed.

A. On September 25, 2002, the Plaintiff obtained medical care approval from the Defendant for occupational diseases in relation to “brain color, border beer, and beer,” and rendered medical care at a hospital. On February 29, 2008, the Defendant decided that the medical care should be terminated on the ground that “the instant injury requires no longer medical care for the injury.” At the date of the completion of the medical care, the Plaintiff had disability that falls under class 1 subparag. 3 of the disability grade due to the instant injury (the condition that the Plaintiff has to always undergo another person’s nursing in the daily treatment due to physical paralysis and physical injury) other than the instant injury that falls under class 1 subparag. 3 of the disability grade due to the instant injury (the condition that the Plaintiff has to undergo another person’s nursing at all times in the daily treatment due to physical paralysis and physical injury).

B. On April 3, 2009, the Plaintiff who represents the Plaintiff and the Nonparty filed a claim for disability benefits with the Defendant (hereinafter “the first claim for disability benefits”). Around April 23, 2009, the Defendant’s employee in charge of the affairs related to the payment of disability benefits notified the Nonparty to the effect that “as there was a diagnosis of disability due to the clibing of the body other than the aftermathal disability according to the written disability diagnosis attached to the written claim for disability benefits, it is more favorable to the Plaintiff to claim disability benefits after obtaining approval as an additional soldier with regard to the clibing of the body.” The Nonparty prepared and submitted a written request for return of the first claim for disability benefits in accordance with the above guidance, and received the first claim for disability benefits from the Defendant on April 24, 2009 all the documents related to the first claim for disability benefits.

C. After that, on August 2, 2010, the Plaintiff filed an application for approval for additional injury and disease medical care on the part of the Defendant on the part of the body guard, and obtained approval for additional injury and disease medical care on August 23, 2010. At the time, the body guard axis of the Plaintiff had not been in a state of need of additional medical care since symptoms have already been fixed, and there was no fact that the Plaintiff had actually received medical care for the body guard thereafter.

D. On August 7, 2012, the Plaintiff filed a second claim for disability benefits with the Defendant (hereinafter “second claim for disability benefits”). On September 5, 2012, the Defendant rendered a disposition of refusal against the Plaintiff on the ground that “the period of three years has expired as of the closing date of medical care (the date of February 29, 2008).” The Plaintiff filed a written request for review on December 4, 2012, which was dissatisfied with the said disposition and submitted the written request for review, but the Defendant decided to dismiss the request for review on May 22, 2013.

E. On October 25, 2013, the Plaintiff filed another claim for disability benefits with the Defendant (hereinafter “instant claim for disability benefits”); however, the Defendant rendered the instant disposition of refusal on November 19, 2013 on the ground that “the period of three years has expired after the lapse of the three-year prescription based on the date of termination of medical care ( February 29, 2008).”

3. Examining the above facts in light of the legal principles as seen earlier, the following determination is possible.

A. The Plaintiff was recognized as a occupational accident, and the body disability remains even after the completion of the medical care and had already been acquired the right to claim disability benefits for the instant injury. Around April 23, 2009, the employee in charge of the Defendant also instructed the Nonparty’s agent of the Plaintiff to the effect that “The Nonparty, who was aware of the Plaintiff’s acquisition of the Plaintiff’s right to claim disability benefits from the instant injury shall be more favorable to receiving disability benefits after obtaining approval for the body injury other than the instant injury and disease,” thereby allowing the Plaintiff to take procedures necessary for receiving disability benefits for the instant injury and additional injury.

The recognition of an additional injury or disease, which is a healing condition, has the characteristic of the pre-determination of a disability grade and the payment of disability benefits, and the disability grade must be determined by comprehensively taking account of the entire injury or disease of the beneficiary. Considering that the Plaintiff filed an application for additional injury or disease medical care with respect to the reduction of body condition in order to jointly claim disability benefits with respect to the physical injury of the instant injury or disease according to the instruction given by the employee in charge of the Defendant, it cannot be said that the Defendant’s approval of additional injury or disease, which was not required to receive medical care, for the reason that the Plaintiff’s approval of additional injury or disease, constitutes an occupational disease, barring any special circumstance. Furthermore, the Defendant’s aforementioned act should be deemed to have explicitly indicated that the Plaintiff’s obligation to pay disability benefits is known through the disability grade determination procedure taking into account both the disability caused by the instant injury and the additional injury caused by the additional injury.

Therefore, with the approval of the defendant's debt, the extinctive prescription of the plaintiff's right to claim disability benefits for additional injury and disease was interrupted.

B. On August 7, 2012, the Plaintiff filed a second disability benefit claim again with the Defendant, which is within three years thereafter, and thus, the extinctive prescription has been interrupted pursuant to Article 113 of the Industrial Accident Insurance Act. The Defendant’s defect in the rejection disposition regarding the second disability benefit claim, and the Plaintiff filed a claim for disability benefit of this case on October 25, 2013, which was within three years from the time the cause for suspension ceased.

C. Ultimately, according to the above debt approval and the second claim for disability benefits, the extinctive prescription was interrupted, and the Plaintiff filed a claim for disability benefits of this case within three years from the time when the cause for interruption ceases to exist. Therefore, the instant refusal disposition based on the premise that the three-year prescription has run after the lapse of the three-year prescription is unlawful.

4. Nevertheless, the lower court determined that the Plaintiff’s claim for disability benefits expired. In so determining, it erred by misapprehending the legal doctrine on the interruption of extinctive prescription under the Industrial Accident Insurance Act, thereby adversely affecting the conclusion of the judgment.

5. Without examining the remaining grounds of appeal by the Plaintiff, the lower judgment is reversed, and the case is remanded to the lower court for further proceedings consistent with this Opinion. It is so decided as per Disposition by the assent of all participating Justices on the bench

Justices Lee Dong-won (Presiding Justice)

심급 사건
-대구지방법원 2014.8.8.선고 2013구단3578
본문참조조문