2016Da20563 (Counterclaim Insurance Money)

2048120 Judgment (Counterclaim)

1. The insurance terms and conditions shall be interpreted fairly and reasonably in light of the purpose and purpose of the terms and conditions in accordance with the principle of trust and good faith, but an objective and uniform interpretation shall be made, without considering the intended purpose and intent of each party to the contract, taking into consideration the interests of the entire insurance organization based on the average customer’s understanding potential. Even after the aforementioned interpretation, in cases where the meaning of the terms and conditions is not clear, such as where the terms and conditions are objectively and objectively interpreted and their respective interpretations are reasonable, it shall be interpreted favorably to customers (see, e.g., Supreme Court Decisions 2006Da505, Sept. 6, 2007; 2008Da81633, May 28, 2009).

2. Review of the reasoning of the lower judgment and the evidence duly selected by the original ginseng reveals the following facts.

A. On January 28, 2003, the deceased B (hereinafter referred to as the "the deceased") entered into an insurance contract with the deceased and the defendant (Counterclaim Plaintiff) who is the beneficiary at the time of the death, and a "long-term Standard Insurance Policy type" (hereinafter referred to as the "State contract of this case") with the insurance coverage amounting to KRW 140,00,000,000,000,000 from the insurance coverage date of the insurance coverage amount to KRW 80,000,000,000,000 from the date of the insurance coverage (hereinafter referred to as the "instant special agreement").

B. Article 14 of the Clause of the State Contract of this case provides that when the insured dies during the period of insurance or becomes disabled in class 1 in the table of disability grade classification, the amount of insurance coverage shall be paid. Article 10 of the Clause of the State Contract of this case provides that the insured shall additionally pay the insurance proceeds for death of KRW 140 million if he/she dies or becomes disabled in class 1 in the table of disability classification in the table of disability grade classification during the period of insurance. The disaster classification table refers to an accident of class 1 through 32 as follows.

In addition, Article 16 (1) of the Clause of this case of this case and Article 12 (1) of the Clause of this case of this case of independent contract "The Company may terminate this contract at the same time with the failure to pay insurance money or exempt the payment of insurance premium when any of the following events occurs." Paragraph 1 of this case provides, "Where the insured intentionally damages himself/herself. However, this provision does not apply where the insured intentionally damages himself/herself in the state of mental illness or where he/she commits suicide or injures himself/herself after two years from the date of commencement of liability (the date of restoration in the case of an irregular contract)."

C. On February 25, 2014, the Deceased died on the same day as he/she committed suicide by hanging in the items in Seocho-gu Seoul, Seocho-gu C and 2 Dong 3.

3. We examine the above facts in light of the legal principles as seen earlier. While the instant special agreement is added to the instant special agreement, it is a type of accident insurance belonging to the insurance type of insurance business under Article 3 insurance business under the Insurance Business Act, which differs from the instant special agreement, which differs from the nature of the insurance, and accordingly differs from the insurance accident, insurance money and insurance premium. Accordingly, Article 12(1)1 of the instant special agreement should be understood in relation to Article 10 of the terms and conditions of the instant special agreement regardless of the content of the instant special agreement. Article 10 of the instant special agreement provides that the time of the death of a disaster directly due to a direct cause or a suicide or self-injury caused by intention does not constitute a disaster, and thus, Article 12(1)1 of the instant special agreement provides that if it is interpreted as exemption and exemption applicable only to the case where the cause for the payment of insurance money under Article 10 of the terms and conditions of the instant special agreement occurred, it does not exist from the beginning, Article 12(1)12(1)1)1 of the instant special agreement.

However, in order to simply deny the validity of a specific contract clause that exists strictly by the Regulation of Standardized Contracts Act, but to say that it is an unqualified provision that is not subject to the interpretation of the terms and conditions, it should be clear that the provision is an ambiguous provision that is not subject to the application of the provision even if it is based on the average customer's possibility of understanding. Thus, Article 12 (1) 1 of the Terms and Conditions of the instant special contract cannot be seen as the same.

Rather, in light of the average customer’s understanding possibility, the above provision does not constitute a Bohovascion accident as stipulated in Article 10 of the Clause of the instant special agreement, in principle, because suicide or self-injury intentionally lacks contingent capacity. However, there is sufficient room to understand to the effect that if the insured damages himself/herself in the state of mental illness, namely, if he/she commits suicide after the lapse of two years from the date of commencement of responsibility, or is in the state of disability of class 1 due to his/her injury, it shall be included in the insurance accident and shall be deemed as

This is a firm position of the Supreme Court that the insurer's consent can be subject to the payment of disaster death insurance proceeds (see, e.g., Supreme Court Decision 2005Da49713, Mar. 10, 2006). Thus, interpreting equally about "when suicide or self-harm becomes an obstacle to class 1 as a result of suicide or hedging after the lapse of 2 years from the starting date of liability" under Article 12 (1) 1 of the Terms and Conditions of the Special Agreement is consistent with the general concept. Even if the provisions of the main sentence of Article 11 (1) 1 of the Terms and Conditions of the Special Agreement are not stipulated in Article 659 (1), 732-2, and 739 of the Commercial Act, even if the insurer is exempted from the liability pursuant to the provisions of Article 11 (1) 1 of the Special Agreement, and therefore, the meaningful part between the parties to the insurance contract of this case as an agreement is not the main sentence, but the proviso to the provisions of the Special Agreement of this case.

Nevertheless, the lower court determined otherwise, that the proviso of Article 12(1)1 of the Terms and Conditions of the instant special agreement is not applicable to the instant special agreement, which is erroneous as it is included in the terms and conditions of the instant special agreement, due to the Plaintiff’s negligence in using the life insurance terms and conditions of the instant special agreement (amended by January 29, 2010) as it is in the process of establishing the terms and conditions of the instant special agreement, and thus, constitutes an insured event for the death, etc. caused by a disaster. In so doing, the lower court erred by misapprehending the legal doctrine on the interpretation of the terms and conditions of the insurance, thereby adversely affecting

On the other hand, the Supreme Court precedents cited in the reply are different from the instant case, and it is inappropriate to invoke the instant case.

4. Therefore, 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 Sang-hoon

Justices Kim Chang-tae, Counsel for the defendant

Justices Cho Jong-hee