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(영문) 서울고등법원 2010. 2. 12. 선고 2009나94744 판결

[보험계약해지무효확인][미간행]

Plaintiff and appellant

Plaintiff (Attorney Noh Jong-soo, Counsel for plaintiff-appellant)

Defendant, Appellant

Samsung Life Insurance Co., Ltd. (Law Firm Song-tae, Attorney Appointment-soo, Counsel for defendant-appellant)

Conclusion of Pleadings

January 20, 2010

The first instance judgment

Seoul Central District Court Decision 2009Gahap66957 Decided September 24, 2009

Text

1. The plaintiff's appeal is dismissed.

2. The costs of appeal shall be borne by the Plaintiff.

Purport of claim and appeal

The judgment of the first instance is revoked. On December 25, 2007 between the plaintiff and the defendant, it is confirmed that the termination of the Universal Irves new contract (contract number: omitted) is null and void.

Reasons

1. Basic facts

The following facts are not disputed between the parties, or may be acknowledged by taking into account the whole purport of the pleadings in the descriptions of Gap evidence 1, 2, and Eul evidence 1, 4, and 5:

A. On December 25, 2007, the Plaintiff entered into a non-party who is the husband with the Defendant as the insured and entered into a non-payment-free franchise insurance contract (hereinafter “instant insurance contract”) with the content of the insured’s serious disease, disability, and death. The terms and conditions of the instant insurance contract stipulate that “contractor or the insured (including the time of health examination in the case of the diagnosis contract) shall inform the insured of the fact that he/she is aware of the fact that he/she was asked at the time of subscription (including the time of health examination in the case of the diagnosis contract)” as to the effect of the breach of the duty of disclosure (Article 26), notwithstanding Article 26 (Notice before the contract), if the contractor or the insured (insured) falsely notifies the fact on important matters by intention or gross negligence, the company may terminate the contract or restrict the guarantee according to the method separately determined by the company (Article 27 (1) main sentence).”

B. From January 12, 2009 to March 9, 2009, the Nonparty hospitalized in the Socheon-do University Confection Hospital branch hospital, and was diagnosed as a acute lefaral disease during treatment, and claimed for the payment of insurance proceeds to the Defendant.

C. Accordingly, on February 10, 2009, the Defendant paid the Plaintiff KRW 57,636,083 of the insurance proceeds from the above white blood disease, and notified the Non-Party of the termination of the insurance contract of this case on the ground of the Non-Party’s violation of the Non-Party’s obligation to notify high blood pressure diagnosis and medication.

2. Judgment on the plaintiff's claim

A. The plaintiff's assertion

(1) First, although the non-party was judged to have been diagnosed by blood pressure before entering into the instant insurance contract, the non-party was merely a patient at the hospital and did not take the prescribed drugs. Furthermore, as a result of the measurement of blood pressure on May 16, 2007, immediately before entering into the instant insurance contract, it is difficult to view that the non-party and the non-party did not think that it falls under the high blood pressure and did not notify the non-party as the result of the measurement of blood pressure on May 16, 2007. Therefore, it is unreasonable that the defendant terminated the instant insurance contract on the grounds of the violation of the duty to notify.

(2) Second, even if the plaintiff and the non-party violated the duty of disclosure, there is no causal relationship between the above duty of disclosure and the insurance accident. Thus, the defendant cannot terminate the insurance contract of this case on the ground of this.

B. Determination

(1) Whether the disclosure obligation is violated

The term "important matters" under Article 651 of the Commercial Act, which are required to notify the insurer at the time of the insurance contract, means the standard for the insurer to determine whether to conclude the insurance contract or the contents of the insurance contract, such as the addition of the premium or special exemption clause, by measuring the occurrence of the insurance accident and the burden of liability arising therefrom, if the insurer objectively knows the fact, it refers to the matters deemed that the insurer should not conclude the contract, or at least the same condition, if it is objectively known. Any fact-finding problem, which has no choice but to vary depending on the type of insurance, must be objectively observed and determined in light of the technology of the insurance. However, it is presumed that the matters asked in writing by the insurer are material matters in the insurance contract (Article 651-2 of the Commercial Act), and if the purport of demanding a certain matter is included in the insurance subscription form, such matters are presumed to be material matters "in accordance with Article 651 of the Commercial Act" (see, e.g., Supreme Court Decision 2014Da18484, Apr. 2013, 2019).

In full view of the purport of the argument as to Gap's evidence Nos. 4, 5, Eul evidence Nos. 2 and 3, and the fact-finding results with respect to the members of this court, the non-party, who received an insurance contract of this case on Nov. 25, 2006 through the measurement of blood pressure from 150/100 MHg as a result of the non-party's measurement, is highly likely to do so by high blood pressure, and complaining of climatic pressure (original pressure). The non-party, who received an insurance contract of this case from the non-party 4, 5, and the non-party 2, and 3, and the non-party's insurance contract of this case, should be subject to the non-party's insurance contract of this case, and the non-party's insurance contract of this case is subject to the non-party 1,50/100, and thus, the non-party's insurance contract of this case and the non-party 1,500,0,07,0.

(2) Whether termination of the contract is void or not

However, Article 651 of the Commercial Act provides that “When a policyholder or the insured has not notified material facts at the time of the conclusion of an insurance contract by intention or gross negligence, an insurer may terminate the contract within one month from the date of knowing such fact, or within three years from the date of the conclusion of the contract. However, this shall not apply where the insurer knew such fact at the time of the contract or has failed to know such fact due to gross negligence.” Article 655 of the Commercial Act provides that “if the insurer has terminated the contract after the occurrence of an insurance accident under the provisions of Article 651, the insurer is not liable for paying the insurance amount and may seek the return of the insurance amount already paid. However, this provision does not apply where it is proved that the occurrence of an insurance accident does not affect the insurance accident under the provisions of the duty of disclosure.” Article 651 of the Commercial Act provides that “In the event of an occurrence of an insurance accident under the same duty of disclosure, it is reasonable to interpret that the insurance accident under the provisions of Article 65 of the Commercial Act does not violate the duty of disclosure even if it does not exist after the duty of disclosure.

Therefore, even if the causal relationship is not acknowledged between the violation of the duty of disclosure and the occurrence of the insurance accident of the Plaintiff and the Nonparty (as seen in the above, the Defendant also recognized it and paid the Plaintiff the insurance money due to the above white blood disease), and the Defendant’s expression of intent to terminate the insurance contract of this case on the ground of the violation of the duty of disclosure by the Plaintiff and the Nonparty is lawful and effective.

3. Conclusion

Therefore, the judgment of the court of first instance is legitimate, and the plaintiff's appeal is dismissed as it is without merit. It is so decided as per Disposition.

Judge Round (Presiding Judge) and at least a copy of a loan