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(영문) 대법원 2014. 7. 10. 선고 2013두8332 판결

[재요양휴업급여청구부지급취소][공2014하,1608]

Main Issues

[1] In a case where a worker files an application for re-medical care benefits for the first claimant who requires a re-determination of recurrence of occupational accidents, whether each extinctive prescription of the right to claim for medical care benefits and the right to claim temporary disability compensation benefits during the period of additional medical care

[2] Where an obligor’s assertion of the completion of extinctive prescription is not permissible as an abuse of right against the principle of good faith

Summary of Judgment

[1] Article 40(1) of the Industrial Accident Compensation Insurance Act provides that "medical care benefits shall be paid to an employee who suffers from an injury or disease due to an occupational reason, and Article 52 of the same Act provides that "the temporary disability compensation benefits shall be paid to an employee who suffers from an injury or disease for a period during which he/she has not been employed as a medical care for an occupational reason." Thus, depending on whether an injury or disease suffered by an employee falls under an occupational accident, whether an application for medical care benefits has been approved or whether the employee has a right to claim temporary disability compensation benefits has actually been determined, and whether an application for medical care benefits has been approved or not can be the premise of the employee's right to claim temporary disability compensation benefits. The latter part of Article 113 of the Industrial Accident Compensation Insurance Act provides that if an employee files a lawsuit against the Korea Workers' Compensation and Welfare Service seeking the cancellation of the approval for medical care benefits due to an employee's failure to obtain medical care benefits, the extinctive prescription period of another claim for temporary disability compensation benefits due to the occupational accident shall be interrupted, as well as the first claim for medical care benefits."

[2] The exercise of the debtor's right of defense based on the extinctive prescription is governed by the principle of good faith and the prohibition of abuse of rights, which are the major principles of our Civil Code. Thus, in special circumstances, such as where the debtor has made it impossible or considerably difficult for the creditor to exercise his right or extinctive prescription prior to the expiration of the prescription, or acted to make such measures unnecessary, or where the creditor has objectively obstructed the creditor from exercising his right, or where the debtor has shown the same attitude that the debtor would not invoke the prescription after the expiration of the prescription, or where the debtor has made the right holder trust as such, there is a great need to protect the creditor, and where other creditors have received the repayment of the debt under the same conditions, etc., the debtor's assertion for the completion of the extinctive prescription is not permissible as an abuse of rights against the principle of good faith.

[Reference Provisions]

[1] Articles 40(1), 51, 52, and 113 of the Industrial Accident Compensation Insurance Act / [2] Article 2 of the Civil Act, Article 112 of the Industrial Accident Compensation Insurance Act

Reference Cases

[2] Supreme Court Decision 2011Du11013 Decided November 24, 2011

Plaintiff-Appellee

Plaintiff (Attorney Ansan-gu et al., Counsel for plaintiff-appellant)

Defendant-Appellant

Korea Labor Welfare Corporation

Judgment of the lower court

Seoul High Court Decision 2012Nu27864 decided April 11, 2013

Text

The appeal is dismissed. The costs of appeal are assessed against the defendant.

Reasons

The grounds of appeal are examined.

1. Article 113 of the Industrial Accident Compensation Insurance Act provides, “The extinctive prescription under Article 112 shall be interrupted by a request for temporary disability compensation benefits under Article 36(2). In such cases, if a request is the first request requiring judgment on whether a occupational accident occurred under Article 5 subparag. 1, the interruption of prescription due to such request shall also affect other insurance benefits as provided under Article 36(1).” However, Article 40(1) of the Industrial Accident Compensation Insurance Act provides, “The medical care benefits shall be paid to a worker who suffers from an injury or disease due to an occupational reason.” Article 52 of the Industrial Accident Compensation Insurance Act provides, “The temporary disability benefits shall be paid to a worker who suffers from an occupational accident or has suffered from an occupational accident for a period for which he/she was unable to find an employment as the medical care benefits for which he/she would suffer from an occupational accident.” In addition, it is reasonable to deem that the first request for temporary disability compensation benefits can be the premise of the worker’s claim for temporary disability compensation benefits even after the worker’s first request for the extinctive prescription of medical benefits.”

The exercise of the obligor’s right of defense based on the statute of limitations is governed by the principle of good faith and the prohibition of abuse of rights, which are the major principles of our Civil Act. As such, where the obligor has made it impossible or considerably difficult for the obligee to exercise the obligee’s right or the interruption of prescription prior to the completion of the statute of limitations, has committed an act that makes it unnecessary for the obligee to exercise his right, or there was an objective obstacle that the obligee could not exercise the right, or when the obligor has made the right holder trust it, or when there exist special circumstances, such as making the obligor not invokes the statute of limitations after the completion of the statute of limitations, or when other creditors under the same conditions receive the repayment of the obligation, etc., the obligor’s assertion for the completion of the statute of limitations cannot be allowed as an abuse of rights against the principle of good faith (see Supreme Court Decision 2011Du1013, Nov. 24, 2011).

2. The lower court determined that the Plaintiff’s claim for temporary disability compensation benefits was not objectively impossible or objectively impossible in exercising the Plaintiff’s right to claim for temporary disability compensation benefits by taking account of the following: (a) the Plaintiff was injured due to occupational reasons from August 9, 2006 to January 7, 2007; (b) the Plaintiff was subject to further medical care benefits application on July 23, 2007; and (c) the Defendant’s employee at the time of receiving an additional medical care application before receiving an operation due to additional medical care; (d) the Plaintiff recommended the Plaintiff to return the additional medical care application after receiving an annual aggregate of 1 year prior to receiving an annual average of 1 year, to the effect that it is difficult to approve the additional medical care; and (e) the Plaintiff was unable to receive the additional medical care benefits after receiving the medical care benefits application on July 23, 2007; and (e) the Plaintiff’s claim for temporary disability compensation benefits against the abuse of rights or the principle of extinctive prescription.

Furthermore, the lower court determined that the extinctive prescription of the right to claim for temporary layoff benefits from January 8, 2007 to February 12, 2007, as the Plaintiff applied for re-medical care benefits to the Defendant on January 8, 2010, the extinctive prescription of the right to claim for re-medical care benefits for treatment from January 8, 2007 to February 12, 2007 pursuant to the first sentence of Article 113 of the Industrial Accident Compensation Insurance Act was suspended, and that the interruption of the extinctive prescription extends to the right to claim for temporary layoff benefits for the said period pursuant to the latter part of Article 113 of

In light of the above legal principles and records, the judgment of the court below is just, and there is no error of law by misapprehending the legal principles as to the Industrial Accident Compensation Insurance Act and the legal principles as to abuse of rights.

3. Therefore, the appeal is dismissed, and the costs of appeal are assessed against the losing party. It is so decided as per Disposition by the assent of all participating Justices on the bench.

Justices Min Il-young (Presiding Justice)