[보험금][하집2001-2,93]
The case holding that an insurance company impliedly ratified an invalid insurance contract by receiving premiums paid by a policyholder for not less than 1 year without any particular objection, as well as by actively undergoing internal procedures with the knowledge that the diagnosis of the insured becomes null and void before the date of commencing the liability for cancer guarantee, which became final and conclusive by the insured's 12 major diseases (including cancer diseases) as an insured event.
The case holding that an insurance company impliedly ratified an invalid insurance contract by receiving premiums paid by a policyholder for not less than 1 year without any particular objection, as well as by actively undergoing internal procedures with the knowledge that the diagnosis of the insured becomes null and void before the date of commencing the liability for cancer guarantee, which became final and conclusive by the insured's 12 major diseases (including cancer diseases) as an insured event.
[1] Article 139 of the Civil Code
[Defendant-Appellant-Appellee] Daejeon District Court Decision 201Na1448 decided May 1, 201
Young Life Insurance Co., Ltd. (Attorney Ahn Jae-young, Counsel for defendant-appellee)
1. The Defendant shall pay to the Plaintiff 29,00,000 won with an annual interest of 25% from May 21, 200 to full payment.
2. The costs of lawsuit shall be borne by the defendant.
3. Paragraph 1 can be provisionally executed.
The same shall apply to the order.
1. Determination as to the cause of claim
A. Facts of recognition
The following facts may be acknowledged, without dispute between the parties, by taking into account the whole purport of the pleadings in the evidence Nos. 1, 1, 2, 3-1, 4-1, 4-2, 1, 1-1, 2, 2-1, and 2-2 of the evidence Nos. 1, 3-2 of the evidence Nos. 3-1, 3-2 of the evidence Nos. 3-1, 2-2 of the evidence Nos. 1, 3-2 of the evidence Nos. 2 of the evidence Nos. 3-1, 3-2 of the evidence Nos. 3-1, and 3-2 of the witness interference, and there is no other counter-proof.
(1) On September 21, 1998, the Plaintiff entered into an insurance contract for the insured, the insurance period of 22 years (the maturity date September 21, 2020), the insured, and each of the beneficiaries designated as the beneficiaries at the time of hospitalization or disability (hereinafter referred to as the "first insurance contract"), and entered into an insurance contract for the living women's health insurance for the living women (including cancer diseases) with Hyundai 12 diseases (including cancer diseases). Of the above insurance accident, the first insurance premium was paid on the day after the lapse of 90 days from the insurance contract date on which the first insurance premium was paid, and the beneficiary agreed to be paid insurance money of 29,000,000 won for the expenses for disease treatment and operation.
(2) On October 198, when the Plaintiff paid the second insurance premium to the Defendant, he was diagnosed on October 28, 1998, which was prior to the date of commencing the liability for cancer guarantee of the said first insurance contract, and was under the ambac control operation on October 20, 1998. The Plaintiff notified the fact of the ambacination to the Non-Party 1, the head of the Defendant’s office of business in the Incheon Western Scinary order through the Defendant’s insurance solicitor and the Plaintiff’s ambacination.
(3)To this end, the above interference argues that the defendant's terms and conditions stipulate that if the insured's diagnosis of cancer was confirmed before the date of commencing the liability for cancer from the date of the insurance contract to the date of commencing the liability for cancer, it shall be deemed that the already paid premium should be refunded, and that the occurrence of the above cancer becomes final and conclusive prior to the date of commencing the liability for the first insurance contract and the first insurance contract
(4)On the other hand, the above order maintained the existing insurance contract and recommended that the premium will be paid continuously because the above order will not be paid to the plaintiff at the time of the occurrence of the above cancer, but in the event of the above 12 diseases other than the above 12 diseases.
(v)In the order of the first half of November 1, 1998, the first half of the year was given leave for the nursing of the plaintiff who was diagnosed with the first half of the year from November 1, 1998.
(6) After that, the Defendant did not refund the insurance premium to the Plaintiff, and the Plaintiff paid the insurance premium every 16 times in total by the end of 1999, and the Defendant received the premium without any objection.
(7) While the Defendant received insurance premiums from the Plaintiff 16 times in total by the end of 1999, the Defendant did not notify the Plaintiff that the said initial insurance contract becomes null and void, or did not request the ambacy diagnosis document to take a procedure to invalidate the insurance contract.
(8) On November 2, 199, the plaintiff was diagnosed with Athroid cancer and was under the control operation. This constitutes a disease which constitutes an insurance accident under the above insurance contract.
(b) Markets:
According to the above facts, the defendant knew that the initial insurance contract of this case is null and void, and did not take measures to return the premium payable by the plaintiff without any particular objection, as well as instead did not take measures to return the premium payable by the plaintiff in accordance with the invalidity of the contract by taking internal procedures, so it is reasonable to deem that the defendant, the insurer, in entering into an insurance contract with the characteristics of mass and semi-conformative contract, is in a state of interest with the professional knowledge of the insurance business as well as the human and material facilities favorable to the ordinary policyholders. In light of the above facts, it is reasonable to deem that the defendant, even though being aware that the initial insurance contract of this case is null and void, has impliedly ratified the invalid insurance contract by receiving the premium for not less than one year, and thereby, the plaintiff and the plaintiff concluded a new insurance contract with the same content as the initial insurance contract with the remainder of modern 12 diseases other than the above
Therefore, barring any special circumstance, the Defendant is obligated to pay the Plaintiff the insurance proceeds of KRW 29,00,000 and damages for delay.
2. Judgment on the defendant's assertion
In this regard, the defendant asserts that the insurance contract is null and void even if the new insurance contract was concluded, since the insurance contract becomes null and void if the insured's diagnosis has been made within the past five years from the date of the first insurance contract.
As long as the Plaintiff and the Defendant were deemed to have concluded a new insurance contract with the knowledge that the initial insurance contract was null and void, it cannot be deemed that the other grounds for invalidation under the terms and conditions of the initial insurance contract were the content of the new insurance contract. ② In addition, the grounds for invalidation of the insurance contract are merely those stipulated in the Commercial Act and other Acts and subordinate statutes if the insured diagnosis was finalized within the past five years from the date of the insurance contract. Since there is no assertion or proof as to the fact that the terms and conditions are included in the initial insurance contract as well as the contents of the new insurance contract due to the notification and explanation to the Plaintiff, it cannot be an obstacle to the recognition of the ratification of the invalid insurance contract. Thus, the above assertion is without merit ( ① the Defendant did not have confirmed the invalid insurance contract without the Plaintiff’s signature to the effect that the Defendant did not know whether the initial insurance contract was null and void, as seen above, the Defendant’s submission of the examination was merely the Defendant’s internal guidelines, and as such, the Defendant’s employees did not know that the initial insurance contract was null and void.
3. Conclusion
Therefore, the defendant is obligated to pay to the plaintiff 29,00,000 won with an annual amount of 25% per annum from May 21, 2000 to the full payment day under the Act on Special Cases Concerning the Promotion, etc. of Legal Proceedings, which is obvious that the delivery day of a copy of the complaint of this case is the day following the delivery day of the copy of the complaint of this case. Therefore, the plaintiff's claim of this case seeking the performance of this case is justified, and the lawsuit cost is assessed against the losing defendant, and is so decided as
Article 24 of the Constitution