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red_flag_2(영문) 서울고등법원 2009. 11. 12. 선고 2009나36618 판결

[보험금][미간행]

Plaintiff and appellant

Plaintiff 1 and two others (Attorney Park Jong-soo, Counsel for the plaintiff-appellant)

Defendant, Appellant

National Agricultural Cooperative Federation (Law Firm Democratic, Attorneys Lee Dong-spon et al., Counsel for the plaintiff-appellant)

Conclusion of Pleadings

September 8, 2009

The first instance judgment

Chuncheon District Court Decision 2008Gadan9453 Decided March 25, 2009

Text

1. Of the judgment of the court of first instance, the part against the plaintiffs falling under the following order of payment shall be revoked.

The defendant shall pay 42,857,142 won to the plaintiff 1 and 28,571,428 won respectively, and 6% per annum from July 10, 2008 to November 12, 2009, and 20% per annum from the next day to the day of full payment.

2. The plaintiffs' remaining appeals are dismissed.

3. The total costs of the lawsuit shall be ten minutes, one of which shall be borne by the plaintiffs, and the other shall be borne by the defendants.

4. The monetary payment portion under paragraph (1) may be provisionally executed.

Purport of claim and appeal

The judgment of the first instance shall be revoked, and the defendant shall pay to the plaintiff 1 42,857,142 won, 28,571,428 won, and 20% interest per annum from the day following the day on which a copy of the complaint of this case is served to the day of complete payment.

Reasons

1. Basic facts

The following facts are not disputed between the parties, or may be recognized by comprehensively taking account of the descriptions of Gap evidence 2, 3, 4, and Gap evidence 9-20, 21, and 22:

A. Plaintiff 1 is the wife of the deceased Nonparty 1 (the Nonparty of the judgment of the Supreme Court, hereinafter “the deceased”). Plaintiff 2 and 3 are the deceased’s persons, and the Defendant is the insurer who entered into a mutual aid agreement II between the two Koreas Office where the deceased worked and the two Koreas Office.

B. On January 17, 2007, the Yangyang-gun Office concluded a mutual aid agreement that sets the period of mutual aid between 00:00 on January 18, 2007 to 24:00 on January 17, 2008 with the employees of the Yangyang-gun Office as the employees themselves who belong to the Yangyang-gun Office, and the beneficiaries entered into a mutual aid agreement that sets the period of mutual aid that the Defendant operates as the employees themselves (hereinafter “instant mutual aid agreement”).

C. According to Article 6 of the instant mutual aid agreement and the terms and conditions incorporated into the said agreement, the insurer shall, upon the death of the beneficiary, provide that KRW 100,000 of the deceased mutual aid money shall be paid

D. Article 15(1)1 of the General Terms and Conditions of the instant mutual aid agreement provides, “A mutual aid shall not be paid where the beneficiary intentionally damages himself/herself, but this shall not apply where the beneficiary has impaired himself/herself in the state of mental illness.” Article 27(1) of the General Terms and Conditions of the instant mutual aid agreement provides, “The Defendant shall pay the mutual aid within 10 days from the date of receipt of the written request for mutual aid, etc., on condition that the Defendant shall pay the mutual aid within 30 days after receipt of the written request for mutual aid, etc.

E. On June 11, 2007, while the deceased applied for a local medical technology clerk (class 8) as a public official in charge of general health examination at the Yangyang-gun Health Center's department of prevention of Yangyang-gun's health clinic, the deceased was diagnosed as a severe euroid in the Non-party 1, Dong, Dong, and Dong, etc. on the day of the death of the deceased (hereinafter "the accident of this case"). At around 18:40, at around 18:40, he was known that the deceased's wife was the first eurat (pquat and its sub-pat) after the aftermath of the local medical technology clerk (class 8), and was diagnosed as a severe euroid at the Non-party 1's eurgian Council located in the Sinsi-si. The deceased's wife was dead (hereinafter "the accident of this case") on June 12, 2007.

F. Although the Plaintiffs filed a claim with the Defendant for the mutual aid money in relation to the instant death accident, the Defendant rejected the payment of the mutual aid money on the ground that the instant death accident only constitutes grounds for exemption from the mutual aid money as “the person to whom the mutual aid money would have intentionally impaired himself/herself,” and that it does not constitute grounds for exemption from the mutual aid money due to “the person to whom the mutual aid money would have damaged himself/herself

2. The parties' assertion

The plaintiffs should be interpreted to mean that the beneficiary has damaged himself/herself without normal accident in the state of mental illness under the terms and conditions of the mutual aid agreement of this case. As long as the deceased committed suicide without normal accident in the state of mental illness, the accident of this case constitutes an exception to the exemption from the exemption from the mutual aid agreement of this case. ② Even though the above exceptional reasons for family affairs are limited to "where the beneficiary has damaged himself/herself without free decision-making due to mental illness, etc.", the deceased was processed on behalf of the above non-party 2 for the period of work, and even after the work of the above non-party 2, the above non-party 2 did not normally perform his/her normal work, and caused severe stress due to his/her failure to perform the above non-party 2's work on behalf of him/her, and as a result, suicide was considerably deteriorated, the accident of this case constitutes a ground for exemption from the mutual aid agreement of this case under the condition of free decision-making of the deceased, and therefore, the defendant asserts that it constitutes an exception to the mutual aid agreement of this case.

As alleged by the plaintiffs, the defendant asserts that the above interpretation may not be permitted since the reason for exception to the exemption from the mutual aid agreement of this case is likely to be abused to the minor mentally ill person who has been injured without normal accident in the state of mental illness. ② The deceased was diagnosed as a friendly certificate on June 11, 2007, and did not receive treatment through mental illness until the suicide was committed. The friendly certificate which the deceased was diagnosed as one of the 10 adults before the death accident of this case was diagnosed as one of the 10 adults, and it is difficult to view that the deceased was unable to make free decision-making by receiving stress on behalf of the above non-party 2, who is an employee of the department in charge of preventive medicine, and that the deceased cannot be seen as the reason for free exemption from the mutual aid agreement of this case without free decision-making in light of the time and place of suicide of the deceased, and the deceased's first-aid agreement cannot be seen as the reason for free exemption from the mutual aid agreement of this case.

3. Judgment by issue

A. The meaning of exceptions to the exemption from the payment of mutual aid money

Article 659(1) of the Commercial Act provides that an insurer shall not be liable to pay the insured amount if the insured event has occurred due to the intention or gross negligence of the policyholder, the insured, or the beneficiary, and Article 732-2 of the Commercial Act provides that the insurer shall not be exempted from the liability to pay the insured amount in the event of an accident caused by the gross negligence of the policyholder, the insured, or the beneficiary in the insurance contract which has caused the death as an insured event. According to the above provision, in the insurance contract which covers the death, the insurer shall not be liable to pay the insurance amount in the event of an intentional accident of the insured, and it is contrary to the principle of good faith in the insurance contract to cause the insured event by intention, and even in such

In light of the legislative intent of Articles 659(1) and 732-2 of the Commercial Act as above, where the beneficiary intentionally injures himself in an insurance contract that covers the death as an insured event, i.e., where the beneficiary intentionally injures himself, suicide means an act of causing death by intentionally cutting his own life for the purpose of the deceased and intentionally cutting his own life for the purpose, and it does not include the case where the insured caused death in a situation where he cannot make free decision due to mental illness, etc., and it shall be deemed that the "case where the beneficiary injures himself in a state of mental illness" as prescribed by the grounds for the exception of the above exemption from the contract of this case is also deemed such meaning (see, e.g., Supreme Court Decisions 2005Da70540, Apr. 14, 2006; 2005Da70577 (Counterclaim) (Counterclaim); 2005Da9713, Mar. 10, 2006).

In addition, in determining whether a person under mutual aid exemption exemption constitutes "the case where a person under mutual aid has injured himself/herself in the state of mental illness," the age and character of the person under mutual aid, physical and mental psychological status of the person under mutual aid, the outbreak time of the mental illness, the progress and the specific situation at the time of the suicide, the surrounding circumstances at which the person under mutual aid exemption exemption exemption exemption is faced with, and the behavior of the person under mutual aid at the time of the suicide, the time and place of the suicide, and other motives, details and methods of the suicide, etc. shall be comprehensively taken into account (see Supreme Court Decision 2005Da70540, Apr. 14, 2006; 2005Da705757 (Counterclaim)).

B. Whether the deceased’s mental condition and exceptional grounds fall under the deceased’s condition at the time of sound reading

이 사건의 경우 갑제6호증, 갑제9호증의 20, 21, 22, 32의 각 기재, 제1심 법원의 □□□의원장에 대한 사실조회결과에 변론 전체의 취지를 종합하면, 망인은 꼼꼼하고 과묵한 성격의 소유자로서 자살 당시 만 33세 정도였고, 1남1녀를 둔 평범한 가정의 가장이었으며, 심한 우울증 증세를 보였던 사실, 망인은 자살 전 ‘망인의 못난 성격을 자책하면서 사무실의 변화에 적응하지 못하고 사람과도 적응하지 못한 망인이 원망스러우며, 이젠 사무실 일에서 벗어나고 싶고, 가족들에게 미안하다’는 등의 내용이 남긴 유서를 남긴 사실, 우울증은 임상적으로 가장 흔한 정신장애 중 하나로 성인 10명 중 1명은 일생동안 한 번 이상 우울병을 경험하며, 우울병의 평균 발병연령은 40세지만 요즘은 점점 빨라지고 있고, 그 대표적인 증상은 우울하며 괜히 슬퍼지거나 불안해지기도 하고, 무슨 일을 해도 재미가 없으며, 자다가 자주 깨고, 입맛이 떨어지며, 식사량이 주는 증상인 사실, 우울병은 주로 성격이 강박적이고 양심적이며 융통성이 적고 책임감이 강하며 급하고 예민한 사람들에게 잘 나타나는 사실, 우울병의 종류로는 지연성 우울병, 격정적 우울병 및 혼수성 우울병 등이 있는데, 이 중 격정적 우울병은 지속적인 불안·걱정·긴장, 장래에 좋지 않은 일이 일어날 것 같은 느낌으로 인한 불안·초조감·좌불안석 등이 동반된 우울증을 말하며, 이 경우 무력감, 분노와 공격의 감정, 죄책감, 자기 징벌의 욕구 또는 망상 등의 이유로 자살을 시도하거나 자해하는 경우도 있는 사실, 망인은 자살하기 위하여 그라목손을 마시기 전에 위 □□□의원을 찾아가 불안, 의욕저하 및 2007년도부터의 대인관계의 어려움 등을 주된 병증으로 호소하였고, 망인을 진료한 위 □□□의원의 정신과 의사 소외 3은 망인의 우울병의 증상이 심하였으며, 망인의 자살과 우울병 사이의 인과관계는 상당히 높을 것으로 추정되고, 우울병 외에 자살의 다른 원인을 찾기 어렵다는 의학적 소견을 밝힌 사실, 망인은 위 □□□의원에서 실시한 검사 결과 격정적 우울병의 경우에 나타나는 편안하게 쉴 수가 없는 느낌, 매우 나쁜 일이 일어날 것 같은 두려움, 신경 과민, 가끔씩 숨이 막히고 질식할 것 같은 느낌, 안절부절한 느낌 및 죽을 것 같는 두려움을 심하게 느끼는 것으로 나타났으며, 전보다 체중이 7㎏ 가량 줄었고 성(sex)에 대한 관심을 완전히 잃었으며, 죽음에 대한 생각을 어느 정도 한다고 답한 사실, 망인의 자살 당시 망인으로 하여금 자살을 결심하게 할 만한 직장 내의 문제나 가정적 어려움 등의 사유는 없었던 사실을 인정할 수 있는바, 위와 같은 망인의 나이와 성행, 위 □□□의원의 검사결과에서 나타난 망인의 심리상황, 자살에 즈음한 망인의 상태, 망인의 가정과 직장 내 상황, 앞서 본 자살행위의 시기와 장소 등에 비추어 보면, 비록 망인이 앓은 우울병이 임상적으로 흔한 정신장애라고 하더라도, 망인은 심한 우울증으로 자유로운 의사결정을 할 수 없는 상태에서 자살하였다고 봄이 상당하므로, 이 사건 사망사고는 이 사건 공제계약의 공제금지급면책의 예외사유에 해당한다고 할 것이다.

C. Sub-decision

Therefore, as stipulated in the instant mutual aid agreement, the Defendant is obligated to pay KRW 100 million to the deceased’s heir according to the percentage of statutory inheritance. As such, the Defendant is obligated to pay the Plaintiff 1 the amount of KRW 42,857,142 ( KRW 100 million x 3/7, and below KRW 3/7; hereinafter the same shall apply), KRW 28,571,428 ( KRW 100 million x 2/7) to the Plaintiffs 2, and 3 respectively, 30 days after the date of receipt of the Plaintiffs’ claim for the mutual aid money for death, etc. as requested by the Plaintiffs 30 days after the date following the day on which the copy of the complaint of this case was served as requested by the Plaintiffs as to the existence and scope of the Defendant’s performance obligation from July 10, 208 to November 12, 2009.

4. Conclusion

Therefore, the plaintiffs' claims of this case are accepted within the scope of the above recognition, and the remaining claims are dismissed for each reason. Since the judgment of the court of first instance is in part different from this conclusion, the part against the plaintiffs who ordered the above payment among the judgment of the court of first instance is revoked, and order the defendant to pay the above amount, and the remaining appeals of the plaintiffs are dismissed for each reason. It is so decided as per Disposition.

Judges Yan Jin-hun (Presiding Judge)