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(영문) 대법원 2020. 1. 30. 선고 2016다267890 판결

[가불금반환등][미간행]

Main Issues

[1] Whether Article 3(1)2 proviso of the Enforcement Decree of the Guarantee of Automobile Accident Compensation Act should be applied in preference to the Civil Act even if the victim of a traffic accident did not claim damages under the Guarantee of Automobile Accident Compensation Act (affirmative)

[2] The case holding that in a case where Eul corporation, an insurer which concluded a comprehensive automobile insurance contract with respect to the above vehicle, has paid Gap's medical expenses as advance payment and sought return of unjust enrichment against Byung et al., and Byung et al. claimed the deduction of the amount equivalent to the medical expense amount based on the medical expense compensation provision under the insurance policy, in a case where Eul et al. claimed the deduction of the amount equivalent to the medical expense amount under the insurance policy, it can be deemed that the purport of the insurer's claim for the deduction of the amount equivalent to the medical expense amount under Article 3 (1) 2 of the Enforcement Decree of the Guarantee of Automobile Accident Compensation Act is included in the case where the medical expense compensation provision is not applicable under the insurance policy, but the amount equivalent to the medical expense amount under the proviso of Article 3 (1) 2 of the Enforcement Decree of the Guarantee of Automobile Accident Compensation Act should be deducted, but the court below failed to make a decision on this issue.

[Reference Provisions]

[1] Article 750 of the Civil Code, Article 3 of the Guarantee of Automobile Accident Compensation Act, Article 3 (1) 2 of the Enforcement Decree of the Guarantee of Automobile Accident Compensation Act / [2] Article 750 of the Civil Code, Article 3 of the Guarantee of Automobile Accident Compensation Act, Article 3 (1) 2 of the Enforcement Decree of the Guarantee of

Reference Cases

[1] Supreme Court Decision 95Da29390 Decided November 28, 1997 (Gong1998Sang, 20) Supreme Court Decision 201Da44563 Decided October 11, 2012

Plaintiff-Appellee

Case non-life insurance Co., Ltd. (Law Firm Ulule, Attorneys Gu-US et al., Counsel for the defendant-appellant)

Defendant-Appellant

Defendant 1 and five others (Ynam Law Firm, Attorneys final leather et al., Counsel for the defendant-appellant)

Judgment of the lower court

Daegu District Court Decision 2016Na305370 Decided October 26, 2016

Text

The part of the judgment below against the Defendants is reversed, and that part of the case is remanded to the Daegu District Court Panel Division.

Reasons

The grounds of appeal are examined.

1. The judgment of the court below

(1) While driving Otoba, the Nonparty shocked the Plaintiff’s vehicle in the opposite opposite lane while driving the Otoba, and accordingly, the Nonparty died after being injured. The Plaintiff, who was an insurer that entered into an automobile comprehensive insurance contract with respect to the Plaintiff’s vehicle, paid KRW 74,177,860 in total of the medical expenses of the Nonparty as advance payment. The Plaintiff filed the instant lawsuit against the Defendants, the Nonparty’ heir, seeking reimbursement of the said KRW 74,177,860 as a return of unjust enrichment.

(2) Meanwhile, the said comprehensive motor vehicle insurance clause provides that “The injury insurance amount in the context of comparative negligence shall be compensated for the amount equivalent to the medical relationship cost if the amount after offsetting the amount of injury falls short of the amount of the medical relationship cost.” In addition, the said comprehensive motor vehicle insurance clause provides that “If the amount after offsetting the negligence based on the sum of the death insurance amount, the injury insurance amount, and the subsequent disability insurance amount falls short of the amount of the medical relationship cost, the amount equivalent to the medical relationship cost shall be compensated.” (hereinafter “the

(3) After recognizing the Nonparty’s fault ratio as 80%, the lower court determined that the Defendants were liable to return KRW 59,342,288, which is the amount equivalent to the Nonparty’s fault ratio among the above KRW 74,177,860, as unjust enrichment according to their respective inheritance shares. In this process, the lower court rejected the Defendants’ assertion that, in the event a lawsuit seeking restitution of unjust enrichment was instituted between the victim and the insurer pursuant to the provision on the calculation of the insurance proceeds under the said automobile comprehensive insurance clause, the insurer should compensate the Plaintiff on the basis of the actual amount of damages calculated according to the standard for calculating the insurance amount, not the standard for the payment of the insurance amount under the terms and conditions, but the general amount of damages. Accordingly, the lower court rejected the Defendants’ assertion that the amount equivalent to the medical expense amount

2. Judgment of the Supreme Court

(1) The lower court’s rejection of the Defendants’ assertion on the amount equivalent to the deduction amount for medical expenses based on the medical expenses compensation provision is justifiable as it is in accordance with Supreme Court Decision 2012Da118273 Decided August 28, 2014.

(2) However, even if the victim of a traffic accident did not claim damages under the Guarantee of Automobile Accident Compensation Act, the court shall preferentially apply the Guarantee of Automobile Accident Compensation Act in preference to the Civil Act (see Supreme Court Decision 95Da29390, Nov. 28, 1997). The proviso of Article 3(1)2 of the Enforcement Decree of the Guarantee of Automobile Accident Compensation Act (hereinafter “proviso of the Enforcement Decree of the Automobile Accident Compensation Act”) provides that, in a case where the amount of damages suffered by the victim falls short of the amount of medical expenses calculated according to the standards for medical fees under Article 15(1) of the Guarantee of Automobile Accident Compensation Act, the relevant medical expenses shall be paid as liability insurance money within the scope of the amount prescribed in [Attachment Table 1]. The purport of the aforementioned provision is to interpret that the amount of damages calculated by deducting the amount equivalent to the rate of negligence of the victim of the traffic accident falls short of the amount of medical expenses corresponding to the above provision, and thus, that the aforementioned provision should not apply to the case of traffic accident victim’s liability insurance relationship between the victim and the amount of indemnity insurance money.

Nevertheless, in the instant lawsuit between the Plaintiff and the Defendants, the lower court determined that the provision on compensation for expenses for medical treatment under the terms and conditions of insurance does not apply, but did not make a judgment that deducts the amount equivalent to the medical expenses under the proviso to the Enforcement Decree of the Automobile Loss Compensation Act from the amount of unjust enrichment to be returned by the Defendants. In so doing, the lower court erred by misapprehending the legal doctrine on the payment of the amount equivalent to the expenses for medical treatment relationship under the proviso to the Enforcement Decree of

3. Conclusion

Therefore, the part of the lower judgment against the Defendants is reversed, and that part of 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 Min You-sook (Presiding Justice)