[보험금][공1992.1.1.(911),82]
(a) The case holding that the insurance company did not conclude the said insurance contract by refusing to accept the application for life insurance for the reason that the occurrence of the insurance accident occurred immediately after the insurance company received the first insurance premium, but the insured is not an insured person as stipulated in the terms and conditions;
B. The purport of the terms and conditions in the life insurance contract as referred to in the above "A" provides that "if the insured is subject to "an unforeseen accident" as stipulated in the attached Table, the insured shall be held responsible from the time of payment of the first insurance premium regardless of whether the insured is eligible insured person."
(a) The case holding that an insurance company did not conclude the insurance contract by refusing to accept the insurance contract on the ground that the insured was a dangerous occupational category whose user is Orala, and the insured was not a qualified insured company as stipulated in the terms and conditions, even though the insured died due to a traffic accident during the first time of receiving the insurance premium after being subscribed for an insurance solicitor to cover 10 times as a risk insurance (life insurance) by the insurance solicitor;
B. Article 2(2) of the Life Insurance Clause of the above "A" provides that "the company shall assume responsibility as stipulated in this Clause retroactively from the date the first insurance premium was paid even if a cause for payment of insurance money occurred before receiving the first insurance premium at the time of subscription. However, as of the date the first insurance premium was paid, if the insured proves that it is not an insured person under this contract as of the date the first insurance premium was paid, it shall not be held responsible for the case where the insured establishes that it is not an insured person under this contract." Paragraph (3) of the above Article provides that " Notwithstanding the provisions of paragraph (2), where a cause for payment of insurance money occurred due to "an unforeseen accident that is not an insured person" as stipulated in the attached Table 2, regardless of whether the insured person is an insured person or whether the diagnosis was completed, the insurer shall be held responsible as stipulated in this Clause from the time of the first insurance premium payment regardless of whether the insured person is an insured person under this condition and whether the accident is an insured person under the same condition as the insured person under the first insurance contract cannot be directly interpreted the insurance contract to the effect.
Article 730 of the Commercial Act
[Defendant-Appellant] Plaintiff 1 et al.
Gwangju Life Insurance Co., Ltd., Counsel for the plaintiff-appellant
Gwangju High Court Decision 90Na6353 delivered on July 10, 1991
The appeal is dismissed.
The costs of appeal are assessed against the plaintiff.
We examine the grounds of appeal.
1. 원심판결 이유에 의하면, 원심은, 거시 증거에 의하여 원고가 1989.6.2. 피고회사의 보험모집원에 대하여 보험계약자 및 보험수익자는 원고, 피보험자는 원고의 아들인 소외인, 계약보험금은 금 10,000,000원 등으로 하고, 피보험자가 도로교통기관사고 등 약관에 정한 재해를 직접적 원인으로 하여 사망할 경우 계약보험금의 10배인 금 100,000,000원의 재해사망보험금을 지급하기로 하는 위험보장배수 10배인 ‘태양보험’가입청약을 하고, 1회분 보험료를 납부한 사실, 피보험자인 위 소외인이 같은 해 6.4. 그 소유의 무등록 125씨씨 오토바이를 운전하던 중 교통사고로 사망한 사실 을 각 인정하고 나서 원고가 위 태양보험계약에 따른 보험금의 지급을 구함에 대하여 거시 증거에 의하여 위 보험계약은 보험계약자의 청약과 보험회사의 승낙에 의하여 성립되고 보험회사는 피보험자가 당해 청약된 보험계약에 적합하지 아니한 경우에는 승낙을 거절할 수 있으며, 보험회사가 보험계약자로부터 제1회 보험료를 받고 승낙을 거절하는 경우에는 거절통지와 함께 받은 보험료를 반환하여야 하는 사실 , 피고회사는 여러 종류의 보험상품을 판매하면서 내부적인 사무처리지침으로 일정한 직종을 위험직종으로 분류하여 특정보험에의 가입 및 그 한도를 제한하고 있는데, 통상 개인보험의 경우 그 사망보험금지급을 기준으로 하면 위험직종 1급으로 분류된 경우 보험가입금액 최고한도 금 30,000,000원, 위험보장배수 2배 이내, 2급의 경우 보험가입금액 최고한도 금 60,000,000원, 위험보장배수 5배 이내, 3급의 경우 보험가입금액 최고한도 100,000,000원 위험보장배수 10배이내로 제한하고 있으며, 영업상 오토바이 사용자는 1급의, 비영업상 오토바이 사용자는 2급의 위험직종으로 분류하고 있고, 이 사건 태양보험은 위험보장배수가 최저 10배로서 위험직종 1급 및 2급에 해당하는 경우에는 애당초 그 가입이 불가능하도록 규정되어 있는 사실 , 위 소외인은 샷슈제작업에 종사하면서 1988.6.경부터 위 사고일까지 업무상 125씨씨 오토바이를 운행하여 왔는데 원고는 이 사건 보험계약청약시 사실과 달리 소외인이 오토바이를 운전하지 않는다고 고지한 사실, 그 후 앞서 본 바와 같이 소외인이 오토바이 운전중의 사고로 사망하고 원고가 이 사실을 피고에게 통보하자 피고는 소외인이 오토바이 운전자임을 내세워 원고에게 보험가입승낙 거절의 통지를 함과 아울러 이미 납부된 1회분 보험료를 반환한 사실등을 인정한 다음, 이에 의하면 원·피고 사이의 위 태양보험계약은 피고가 적법하게 승낙을 거절함으로써 성립되지 않았다고 판단하여 원고의 주장을 배척하였다.
In light of the records, we affirm the above fact-finding and judgment of the court below, and there is no error of law such as incomplete deliberation or violation of the rules of evidence.
2. Sub-committees cannot be held liable pursuant to Article 2(3) of the above solar terms and conditions. Thus, since the defendant cannot be held liable for the payment of insurance proceeds under Article 2(2) of the above solar terms and conditions, it shall be held liable retroactively to the date of the first insurance premium payment (in the case of a diagnosis contract, the time of the completion of the health examination) even when the company has received the first insurance premium at the time of subscription and the cause for payment of insurance proceeds has occurred before accepting the subscription. However, as of the date of the first insurance premium payment (in the case of a diagnosis contract, the time of the completion of the health examination), if the company proves that the insured is not an eligible insured person under this contract, it shall not be held liable if it is not a road traffic accident, which is not an insured person under this contract, but a road traffic accident, which is not an insured person under this condition before receiving the first insurance premium, and it shall not be interpreted as an insured person under this condition even if it comes to the effect that the first insurance premium was not an insured person under this condition.
3. Therefore, the appeal shall be dismissed and all costs of appeal shall be assessed against the losing party. It is so decided as per Disposition by the assent of all participating Justices.
Justices Park Jong-ho (Presiding Justice)