2016Da216731, Confirmation of the existence of an obligation

2016Da216748 (Counterclaim Insurance Money)

Algeral Life Insurance Co., Ltd.

person

1. A;

2. B

3. C.

Suwon District Court Decision 2015Na16634, 2015 Ghana, March 11, 2016

27115 Judgment (Counterclaim)

October 13, 2016

The judgment of the court below is reversed, and the case is remanded to Suwon District Court.

The grounds of appeal are examined.

1. An insurance contract shall be interpreted fairly and reasonably in light of the purpose and purpose of the contract in question in accordance with the principle of trust and good faith, but it shall be interpreted objectively and uniformly in consideration of the interests of the entire insurance organization based on the average customer’s interest, without considering the intended purpose and intent of the individual contracting party. Even after the aforementioned interpretation, in cases where the meaning of the contract is not clear, such as where the standardized contract clauses are objectively and objectively interpreted and their respective interpretations are reasonable, it shall be interpreted favorably to customers (see, e.g., Supreme Court Decisions 2006Da5505, Sept. 6, 2007; 2015Da24347, May 12, 2016).

2. Review of the reasoning of the lower judgment and the evidence duly admitted by the lower court reveals the following facts.

A. On February 19, 2004, D entered into a new insurance contract with the Plaintiff (Counterclaim Defendant; hereinafter referred to as the “Plaintiff”) and the insured as D on February 19, 2004, which covers D’s heir at the time of death, and entered into a separate additional insurance premium and a non-distribution special agreement (hereinafter referred to as the “instant special agreement”).

B. Article 17 of the Clause of the State Contract of this case provides that when the insured dies during the period of insurance or becomes a state of disability of class 1 in the table of disability grade table, general death insurance proceeds shall be paid. Article 10 of the Clause of the State Contract of this case provides that when the insured dies or becomes a state of disability of class 1 in the table of disability classification as prescribed by the Disaster Classification Table during the period of insurance, additional insurance proceeds for death of a disaster shall be paid, and the disaster classification table refers to an accident of class 1 through 32, which refers to an accident of class 1 in the following classification table."

C. In addition, Article 19(1) of the Clause of this case and Article 12(1) of the Clause of this case independently provide that "the company may terminate this contract at the same time with no insurance money when any of the following causes occurs for the payment of insurance money", and subparagraph 1 of Article 19 of the Clause of this case provides that "if the insured intentionally damages himself/herself in the state of mental illness, he/she shall not harm himself/herself, but shall not be the case where the insured intentionally damages himself/herself in the state of mental illness and where he/she becomes a state of disability of class 1 in the disability classification table by committing suicide or impairing himself/herself after the lapse of two years from the date of commencement of responsibility (the date of termination of the

3. We examine the above facts in light of the legal principles as seen earlier. While the instant special agreement is added to the instant special agreement, it is a type of accident insurance belonging to the insurance type of insurance business under Article 3 insurance business under the Insurance Business Act, which differs from the instant special agreement, which differs from the nature of the insurance, and accordingly differs from the insurance accident, insurance money and insurance premium. Accordingly, Article 12(1)1 of the instant special agreement should be understood in relation to Article 10 of the terms and conditions of the instant special agreement regardless of the content of the instant special agreement. Article 10 of the instant special agreement provides that the time of the death of a disaster directly due to a direct cause or a suicide or self-injury caused by intention does not constitute a disaster, and thus, Article 12(1)1 of the instant special agreement provides that if it is interpreted as exemption and exemption applicable only to the case where the cause for the payment of insurance money under Article 10 of the terms and conditions of the instant special agreement occurred, it does not exist from the beginning, Article 12(1)12(1)1)1 of the instant special agreement.

However, in order to say that a clause that exists strictly does not deny its validity under the Regulation of Terms and Conditions Act, but simply is an infinite provision that is not subject to the interpretation of the terms and conditions, it should be clear that it is an infinite provision that is not subject to the provision, even if it is based on the average customer's understanding possibility. Thus, it cannot be viewed as such under Article 12 (1) 1 of the Terms and Conditions.

Rather, according to the average customer's understanding possibility, the above provision does not constitute an accident that is an insurance accident as stipulated in Article 10 of the Clause of this case, in principle, because suicide or self-injury intentionally lacks contingent capacity. However, there is sufficient room to understand to the effect that if the insured damages himself/herself in the state of mental illness and commits suicide or injures himself/herself after the lapse of 2 years from the date of commencement of liability, it is sufficient to understand to the effect that it is included in the insurance accident to be considered as a cause for payment of insurance proceeds.

This is a firm position of the Supreme Court (see, e.g., Supreme Court Decision 2005Da49713, Mar. 10, 2006) that a person who has damaged himself/herself in the state of mental disease may be subject to the cause of payment of disaster death insurance (see, e.g., Supreme Court Decision 2005Da49713, Mar. 10, 2006). It conforms to the general concept that if the person committed suicide or injured himself/herself after the lapse of two years from the starting date of liability, it would be in a situation of disability of Grade I. In addition, even though the main sentence of Article 14(1)1 of the Clause of the Special Agreement is not a provision of Article 14(1), Article 659(1), Article 732-2, or Article 739 of the Commercial Act, the insurer shall be exempted from the liability under the provisions of the main sentence of Article 12(1)1 of the Special Agreement, and it appears that the proviso of Article 12015Do416.

4. Nevertheless, the lower court determined otherwise, that the proviso to Article 12(1)1 of the Terms and Conditions of the instant special agreement is applicable to the instant special agreement, which is erroneous in the terms and conditions of the instant special agreement, as the Plaintiff uses life insurance terms and conditions (amended by January 29, 2010) as it is in bad faith during the process of establishing the terms and conditions of the instant special agreement, and thus constitutes an insured accident against the death,

In so determining, the lower court erred by misapprehending the legal doctrine on the interpretation of the insurance terms and conditions, thereby adversely affecting the interpretation of the terms and conditions of the instant special agreement.

5. Therefore, the lower judgment is reversed, and 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 Kim Jae-sik, Counsel for the defendant

Justices Park Byung-hee

Chief Justice Park Jong-young

Justices Kim Jong-il