2015 Gohap 5223 (Confirmation of Non-existence of Obligations)

2015 Ghana 5230 (Counterclaim Insurance Money) Insurance proceeds

Dong Life Insurance Co.

Gangnam-gu Seoul Metropolitan Government Compliance Team of 432 Dongbu Financial Center 7th floor.

The representative director Lee Tae-chul

Law Firm Pacific (Law Firm Pacific)

Attorney Yang Jae-in

1. A;

2. B

3. C

Defendant’s Address Jeonju-si

[Judgment of the court below]

Attorney Sho-young, Park Jae-in

March 23, 2016

May 18, 2016

1. The Plaintiff (Counterclaim Defendant) pays to the Defendant (Counterclaim Plaintiff) 85, 714, 285 won, Defendant B, and C each amount of KRW 57,142,857 and each of the said amounts, 8.8% per annum from May 18, 2014 to May 18, 2016, and 15% per annum from the next day to the date of full payment.

2. The plaintiff (Counterclaim defendant)'s main claim and the defendant (Counterclaim plaintiff)'s remaining counterclaims are all dismissed.

3. Of the costs of lawsuit, the part resulting from the principal lawsuit is borne by the Plaintiff, the 9/10 of the part resulting from the counterclaim by the Plaintiff (the counterclaim Defendant), and the 1/10 of the costs by the Defendant (the counterclaim Plaintiff) respectively.

4. Paragraph 1 can be provisionally executed.

Main Action: Insurance in the separate sheet between the Plaintiff (Counterclaim Defendant, hereinafter referred to as “Plaintiff”) and the network D (Elimination)

As to the contract, the Plaintiff’s obligation to pay insurance proceeds to the Defendant (Counterclaim Plaintiff; hereinafter “Defendant”)

I confirm that the existence does not exist.

Counterclaim: 97, 416, 710 won, Defendant B and C, respectively, 64, 944, 473 won and its substitute against Defendant A.

From May 18, 2014 to the service date of a duplicate of the counterclaim of this case, 8.8% per annum, and from the following day:

Until the day of full payment, 15% interest per annum shall be paid.

1. Facts of recognition;

A. On June 29, 2001, the deceased D (hereinafter referred to as "the deceased") entered into a non-dividend franchise insurance contract (hereinafter referred to as "main contract of this case") with the condition that the insured shall pay insurance money to the death or disability of the insured by making the deceased and the beneficiary as the heir at the time of the death, as shown in the attached Table (Elimination) with the Plaintiff on June 29, 2001, and entered into a disaster death agreement (hereinafter referred to as "the special agreement of this case"). In addition, the agreement of this case with the subscription amount of KRW 200 million was also entered into. The insurance contract of this case in combination with the main contract of this case.

B. Terms and conditions incorporated into the content of the instant insurance contract are as follows.

C. On April 28, 2014, the Deceased: (a) committed suicide in Jeonju-si, Jeonju-si, a 49 residential area (hereinafter “instant accident”).

D. The deceased’s heir had Defendant A and C, who is his husband, and the Defendants claimed insurance money under the instant insurance contract to the Plaintiff on May 15, 2014. The Plaintiff paid the Defendants KRW 100 million of the general death insurance money under the instant main contract.

[Grounds for Recognition] Facts without dispute, Gap evidence Nos. 2, 3, 4, 5, 15, 16, and Eul evidence No. 1 (including each number), the purport of the whole pleadings

2. The parties' assertion

A. The plaintiff's assertion

The plaintiff asserts that there is no obligation to pay disaster death insurance money based on the special agreement of this case for the following reasons.

1) The instant accident is the case where the insured commits suicide, and suicide does not constitute a disaster, and thus, does not constitute a ground for the payment of the insurance proceeds for death of a disaster.

2) The latter part of the proviso of Article 12(1)1 of the Terms and Conditions of the instant special agreement merely provides for an exception to compensation on the premise that an insurance accident occurred under the structure of the terms and conditions, but does not provide for a new insurance accident or an extension of the objective scope of the insurance accident. Thus, the latter part of the proviso of Article 12(1)1 of the instant special agreement providing for the exemption ground for the exemption ground for suicide, which cannot be a ground for the exemption of insurance money, is merely an erroneous indication in the instant special agreement.

3) If the latter part of the proviso of Article 12(1)1 of the Terms and Conditions of the instant special agreement is interpreted as a provision expanding the objective scope of the insurance accident, the said special agreement would put an unexpected disadvantage to the insurance organization and cause social problems that encourage suicide to the insured who are similar insurance, and thus, is contrary to Article 103 of the Civil Act, and the latter part of the proviso of Article 12(1)1 of the Terms and Conditions of the instant special agreement is null and void in light of the principle

B. The defendants' assertion

As to this, the Defendants asserted that ① the deceased, who was receiving treatment due to a depression, was able to report the Sewol ferry incident while being being treated due to a depression, and caused the aggravation of the depression, so that he committed a suicide in a temporary network condition, he cannot be viewed as “in case of intentionally damaging himself,” and ② even if he committed suicide, the plaintiff is obliged to pay the insurance premium for the death of a disaster to the defendants who are beneficiary, pursuant to the latter part of Article 12(1)1 of the Terms and Conditions of the instant Special Agreement, since he committed the suicide after the lapse of two years from the date of the commencement of the liability of the instant insurance contract. Article 12(2) of the Terms and Conditions of the instant Special Agreement provides that the plaintiff is obligated to return the insurance premium already paid to the defendants, as the plaintiff terminates this contract or the contract becomes null and void due to a cause or event set forth in any subparagraph of Article 12(1) of the same Agreement.

3. Determination on the insurance proceeds resulting from a disaster

A. As seen earlier, whether the instant special agreement constitutes the cause for the payment of insurance proceeds is the cause of the deceased’s suicide, and there is no evidence to support the Defendants’ assertion that the said suicide does not constitute a case of intentional harm to himself. Therefore, the Defendants’ assertion related to this part does not have to be further examined. Accordingly, under the premise that the instant accident does not constitute a “disaster,” which is an contingent external accident as stipulated in the instant special agreement, two years after the date of commencement of liability, I would like to examine whether the Plaintiff’s obligation to pay the instant accident committed by the deceased is recognized even after the lapse of two years from the date of commencement of liability.

B. The interpretation of the insurance contract of this case and the Plaintiff’s obligation to pay the insurance proceeds resulting from the Plaintiff’s disaster 1) shall be interpreted fairly and reasonably in light of the purpose and purpose of the contract of this case in accordance with the principle of trust and good faith. The insurance contract of this case shall be interpreted objectively and uniformly without taking into account each party’s intended purpose or intent, taking into account all interests of the insurance organization as an average customer. Even after such interpretation, if the meaning of the contract of this case is not clear, such as the contract of this case objectively different interpretation and the reasonableness of each interpretation, it shall be interpreted favorably to the customer (see, e.g., Supreme Court Decisions 2006Da5505, Sept. 6, 2007; 2008Da81633, May 28, 2009). However, the contract of this case is an accident insurance of insurance type of insurance business of insurance business of insurance business of insurance business of insurance business of this case, and the latter part of the contract of this case should be understood differently from the insurance contract of this case No. 10.

Article 10 of the Terms and Conditions of the instant Special Agreement provides that the time when a person dies due to a disaster or becomes a disability of class 1, and suicide or self-injury by intention does not constitute a disaster. Therefore, if the latter part of Article 12(1)1 proviso of the Terms and Conditions of the instant Special Agreement is construed as a provision that limits exemption and exemption applicable only to the case where a cause for paying insurance proceeds under Article 10 of the Terms and Conditions of the instant Special Agreement occurs, the latter part of Article 12(1)1 proviso of the Terms and Conditions of the instant Special Agreement provides that the latter part of Article 12(1)1 proviso of the same Agreement shall be

However, in order to say that a clause that exists strictly does not deny its validity by the Act on the Regulation of Terms and Conditions, but simply is an unqualified provision that is not subject to the interpretation of the terms and conditions, it should be apparent that the provision is not subject to the application of Article 12 (1) 1 of the Terms and Conditions. The latter part of the proviso of Article 12 (1) of the Terms and Conditions cannot be seen as such.

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 that "if a person injures himself/herself in the state of mental illness, he/she may be subject to the payment of insurance proceeds (see, e.g., Supreme Court Decision 2005Da49713, Mar. 10, 2006)". Thus, it conforms to the general concept that interpreting "if a person commits suicide or injures himself/herself after two years from the date of commencing liability, thereby causing disturbance in the first degree," and even if the provisions of the main sentence of Article 12 (1) 1 of the Clause of this case are not stipulated in Article 12 (1), Article 659 (1), Article 732-2, and Article 739 of the Commercial Act, even if the insurer is exempted from the liability pursuant to the provisions of the main sentence of Article 12 (1) 1 of the Clause of this case, the plaintiff's assertion that the agreement between the parties to an insurance contract of this case is meaningful, not the main sentence, but the proviso to Article 12 (1) 251 of the Clause of this case is unreasonable.

C. Scope of payment of the Plaintiff’s accident death benefit

The fact that the deceased, the insured of the instant special agreement, committed suicide on April 28, 2014, which was two years after the date on which the liability of the instant special agreement was commenced, is as seen earlier. According to the evidence No. 5, the Defendants, the legal inheritor of the deceased, claiming for payment of insurance proceeds on May 15, 2014. Upon the beneficiary’s claim for insurance proceeds under the instant insurance contract, the Plaintiff determined to apply interest for delay in arrears at the rate of 8.8% from the day after the date on which the beneficiary’s claim for insurance proceeds was made, to the Defendants, the beneficiary of the instant special agreement, as the legal inheritor of the deceased, 200,000 won ( = 20,000,000 won x 3/7,00 won x less than the unit x 3/7,000, 2000, 200, 207, 205 x 207, 2005).

5. By the 18.18., the parties are obligated to pay 8.8% of the agreed rate, and 15% of the annual interest per annum under the Act on Special Cases concerning Expedition, etc. of Legal Proceedings from the next day to the day of full payment.

4. Determination on the refund of the paid-in premium

A. The defendants' assertion

The Defendants asserts that the instant insurance contract should be terminated upon the death of the Deceased or no longer effective due to the death of the Deceased, and that the Plaintiff should return the premium paid by the Deceased pursuant to Article 15(1)2 of the terms and conditions of the instant prime contract and Article 12(2)1 of the terms and conditions of the instant contract to the Defendants, the inheritor of the Deceased.

B. Determination

In the case of a general termination (voluntary termination) of an insurance contract, the insurance company pays the cancellation refund in accordance with the calculation method of insurance premium and liability reserve, and provides for such details as the instant prime contract and the terms and conditions of the instant special agreement (Articles 6 and 17(1) of the terms and conditions of the instant prime contract, and Article 4 of the instant special agreement).

On the other hand, Article 15 of the Clause of the State Contract and Article 12 of the Special Agreement of this case provide that "in the event the effect of the insurance contract terminates without receiving the insurance money by some of the contract parties due to the reason under the title "accident" which does not pay the insurance money, the whole amount of the insurance premium paid, not refund for cancellation, shall be refunded.

The Plaintiff paid the insurance proceeds of the instant prime contract due to the instant accident, thereby the termination of the instant prime contract. As seen earlier, the Plaintiff is obligated to pay the insurance proceeds for the death of a disaster to the Defendants pursuant to the instant prime contract and special agreement, so the Defendant’s assertion that was made on the grounds of the invalidation of the instant prime contract and special agreement’s early termination or non-payment of insurance proceeds is without merit, and the Plaintiff is not obligated to

5. Conclusion

Therefore, the defendant's counterclaim is justified within the above scope of recognition, and the plaintiff's main lawsuit and the defendant's remaining counterclaim are dismissed as it is without merit. It is so decided as per Disposition.

Judges - Kim Jong-young

Judges Kim So-chul

Judges Edification