2016 Ghana 5143683 Insurance proceeds

A

Hyundai Maritime Fire Insurance Corporation

January 26, 2018

May 11, 2018

1. The plaintiff's claim is dismissed.

2. The costs of lawsuit shall be borne by the Plaintiff.

The defendant shall pay to the plaintiff 10 million won with 15% interest per annum from the day following the delivery date of a copy of the complaint of this case to the day of complete payment.

1. Basic facts

A. On March 17, 2009, the Plaintiff, the father of the deceased B (hereinafter referred to as “the deceased”) entered into an insurance contract with the Defendant (hereinafter referred to as “instant insurance contract”) with the following contents.

○ Main contents of the insurance policy

-Name of goods: Unnegotiable uniform uniform insurance

- Insurance period: from March 17, 2009 to March 2085, March 17, 2009

- Insured: the Deceased

-the beneficiary: the plaintiff and the other beneficiary upon the death of the insured;

- Amount of insurance coverage: Basic contract shall pay KRW 50 million to the insured amount at the time of death due to an injury, 50,000,000,000,000,000,000 of the insured amount at the time of death due to an injury.

○ Main Terms and Conditions of Insurance

Article 13 (Compensation for Loss) (1) If the insured has sustained an injury to his body due to a sudden and incidental accident during the period of insurance, the company shall compensate for the loss resulting from such injury in accordance with the terms and conditions of this Agreement.

Article 14 (Compensation for Non-Compensation) (1) The Company shall not pay compensation for any loss arising from the following causes:

1. Intentional intention of the insured (not guilty);

Article 15 (Death Insurance Money) (1) If the insured was injured by an accident prescribed in Article 13 (Compensation for Loss) during the insurance period after the date on which the insured falls under the age of 15 and died as a result of such accident, the company shall pay the amount of insurance coverage stated in the insurance policy (insurance Policy) to the beneficiary as the death insurance money.

○ Main contents of the Clause on Special Provision on Security for Injury, Death or Disability Additional Clause

Article 1 (Compensation for Loss) (1) If the insured has sustained any bodily injury due to a sudden and incidental accident during the insurance period of this Special Terms and Conditions entered in a certificate of insurance coverage, the company shall be bound to compensate for the loss resulting from such injury in accordance with this Special Agreement.

Article 2 (Non-Compensation for Loss) Damage not covered by this Special Agreement shall be at the risk of Article 14 (Non-Compensation for Loss) of Chapter II Section 1 (General Terms and Conditions).

Article 4 (Death Insurance Money) (1) If the insured has sustained an injury during the insurance period, and has died directly as a result of the accident, within two years from the date of the accident, the company shall pay to the beneficiary the purchase amount of insurance under this special agreement as the death insurance money stated in the insurance policy (insurance Policy).

C. On September 24, 2015, at around 09:41, the Deceased was found to be out of water, after having died in the Han River water near approximately 50 meters at the south of Han River basin P-14 in Seongdong-gu, Seongdong-gu, Seoul (hereinafter “instant accident”). As a result of the investigation by the Seoul Sungdong Police Station, there was a postmortem’s opinion that the deceased’s death is presumed to have no special damage or injury to the entire body and the deceased’s private life is presumed to be benefiting from death, and there was a recurrence of the hospital medical records to the deceased. In light of the fact that the deceased’s statement that the deceased selected suicide because of economic force without a certain occupation, the deceased’s death was presumed to have a cause of suicide and that there was no other suspicion of death was concluded on the ground that the deceased’s death was not discovered.

[Ground of recognition] Facts without dispute, Gap evidence 1 through 8, Eul evidence 1 and 2, the purport of the whole pleadings

2. Summary of the parties’ assertion

The plaintiff asserts that, since the deceased, as an insured event under the terms of the insurance contract of this case, the defendant is obligated to pay the sum of KRW 100 million to the plaintiff who is the beneficiary of this case. Accordingly, the defendant asserts that the deceased's death cannot be deemed to have been caused by the "emergency and incidental accidents" as stipulated in the insurance contract of this case, and even if so, the accident of this case is considered to be suicide by the deceased's intentional act, and thus, it constitutes a reason for exemption as stipulated in

3. Determination

(a) Relevant legal principles;

The term "accident" among the requirements of an accident covered by a personal insurance contract means an accident caused by an unforeseeable cause, which is not intentional but unforeseeable, and which means an accident which causes an unforeseeable result in ordinary process. As to the probability of such accident, the claimant has the burden of proof (see, e.g., Supreme Court Decision 2003Da35215, 3522, Nov. 28, 2003).

As seen earlier, the general and special terms and conditions applicable to the insurance contract of this case are classified as damages that do not compensate for the insured's "damage caused by the insured's intentional act" in defining "injury caused by an accident which is urgent and remote, and further within 2 years from the direct result of such injury" as an insured accident. Thus, such insurance terms and conditions cannot be interpreted as the same as the exemption from liability where the insured intentionally committed suicide in the life insurance contract which is a peril insured against. Therefore, in light of the language, structure and form of the above terms and conditions, the insurance contract of this case does not constitute an insured accident per se of the insured's death, and it cannot be deemed that the insured's accident occurred only when the plaintiff proves that the deceased's death was the direct result of the injury caused by an accident. However, it is difficult to prove that it is not an accident due to intention, and it is difficult to prove that the claimant's intentional act is not a strict proof as to the ordinary legal requirements, but to prove that it is not a judge's intentional accident.

B. Determination

In this case, according to the legal principles as seen earlier, the Plaintiff must prove the fact that the instant accident was not an intentional accident, and there is no evidence to prove such fact. Rather, in full view of the facts admitted and the purport of the entire arguments on the evidence, the Deceased was found to be a dead body on the Han River surface near the South Tridong Group, and there was no special damage or external wound on the body of the Deceased, the Deceased was treated as a dead body on the part of the body of the deceased before the instant accident, and the Deceased was treated due to a recurrence, depression, depression, or sacrific injury before the instant accident. The bereaved family members were suspected of death or sacrific injury. At the time of the investigation, the deceased’s bereaved family members were able to undergo an autopsy. At the time of the investigation, there was no sufficient contact to ask for help by lending money from the deceased without a certain occupation. Economic force, and there was no other suspicion that the deceased voluntarily selects suicide, and there is no other evidence to suspect that the deceased’s body’s statement to the deceased is legitimate.

Therefore, it is difficult to recognize that the deceased died due to the "accident in the future" stipulated in the insurance contract of this case. Thus, the plaintiff's claim of this case premised on the occurrence of the insurance accident stipulated in the insurance contract of this case cannot be accepted.

4. Conclusion

Therefore, the plaintiff's claim is dismissed as it is without merit. It is so decided as per Disposition.

Judges Kim Yong-tae