Cases
2015 Ghana 11934 (Mains) Verification of Non-existence of Obligations
2015dan11941 Other (Counterclaim)
Plaintiff (Counterclaim Defendant)
ASEAN life insurance company
Defendant (Counterclaim Plaintiff)
1.A
2.B
3. C
Defendant 2, 3 is a minor, and the legal parent parentA
Conclusion of Pleadings
April 20, 2016
Imposition of Judgment
May 18, 2016
Text
1. It is confirmed that the obligation to pay the amount of the insurance proceeds for the re-accidentd death under a special contract with the Plaintiff (Counterclaim Defendant) for the Defendant (Counterclaim Plaintiff) does not exceed the amount specified in paragraph (2) below.
2. The Plaintiff (Counterclaim Defendant) shall pay to the Defendant (Counterclaim Plaintiff) A 32,285,714 won, and to the Defendant (Counterclaim Plaintiff) B and C 2,857,142 won, respectively, and 6% per annum from July 18, 2015 to May 18, 2016, and 15% per annum from the next day to the date of full payment.
3. Each of the claims by the Plaintiff (Counterclaim Defendant) against the remainder of the principal lawsuit and the remainder of the counterclaim by the Defendant (Counterclaim Plaintiff) are asserted.
4. The costs of lawsuit shall be borne by the plaintiff (a counterclaim defendant) by aggregating a principal lawsuit and a counterclaim.
5. Paragraph 2 can be provisionally executed.
Purport of claim
Main Action: Insurance contract between the Plaintiff (Counterclaim Defendant, hereinafter referred to as “Plaintiff”) and the network D in the attached Form
Insurance money for the Defendant (Counterclaim Plaintiff; hereinafter referred to as “Defendant”) regarding a special agreement
It is confirmed that the payment obligation does not exist.
Counterclaim: The Plaintiff’s 32,285,714 won to Defendant A, Defendant B, and C respectively, and each of the said money.
From July 17, 2015 to the service date of a duplicate of the counterclaim of this case, 6% per annum and from the following day to the service date of the duplicate.
C. By the date of full payment, 20% interest per annum shall be paid.
Reasons
A principal lawsuit and a counterclaim shall be deemed simultaneously.
1. Facts recognized;
A. On May 19, 2003, the Plaintiff engaged in insurance business entered into the term of insurance contract with the deceased D (hereinafter referred to as “the deceased”), the insured, and the beneficiary at the time of death, with the statutory heir, a standard type of life insurance contract for non-payment for the death of the insured and certain obstacles (hereinafter referred to as “the instant main contract”). At the time of entering into the instant insurance contract, the Deceased subscribed to the term “special agreement for non-payment for non-payment for the insured (hereinafter referred to as “the instant special agreement”). At the time of entering into the instant insurance contract, the Deceased subscribed to the term “the non-payment for non-payment for the insured” (hereinafter referred to as “the instant special agreement”).
B. The Deceased committed suicide on February 28, 2015. At the time of the Deceased’s death, Defendant A and C, the spouse of the deceased, were the deceased’s spouse, and Defendant B and C.
C. On March 23, 2015, Defendant A filed a claim against the Plaintiff on behalf of the co-inheritors of the Deceased for the payment of insurance proceeds from the deceased’s death. Accordingly, the Plaintiff paid KRW 40,000,000 to the Defendant A with the general net insurance proceeds under the instant prime contract.
D. Article 18 (1) of the Special Agreement of this case provides that "the plaintiff shall issue a receipt when he receives the required documents at the time of receiving the insurance money, and shall pay the insurance money or the refund for cancellation within three days from the date of receiving the documents. However, in the case of insurance money, if it is necessary to investigate or confirm the cause for payment, it shall be paid within ten days from the date of receiving the documents." Paragraph (2) of the same Article provides that "the plaintiff shall calculate the interest for the period until the date of paying the insurance money in accordance with Paragraph (1) of the same Article as "the calculation of the interest rate at the time of paying the insurance money at the time of paying the insurance money", and according to the table "Calculation of the interest rate at the time of paying the insurance money at the time of paying the insurance money" attached to the Special Agreement of this case, the interest rate at the time of paying the insurance money for death of a disaster shall be set according
[Judgment of the court below] Facts without dispute, Gap's evidence of subparagraphs 1 through 7, and the purport of the whole pleadings
2. The parties' assertion
A. The plaintiff
The Deceased committed suicide, which is an exemption from the payment of insurance money under the terms and conditions of the instant special agreement, falls under the case of intentionally damaging himself/herself (Article 12(1)1 of the terms and conditions of the instant special agreement). Therefore, the Plaintiff is not obligated to pay the insurance money for the death of a disaster pursuant to the instant special agreement. Since the Defendants are dissatisfied with this, they seek re-verification of the Plaintiff’s obligation to pay the said insurance money to the Defendants.
B. The Defendants
In the first place, the deceased committed suicide in a situation where he could not make free decisions such as mental illness, etc., which is caused by "disaster," which is the cause for the payment of insurance proceeds stipulated in the special agreement of this case, and the plaintiff is obligated to pay the Defendants, the beneficiaries of the special agreement of this case, to the beneficiaries of the special agreement of this case, the insurance proceeds for the death of disaster as stipulated in Article 10 (1) of the terms and conditions of the special agreement of this case according to their shares of inheritance. Preliminaryly, even if the accident of this case does not fall under "disaster", the plaintiff is obligated to pay the insurance proceeds for the death of disaster to the Defendants in accordance with
3. Determination
(a) A claim for insurance proceeds from a disaster resulting from suicide in the state of mental illness;
In light of the legislative intent of Articles 659(1) and 732-2 of the Commercial Act, where a suicide is stipulated as an insurer’s exemption from liability in an insurance contract where death is caused by an insurer’s insurance contract with an insurance company, the act of causing death by intentionally cutting the life of the deceased for its purpose and intentionally cutting the deceased’s own life for its purpose. It does not include the case where the insured was unable to make a free decision due to mental change, etc., and whether there was a death in a situation where it is impossible to make a free decision due to mental disease, etc., the determination of whether there was a death in a situation where it was impossible to make a free decision due to mental disease should be made by comprehensively taking into account the age and character of the person who committed the suicide, physical and mental psychological situation of the person who committed the suicide, the occurrence and progress of the mental disease, the detailed situation at the time of the suicide, surrounding circumstances surrounding the person who committed the suicide at around the time of the suicide, the behavior of the person who committed the act, the motive and manner of the suicide, etc. (see, etc.).
In light of these legal principles, according to the defendants' primary arguments, the deceased was provided with gambling, Internet addiction, and toxic insects on June 27, 2014. The deceased was provided with a prescription for a drug after being treated as gambling at Ewon on June 27, 2014. The deceased was provided with a prescription after being diagnosed with fluoral disease due to the specific symptoms of the same symptoms in F mental health department. On February 16, 2015 and February 23, 2015, the deceased was provided with a prescription after being diagnosed with fluoral fluoral fluoral fluoral fluor's disease and alcohol dependence on the symptoms of G Council members. The deceased committed suicide on February 28, 2015 after the above diagnosis.
However, even if the deceased was suffering from mental illness such as depression at the time of suicide, it is difficult to readily conclude that the above recognition room alone caused the death to the extent that the deceased could not make a free decision, and there is no other evidence to acknowledge it. Therefore, the Defendants’ counterclaim’s main assertion on this premise is without merit without examining the remainder.
B. Determination on the claim for the insurance proceeds resulting from suicide after the lapse of two years from the commencement date of liability
1) Occurrence of a disaster death claim
According to the statement in Gap evidence No. 5, the special agreement of this case provides that the insurance amount of the special agreement of this case shall be paid if the accident occurred during the insurance period of the special agreement of this case directly due to the accident of this case, or if the person subject to insurance (insured) intentionally damages himself/herself (Article 10 (1) of the terms of the special agreement of this case). On the other hand, the special agreement of this case provides that "the same shall not apply where the insured intentionally damages himself/herself from the state of mental illness and where he/she causes a disability of Grade I in the table of disability classification by suicide or damage to himself/herself (Article 12 (1) 1 of the terms of the special agreement of this case, hereinafter referred to as "the terms of the contract of this case")."
According to the above facts, although the special agreement of this case does not pay insurance money in the case of death caused by suicide, it is reasonable to view that the insurance money is paid in the case of suicide after the lapse of two years from the commencement date of the liability. It is reasonable to view that the contract of this case was exceptionally made with the content of the payment of insurance money in the case of suicide after the lapse of two years from the commencement date of the liability of the special agreement of this case. The fact that the deceased committed suicide on February 28, 2015, which appears to be the commencement date of the liability of the special agreement of this case, was found as above. Thus, the plaintiff is obligated to pay 80,000,000 won to the defendants, who are beneficiary of the special contract of this case, according to the legal shares of the defendants, unless there are special circumstances.
2) Judgment on the Plaintiff’s assertion
A) Claim to interpret the limitation of the standardized contract of this case
The plaintiff asserts that the terms and conditions of the contract of this case in this case stipulate only the insurer's exemption from liability on the premise that "disaster, which is a ground for the payment of insurance money as stipulated in Article 10, occurs." In order to claim the payment of insurance money under the contract of this case, "disaster falling under the ground for the payment of insurance money" should occur. However, in the case of death due to intentional suicide, the contract of this case does not fall under "disaster, which is an insurance accident," and therefore, there is no room for its application from the beginning.
As to the Plaintiff’s assertion, the instant special agreement is added to the instant main contract, but it differs from the instant main contract, which is a type of accident insurance belonging to the insurance type of insurance business under the Insurance Business Act, which is a type of life insurance business under the Insurance Business Act, and is a separate insurance contract that differs from the type of insurance accident, insurance money, and insurance premium. Accordingly, regardless of the content of the instant main contract, the instant special agreement should be understood in relation to Article 10 of the terms and conditions of the instant special agreement.
However, Article 10 of the Terms and Conditions of the instant Special Agreement provides that the time when a disaster occurs directly due to a direct cause or a death of class 1 or a disability of class 1 shall be subject to the payment of insurance proceeds. Since suicide or self-injury caused intentionally does not constitute a disaster due to lack of contingentness, if the terms and conditions of the instant Special Agreement are construed as a provision limiting exemptions and exemptions applicable only to cases where the cause for the payment of insurance proceeds under Article 10 of the Terms and Conditions of the instant Special Agreement occurred, the terms and conditions of the instant Special Agreement
Rather, in light of the average customer’s understanding possibility, the above provision does not constitute an intentional suicide or self-injury, as a matter of principle, and thus does not constitute a test accident as stipulated in Article 10 of the Terms and Conditions of the instant Special Agreement. However, there is sufficient room to understand to the effect that if the insured damages himself/herself in the state of mental illness, namely, if he/she commits suicide after the lapse of two years from the date of commencement of responsibility, or if he/she is in the state of disability of class 1 due to his/her injury, it shall be included in the insured incident
As seen earlier, it is reasonable to interpret equally as follows: (a) it is in line with the general concept that the insurer may be exempted from liability pursuant to Articles 659(1), 732-2, and 739 of the Act even if the clause of this case is not a provision of the contract of this case; and (b) it is the proviso that the agreement between the parties to the insurance contract of this case that is meaningful as an agreement between the parties to the insurance contract of this case is not the main text of the provision of the exemption liability but the proviso that sets forth the reasons for negligence as well as the main text of the provision of the reasons for negligence (see Supreme Court Decision 201Da24347 decided May 12, 2016, Supreme Court Decision 2015Da24347 decided May 2, 2016).
Therefore, the plaintiff's above assertion is not accepted.
B) A petition for invalidation under Article 151(3) of the Civil Act
The plaintiff asserts that the part of the proviso of the contract of this case "when a cause for the payment of insurance money occurs after two years have passed from the beginning of the liability under the special agreement of this case" is a condition to suspend the obligation to pay insurance money, and the suicide cannot be compatible with "disaster" due to the nature of the special agreement of this case because it does not fall under "accidents" under the concept of "accidents". Therefore, the condition of suspension that "the cause for the payment of insurance money should occur due to the occurrence of the accident" in the special agreement of this case cannot be met from the beginning. This part is invalid pursuant to Article 151 (3) of the Civil Act.
However, Article 151(3) of the Civil Act provides that "if a condition is not fulfilled at the time of the juristic act, it shall be deemed a juristic act without any condition if such condition is a condition subsequent, and the juristic act shall be null and void if such condition is a condition precedent." Although the proviso clause of the contract clause of this case does not fall under "disaster", in principle, suicide does not fall under an insurance accident because of lack of contingency. However, although the proviso clause of the contract clause of this case does not fall under an exceptional clause, if the insured commits suicide after the lapse of two years from the date on which the liability of the special contract was entered into, the purport that if the insured commits a suicide after the lapse of two years from the date on which the special contract was entered into, it shall be deemed that the cause for the payment of insurance proceeds that would be included in the insurance accident, and therefore, the proviso of Article 12(1)1 of the Clause of the
(c)the recommendation of violation of the law and regulations;
The Plaintiff asserts to the effect that, even in the case of suicide, if it is necessary to pay the accident death insurance money according to the German medicine of this case, it goes against Article 659 of the Commercial Act, which is a mandatory provision.
Article 659(1) of the Commercial Act provides that an insurer shall not be liable to pay insurance proceeds in cases where an insured event occurs due to the intention of the insured, etc. in an insurance contract which covers death as an insured event. This is because not only violates the principle of good faith under an insurance contract, but also if the insured causes an insured event by intention, it is possible to use the insurance contract for unjust purposes, such as acquisition of insurance proceeds.
However, the proviso of the contract of this case provides that "where the insured commits suicide after the lapse of two years from the commencement date of liability," the insurer shall be subject to liability clause against the insurer. The purpose of the proviso is to stipulate that the insured's suicide is highly likely to occur for the purpose of receiving the insurance proceeds within a certain period from the commencement date of liability, and that such risk is relatively low after the lapse of a certain period, the standard time is set at two years, and the insurance proceeds are uniformly paid after the lapse of the above period. In the case of suicide for which the insurance proceeds are not received, it is consistent with the basic principles of the life insurance: Provided, That it is difficult to prove that the insured commits suicide for the purpose of receiving the insurance proceeds in the current year is committed, it is reasonable to set up two years following the policy-based determination as follows, and that the insurer bears an obligation to pay the insurance proceeds after the lapse of 20 years, and that the insurer is obliged to pay the insurance proceeds after the lapse of 30 years from the expiration of the policy-based special agreement, and that the provision of this case shall not be considered in good social order.
Therefore, the plaintiff's above assertion is without merit.
(d) equitable assertion with other special agreements;
The Plaintiff asserts to the effect that the provision on suicide exemption and suicide exemption clause that are identical or similar to the terms and conditions of the instant contract is in violation of the principle of equity to ensure the payment of insurance proceeds in the event of the insured’s suicide pursuant to the suicide exemption clause only in the instant special agreement. According to each of the following: (i) Gap evidence No. 12-1 and 8; (ii) Gap evidence No. 13; and (iii) Gap evidence No. 14-1, No. 14-1, No. 2, 3, and 4, it is difficult to readily conclude that the Plaintiff’s suicide exemption insurance, as alleged by the Plaintiff, was included in the non-paid dividends pension; (iv) non-dividend dividends; (v) non-dividend dividends; (v) non-dividend pension insurance; (v) non-dividend dividends; (v) life-free dividends; and (v) life-free dividends; and (v) life-free dividends; and (v) the Plaintiff’s assertion that the insurance company sold the insurance proceeds under the instant special agreement or non-payment exemption clause does not contain the foregoing.
(e)other grounds for preventing the occurrence of insurance claims, i.e.
In addition, the Plaintiff asserted that the Plaintiff’s claim for the payment of insurance money according to the special agreement for death, as it was in a suicide accident, such as the instant case against the risk of suicide, would encourage suicide, and that it would be unfair from the perspective of social and economic equity by causing the financial crisis of a life insurance company, such as the Plaintiff, but it is not sufficient to recognize such circumstance solely on the basis of the evidence submitted by the Plaintiff, and it is not possible to prevent the Deceased and the Plaintiff from performing its duty to pay insurance money pursuant to the instant insurance contract and the instant special agreement. Accordingly, the Plaintiff’s allegation is without merit.
C. Sub-committee
Therefore, the Plaintiff’s 34,285,714 won (i.e., the Plaintiff’s share of less than KRW 3/7,000 in X’s share of inheritance in X), Defendant B, and C, respectively, KRW 22,857,142 (i.e., the amount of accident death insurance KRW 80,000,000 X statutory share of inheritance 2/7) to Defendant A, and accordingly, it is reasonable to dispute the existence and scope of the above payment obligation from July 18, 2015, which is the following day of the payment date of the insurance money pursuant to Article 18(1) of the Clause of the instant Special Agreement, on the following day of the Defendants’ claim for damages for delay from July 18, 2015 to May 18, 2016, which is the date of the instant judgment, the Defendants’ claim for damages for delay within the agreed rate of up to 6% per annum, and the Defendants’ claim for damages for delay by 15% per annum.
Meanwhile, in relation to the instant special agreement, the Plaintiff, an insurer, did not have any insurance money to be paid to the Defendants in excess of the said money. Thus, insofar as the Defendants are dissatisfied with this, it should be deemed that there exists a benefit to seek confirmation.
4. Conclusion
Therefore, the plaintiff's principal lawsuit and the defendants' counterclaim are accepted within the scope of each recognition above, and the remaining principal lawsuit and counterclaim are dismissed as they are without merit.
Judges
Maternity and Doz.
Note tin
1) On September 3, 2015, the Plaintiff stated that the extinctive prescription has expired on the fourth page of the complaint submitted on September 3, 2015, but on March 9, 2016
At the date of pleading, the plaintiff's legal representative made a statement at the time of pleading, or the plaintiff's written reply against the defendants' counterclaim on April 8, 2016
In light of the fact that the filial side is not included, it appears to be an error. Therefore, it is not judged separately.
Site of separate sheet
Insurance contracts
(Elimination of Insurance Contracts)