2021Guhap51256 The revocation of the disposition of revocation of the bereaved family's benefits and funeral site pay.

Korea Labor Welfare Corporation

on March 25, 2021

April 8, 2021

1. The disposition that the Defendant rendered to the Plaintiff on November 25, 2020 on the bereaved family’s benefits and funeral expenses shall be revoked.

2. The costs of the lawsuit are assessed against the defendant.

The same shall apply to the order.

1. Details of the disposition;

A. On July 20, 2012, 200, 21: (a) the Plaintiff complained of two copies at the construction site on the part of July 20, 2012, and returned home, and was sent back to the hospital. Around 21:00, the Plaintiff was diagnosed with cerebral typhrosis by male and chroposis, cerebral cerebral tyrosis, cerebral tyrosis by serious cerebral cerebral tyrosis, cerebral tyrosis by sub-bral tyrosis, and cerebral tyral tyrosis.

B. On September 26, 2012, the Defendant claimed medical care benefits to the Defendant, but was not approved on October 30, 2012, and both the request for review was dismissed on April 26, 2013 and the request for review on June 19, 2013.

On May 27, 2015, he died.

C. The Plaintiff is the spouse of the Plaintiff (hereinafter “the Plaintiff”). On May 13, 2019, the Plaintiff sought reimbursement of survivors’ benefits and funeral expenses on the ground that the deceased’s death constituted an occupational accident. The Defendant’s death on August 14, 2019 constituted occupational accident. However, the Plaintiff’s right was terminated by the statute of limitations for three years pursuant to Article 112(1)1 of the former Industrial Accident Compensation Insurance Act (amended by Act No. 15665, Jun. 12, 2018).

D. On November 13, 2020, the Plaintiff sought the payment of survivors’ benefits and funeral expenses. The Defendant rejected the payment on November 25, 2020 for the same reasons as the above (c) (hereinafter “instant disposition”).

[Ground of recognition] Facts without dispute, Gap evidence Nos. 1 and 4, the purport of the whole pleadings

2. Grounds and related statutes;

▣ 구 산업재해보상보험법(2018. 6. 12. 법률 제15665호로 개정되기 전의 것. 이하 ‘구법’이라 한다)제112조(시효) ① 다음 각 호의 권리는 3년간 행사하지 아니하면 시효로 말미암아 소멸한다1. 제36조 제1항에 따른 보험급여를 받을 권리제36조(보험급여의 종류와 산정 기준 등) ① 보험급여의 종류는 다음 각 호와 같다. (후략) 1. 요양급여 2. 휴업급여 3. 장해급여 4. 간병급여 5. 유족급여 6. 상병보상연금 7. 장의비 8. 직업재활급여② 제1항에 따른 보험급여는 제40조, 제52조부터 제57조까지, 제60조부터 제62조까지, 제66조부터 제69조까지, 제71조, 제72조, 제91조의3 및 제91조의4에 따른 보험급여를 받을 수 있는 사람(이하 “수급권자”라 한다)의 청구에 따라 지급한다. ▣ 산업재해보상보험법(이하 ‘개정법’이라 한다)제112조(시효) ① 다음 각 호의 권리는 3년간 행사하지 아니하면 시효로 말미암아 소멸한다. 다만, 제1호의 보험급여 중 장해급여, 유족급여, 장의비, 진폐보상연금 및 진폐유족연금을 받을 권리는 5년간 행사하지 아니하면 시효의 완성으로 소멸한다. 1. 제36조 제1항에 따른 보험급여를 받을 권리② 제1항에 따른 소멸시효에 관하여는 이 법에 규정된 것 외에는 「민법」에 따른다. 제113조(시효의 중단)제112조에 따른 소멸시효는 제36조제2항에 따른 청구로 중단된다. (후략)부칙 제1조(시행일) 이 법은 공포 후 6개월이 경과한 날부터 시행한다. (후략)▣ 민법제178조(중단후에 시효진행)① 시효가 중단된 때에는 중단까지에 경과한 시효기간은 이를 산입하지 아니하고 중단사유가 종료한 때로부터 새로이 진행한다.

3. Whether the instant disposition is lawful

A. On the premise that the three-year statute of limitations applies to the Plaintiff’s right to bereaved family benefits and funeral expenses, the Defendant rendered the instant disposition rejecting the payment on the ground that the statute of limitations has already expired at the time of the instant claim.

B. However, it is reasonable to view that the Plaintiff’s claim was not complete due to the following reasons. The instant disposition based on a different premise is unlawful.

The Industrial Accident Compensation Insurance Act was amended by Act No. 15665, Jun. 12, 2018; the extinctive prescription period for entitlement to insurance benefits, such as survivor’s benefits and funeral expenses, was three to five years (the pertinent provision shall enter into force from December 13, 2018). The Appellant died on May 27, 2015; and the Plaintiff claimed the payment of survivors’ benefits and funeral expenses for which three years elapsed, but the claim was made again on November 13, 2020 on the ground of the lapse of the extinctive prescription period.

1) First, we examine whether the extinctive prescription period concerning the claim for payment of benefits ought to be deemed three years according to the former Act, and whether it should be deemed five years according to the amended Act.

In full view of the aforementioned facts and circumstances, it is reasonable to view that the period of extinctive prescription of the Plaintiff’s survivor’s survivor’s benefit and funeral expenses claim is applicable pursuant to the amended Act. Since the five-year prescription period has not yet expired on May 13, 2019 that the Plaintiff first sought payment, the said claim was interrupted upon the said claim, and the period of extinctive prescription has not yet expired (Articles 113 and 112(2) of the Industrial Accident Compensation Insurance Act, Article 178(1) of the Civil Act), and the Plaintiff’s claim at the time of the instant claim on November 13, 2020 had not yet expired.

① The right to receive insurance benefits, such as survivor’s benefits and funeral expenses, under the Industrial Accident Compensation Insurance Act, shall be acquired as of the date the cause for payment occurred, such as the death of a disaster (see, e.g., Supreme Court Decision 2004Du12957, Feb. 22, 2007). However, the determination pursuant to the Act and subordinate statutes at the time of the occurrence of the cause for payment cannot naturally be said to be in accordance with the relevant Act and subordinate statutes regarding the substantive right to receive insurance benefits, i.e., the period of time during which the Plaintiff may exercise substantive rights, such as the type and amount of insurance benefits, and extinctive prescription, etc. (see, e.g., Supreme Court Decision 2004Du12957, Feb. 22, 2007). In addition, even if the cause for payment of death before the enforcement of the Act and subordinate statutes arose, the insurance benefits are paid by applying the five-year extinctive prescription period under the Act and subordinate statutes at the time of the amendment was made by the Plaintiff at the time of the death.

② Industrial accident compensation insurance is aimed at supporting the livelihood stability of the unemployed and their bereaved family members who have an ability to work by social insuranceizing the employer’s liability for compensation for occupational accidents. The amended Act changed the period of extinctive prescription from three to five years with respect to the right to receive insurance benefits, such as survivor pension and funeral expenses. The purport of the amended Act is to promote national pension and equity and support the livelihood stability of the workers and their bereaved family members who have an occupational accident by extending the period for requesting entitlement to insurance benefits to five years, such as the national pension, which is the same social insurance. The amended Act was enforced from December 13, 2018. There was no transitional provision regarding cases where the right to receive insurance benefits was not exercised for three years under the former Act. As long as the extinctive prescription period under the amended Act does not exclude the completion of the extinctive prescription period under the former Act, allowing the workers and their bereaved family members who have an occupational accident to receive insurance benefits as much as possible accords with the legislative purpose of the Industrial Accident Compensation Insurance Act

③ Survivors’ benefits and funeral expenses of the Industrial Accident Compensation Insurance Act are when objective circumstances arise that satisfy the substantive requirements prescribed by the Act, namely, where an employee dies due to occupational reasons and where funeral expenses are paid, each cause for the payment occurs if the employee dies due to occupational reasons, and the bereaved family members, etc. obtain the right to receive abstract insurance benefits (see, e.g., Supreme Court Decision 2004Du12957, Feb. 22, 2007). As such, setting the period of extinctive prescription in the form of extinctive prescription to convert the exercise of rights to such benefit into a specific right is Article 112 of the Act. The Defendant recognized that the Plaintiff satisfies the substantive requirements of the right to receive survivors’ benefits and funeral expenses. The amended Act recognizes that the period of application extended under the amended Act directly affects the interests of the general public. However, the application of the period of insurance benefits for occupational accidents that meet the substantive requirements is small to promote social welfare of the employee by expanding the scope of application to bereaved family members, etc. suffering from occupational accidents (see, e.g., Supreme Court Decision 2005Du374, May 20138.

2) Next, we examine the starting point of the extinctive prescription as to when the Plaintiff was able to exercise the right to receive insurance benefits.

In full view of the facts and circumstances as seen earlier, it is difficult to deem that the Plaintiff could have exercised the right to receive insurance benefits, such as survivor benefits, from May 27, 2015, when it was deceased by the deceased. In this regard, the Plaintiff’s right to claim on November 13, 2020 at the time of the instant claim was not expired.

(1) In cases where it is objectively unclear whether a claimant is an occupational accident and it is impossible for the claimant to know whether to acquire the right to receive benefits without negligence, the extinctive prescription of a claim cannot run uniformly in light of social justice and the ideology of equity, and the reason for the existence of the extinctive prescription system. In cases where there are circumstances where it is impossible to verify the existence of a right from an objective perspective, the extinctive prescription of a claim shall run from the time when the claimant knew or could have known the occurrence of the right (see, e.g., Supreme Court Decisions 2007Da19624, Nov. 13, 2008; 2017Da281367, Feb. 4, 2021).

② Around July 20, 2012, the Defendant did not recognize an injury caused by occupational illness on October 30, 2012 with respect to cerebrovascular, cerebrovascular, etc. diagnosed by a deceased person around July 20, 2012. The deceased person died on May 27, 2015. As to the death caused by an injury caused by an occupational disease, the death is objectively unclear as to whether the death falls under an occupational accident, and the claimant was unable to have known that he/she acquired the right to receive survivors’ benefits, etc. without negligence. Therefore, it is difficult to view that the extinctive prescription period for the right to receive insurance benefits, such as the Plaintiff’s survivors’ benefits, etc., begins from May 27, 2015, and that the Defendant runs from August 14, 2019, as long as the Defendant fell under an occupational accident.

③ In addition, it is difficult to deem that calculating extinctive prescription period accords with the principle of trust and good faith on the premise that the Defendant, who did not recognize occupational accidents on the part of the deceased, was able to exercise the right to claim insurance benefits on the premise that the death was an occupational accident.

4. Conclusion

The plaintiff's claim is reasonable, and it is so decided as per Disposition.