2016Da271455 Claims

Case Non-Life Insurance Co., Ltd.

Law Firm Cheong-woo, Counsel for the plaintiff-appellant

[Defendant-Appellee] Plaintiff 1 and 2 others

Korea Labor Welfare Corporation

Daegu District Court Decision 2016Na307949 Decided November 23, 2016

23, 2020.7

The appeal shall be dismissed.

The costs of appeal shall be borne by the defendant.

The grounds of appeal are examined.

1. As to the ground of appeal on the existence of the plaintiff's right to indemnity against the defendant

A. 1) In light of the terms and conditions of the Korea Workers’ Compensation and Welfare Service’s Accident Compensation Insurance Act (hereinafter “Seoul Workers’ Compensation and Welfare Service”) that provides that an insurer shall be liable for compensation only for the portion exceeding the coverage of the Liability for Compensation for Industrial Accidents Act (hereinafter “Industrial Accident Compensation Insurance Act”) out of the liability to be borne by the insured workers due to occupational accidents, the insurer is limited to the insured’s liability for damages exceeding the industrial accident compensation portion, and thus, the insurer is not obliged to pay the insurance proceeds to the employees of the Korea Workers’ Compensation and Welfare Service (see, e.g., Supreme Court Decisions 2012Da1870, Jul. 10, 2014; 2009Da8581, Jan. 12, 2012).

Unless there is any circumstance, it is difficult to view that a third party without interests first compensates the victimized employee against the intent of the Labor Welfare Service. If the insurer of the Labor Welfare Insurance returns the compensation that the victimized employee received because the repayment made by the insurer of the Labor Welfare Service is not effective due to such reasons as against the will of the Labor Welfare Service, which is the debtor, to the insurer of the Labor Welfare Service, the victimized employee would return the compensation that the victimized employee received to the insurer of the Labor Welfare Service. However, it violates the purport of the Industrial Accident Insurance Act, i.e., the compensation procedure can be completed only when the industrial accident insurance benefits

B. Review of the original judgment and the reasoning of the first instance judgment as cited by the lower court reveals the following facts.

1) The Plaintiff is an insurer who entered into a collateral insurance contract with (company name omitted) that operates the mechanical equipment construction business, etc. The Plaintiff is an insurer who entered into the collateral insurance contract. According to the terms and conditions of the collateral insurance contract, the Plaintiff is liable to compensate for losses incurred by (company name omitted) employees of the insured (company name omitted) due to occupational accidents (Article 10(1)). However, if the amount of compensation exceeds the amount of indemnity covered by mandatory insurance, the Nonparty, who is an employee of the Plaintiff, is liable to compensate only the excess amount (Article 12(1)2) (Article 12(2)). The Nonparty, who is a company name omitted, was crashed while going up at the construction site on June 24, 201, and sustained injuries in Section 4 of pressure during the required period (hereinafter “instant accident”).

3) During the period from June 24, 201 to July 21, 2015 pursuant to the Industrial Accident Insurance Act, the Nonparty received temporary disability compensation benefits and medical care benefits from the Defendant, and did not claim disability benefits according to the specialist’s opinion that no disability is recognized due to the instant accident. (4) The Nonparty filed a lawsuit seeking compensation for damage caused by the instant accident against the Nonparty on December 15, 2011 (name omitted). The first instance court determined that the permanent disability caused by the instant accident is recognized, based on the results of physical assessment on October 29, 2013, the Nonparty paid the Nonparty KRW 23,129,470 as temporary disability compensation benefits and medical care benefits, and that the Nonparty paid the Nonparty KRW 40 to the Nonparty (the Nonparty’s company name omitted), but the Nonparty’s appeal was dismissed on the aggregate of KRW 58,788,136 and damages for delay. (25) The Nonparty’s appeal was dismissed on 2015.

C. Examining these factual relations in light of the legal principles as seen earlier, the Plaintiff’s obligation to pay disability benefits of KRW 14,454,00,00, which constitutes disability benefits, out of the amount paid to the Nonparty as the result of the pertinent civil lawsuit, based on the result of the pertinent civil lawsuit. These circumstances are known as a result of physical assessment conducted in the course of the pleading of the relevant civil lawsuit. In the event that the Plaintiff pays all the amount of damages to the Nonparty, the amount equivalent to disability benefits was paid to the Defendant on behalf of the Defendant, and the Plaintiff received the amount of damages in recognition that the Nonparty had the obligation to pay disability benefits through the Nonparty’s physical assessment result. Accordingly, even if the Plaintiff did not have the obligation to pay to the Nonparty, the obligation to pay disability benefits of the Defendant under Article 469 of the Civil Act was extinguished, and the Plaintiff may seek compensation to the Defendant.

D. On the premise that the lower court falls under a third party as stipulated in Article 87(2) of the Plaintiff Additional Property Insurance Act, and on the premise that the Plaintiff was exempted from the obligation to pay disability benefits as the Plaintiff paid insurance money equivalent to the amount of damages to the Nonparty, the lower court determined that the Plaintiff is entitled to exercise the right to indemnity against the Defendant within the scope of disability benefits that the Defendant exempted the Defendant from paying. However, the third party as stipulated in the main text of Article 87(1) and Article 87(2) of the Industrial Accident Insurance Act refers to a third party who is liable for tort liability or liability for damages against the victimized employee, or a person who is liable for direct compensation against the victimized employee. Accordingly, the Plaintiff, who did not have the obligation to pay for the industrial accident compensation portion, constitutes the Plaintiff.

In this respect, the reasoning of the lower judgment is somewhat inappropriate. However, the lower court’s conclusion that the Plaintiff could claim reimbursement against the Defendant for the amount equivalent to the above disability benefits is justifiable, and it did not err by misapprehending the legal doctrine on the right to indemnity as alleged in the ground of appeal on this part, thereby affecting the conclusion

2. As to the remaining grounds of appeal

The plaintiff filed a lawsuit in this case by selective combination of claims based on the right of indemnity and claims based on the right of subrogation, and the original court did not render any judgment on partial acceptance of claims based on the right of indemnity and on the right of subrogation. Accordingly, in the case of this case where only the defendant appealed, as seen earlier, insofar as the conclusion of the court below that partially accepted claims based on the right of indemnity is justifiable, the legitimacy of the defendant's remaining grounds of appeal as to the claims based on the right of subrogation does not affect the conclusion of the judgment, and therefore, the defendant's above argument is without merit.

3. Conclusion

Therefore, the appeal is dismissed, and the costs of appeal are assessed against the losing party. It is so decided as per Disposition by the assent of all participating Justices on the bench.

Justices Ansan-chul

Justices Park Sang-ok

Justices Noh Jeong-hee

Justices Kim Jae-hwan of the District Court