[1] The principle of disadvantage of the author in interpreting the insurance clause

[2] In a case where: (a) while undergoing an in-house border inspection by Gap, a paper was discovered with less than 1cm in the workplace; (b) after undergoing an in-house border inspection by Byung, a clinical specialist, issued a diagnosis of “in-house malicious life” as to the above types of life; and (c) the above types of life constitutes “A” as stipulated in the terms and conditions of an insurance contract concluded with Byung insurance company, etc., the case held that the court below erred by misapprehending the legal principles as to the interpretation of the above insurance terms and conditions, on the grounds that the scope of the amount of insurance accident or insurance money payment falls under a case where the above insurance terms and conditions are objectively different and it is unclear that the meaning of the terms and conditions is unclear; and (d) occupational cancer whose detailed specifications are unknown, such as the type of occupational cancer, falls under the category of “A” under the principle of disadvantage of the originator under Article 5(2) of the Regulation of Standardized Contracts Act, and based on the result of organizational inspection conducted by Byung specialist, the judgment below erred by misapprehending the legal principles as to the terms and conditions.

[1] The insurance terms and conditions shall be interpreted fairly and reasonably in light of the purpose and purpose of the terms and conditions in good faith, and shall not take into account the intended purpose and intent of each party to the contract, and shall be objectively and uniformly interpreted in consideration of the interests of the entire insurance organization based on average customer’s understanding. Even after such interpretation, in cases where the meaning of the terms and conditions is not clear, such as where the terms and conditions are objectively and objectively interpreted and their respective interpretations are reasonable, it shall be interpreted favorably to customers.

[2] The case holding that the above insurance policy provides that "A cancer" is defined as "a disease classified as malicious life from the basic classification of Korean Standards for Disease and Death Classification, and its size is less than 1cm, and that the clinical doctor, who is the head of a workplace, issued a diagnosis of "A" as to the above types of disease based on the result of organizational inspection conducted by Byung, and that the above types of disease constitutes "A" and its spouse, and that it is reasonable to interpret the above insurance policy as "A" as "a disease classified as malicious life from the basic classification of Korean Standards for Disease and Death Classification," and that it is reasonable to interpret the above insurance policy as "a disease whose size is less than 1cm and which is less than 1cm," and as such, it is reasonable to interpret the terms as "A's new type of disease classification standard as "a's new type of disease" under the premise that B's new type of disease is unreasonable and that it is not reasonable to interpret the same as "a's new type of disease classification standard as that of 2010.

[1] Article 5 of the Regulation of Standardized Contracts Act / [2] Article 5 of the Regulation of Standardized Contracts Act

[1] Supreme Court Decision 2009Da60305 Decided December 9, 2010 (Gong2011Sang, 100) Supreme Court Decision 201Da1118 Decided April 28, 201, Supreme Court Decision 2013Da90891, 90907 Decided October 27, 201 (Gong2016Ha, 1752)

[Judgment of the court below]

Samsung Life Insurance Co., Ltd and one other (LLC et al., Counsel for the defendant-appellant)

Seoul Central District Court Decision 2016Na57177 Decided August 10, 2017

The judgment of the court below is reversed, and the case is remanded to the Seoul Central District Court Panel Division.

The grounds of appeal are examined.

1. The insurance terms and conditions shall be interpreted fairly and reasonably in light of the purpose and purpose of the terms and conditions in accordance with the principle of trust and good faith, but shall be interpreted objectively and uniformly, without taking into account the intended purpose and intent of each party to the contract, based on an average customer’s interests. Even after such interpretation, in cases where the meaning of the terms and conditions is not clear, such as where the provisions of the terms and conditions are objectively and objectively interpreted and their respective interpretations are reasonable, it shall be interpreted favorably to customers (see, e.g., Supreme Court Decisions 2009Da60305, Dec. 9, 2010; 201Da1118, Apr. 28, 2011).

2. Review of the reasoning of the lower judgment and the record reveals the following circumstances.

A. 1) On January 31, 2001, the Plaintiff entered into an insurance policy with Defendant Samsung Bio-life insurance company (hereinafter “Defendant Samsung Bio-life insurance”) with the insured and the beneficiary as its own. On September 22, 2001, the Plaintiff entered into an insurance policy with the Defendant Samsung Bio-life insurance company (hereinafter “Defendant Samsung Bio-life insurance”) with the “Undividend Samsung Type Insurance without dividends” on September 22, 2001, and on January 12, 2007, respectively.

2) On September 5, 1998, between the Plaintiff’s spouse Nonparty 1 and the Defendant New Life Insurance Co., Ltd. (hereinafter “Defendant New Life Insurance Co., Ltd.”) (hereinafter “Defendant New Life Insurance Co., Ltd.”) concluded the “Undividend New Life Insurance” with the Plaintiff as the insured and the beneficiary (hereinafter “each insurance contract of this case”).

B. Under the terms and conditions of each of the instant insurance contracts, “amam” refers to the disease (see attached Table 3 and attached Table 3) classified as malicious life in the basic classification of the Korean Standard Disease and Death Classification. In addition, the disease classified as malicious life refers to the disease falling under the following among the third amended Korean Standard Disease and Death Classification, and one of the following diseases is included in the classification number c15-C26. After the fourth amendment, the disease is included in the Korean Standard Disease and Death Classification.

In addition, the terms and conditions of each insurance contract of this case provide that the diagnosis and determination of cancer should be conducted by a person with a professional doctor's license of autopsy pathology or clinical pathology, and that diagnosis should be based on the present opinion about tissue or blood examination, but if such rupture diagnosis is not possible, the clinical diagnosis of cancer is recognized as evidence of cancer.

(c) The Korean Standard Disease and Death Classification is a data systematically categorized according to the similarity of diseases and death data, such as mandatory recording data and statistical surveys on the cause of death, in the Republic of Korea.

In Chapter 2, the Korean Standard Disease Classification No. 3 provides disease classification numbers by subdividing the classification according to the behavior pattern of new organisms into parts of body. In order to apply these disease classification numbers, Part 4 is referred to as the "New Organism Classification". The first four types of new Organisms indicate the organizational form of new Organisms and the fifth number is indicated as their behavior pattern. In other words, Part 4 provides that the behavior pattern of new Organisms is malicious, 00-D48, 300, 3000, 4000, 300,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000,000.

Therefore, in the case of workplace-specific cancer (creciologic species, carciologic species), the type classification number under Part 4 of the Korean Standard Disease and Death Classification falls under the category of malicious life if 'M8240/3', and the type classification number under Part 3 falls under C20 of the disease classification number, and d37 of the disease classification number in the case of 'M8240/1' if 'M8240/1', the type classification number is 'M8240/3'. However, the Korean Standard Disease and Death Classification does not include the disease classification number by distinguishing the information such as the size, aggression, and decentralization of workplace-specific cancer species.

(d) in the form classification of new organisms of Part IV of the Korean Standard Disease and Death Classification, the type classification number of workplace cancer has been changed as follows:

1) In the third revised Korean Standard Disease and Death Classification, effective January 1, 1995, the term "NOS" is classified as "M8240/3," as "M8240/1," and the term "scarin species, the detailed number of which occurred in the shock," as "M8240/1," respectively, as "M8240/1," respectively. This is also applicable to the fourth revised Korean Standard Disease and Death Classification, effective January 1, 2003.

2) The fifth revised Korean Standard Disease and Death Classification, which came into force on January 1, 2008, ordered “unscisfypin species” to be “M8240/1” and “M8240/3” to be “M8240/3”. This is also applicable to the sixth Korean Standard Disease and Death Classification, which came into force on January 1, 201.

Meanwhile, the Korean Standard Disease and Death Classification Guidelines prepared to be utilized as a supplementary material for the Korean Standard Disease and Death Classification No. 2 Guidelines, 2014, stating that “If the size of workplace-type cancer 1 is less than 1cm with the size of less than 1cm and there is no blood-related and nearby straining, the form of action may be classified as /1.” However, if the contents of the Guidelines for the Disease Code conflict with the Korean Standard Disease and Death Classification, the Korean Standard Disease and Death Classification is preferentially applied, and the above contents were deleted from the Corpon Guidelines for the Korean Standard Disease and Death Classification in 2016.

3) Under the 7th revised Korean Standard Disease and Death Classification, which was effective January 1, 2016, the term “clearly malicious cancer” was classified as “M8240/1,” and “M8240/3” into “M8240/3. In other words, without distinguishing the development components, all the details of the obscure cancer were classified as malicious. In particular, the detailed unknown Materns (M8240/3) added the name of “Class 1 (Nurendocoptyor, Grade 1)” to the title, and added the class and name to the table. Accordingly, the 3 (ICD-3) of the International Classification of the Mayang School Diseases and International Disease Classification as amended on September 9, 2011, was also classified as “M240/38 (M240/3).”

E. In recent years, there was controversy as to whether it was malicious species, whether it was caused by the fire extinguishing machine, or a cross-border species.In 2008 thesis (a proposal for registration of fire extinguishing machine for pathology) and 2012 paper, which referring to foreign data, were prepared by the Kiology Association in 2008 and in 2012, this paper suggested that if the neutic flabic fladic fladic fladic fladic fladic fladic fladic fladic fladic fladic fladic fladic fladic fladic flad flad flad flad flad flad flad flad flad flad flad flad flad flad flad flaf flaf flaf.

F. On February 11, 2015, the Plaintiff was found at the ○○○○○○○○ Branch, which was in the Si of Gunsan, and was subject to the malination of the kind of food (hereinafter “instant species”). On February 14, 2015, Nonparty 2 prepared an organizational pathology test report stating that “workplace species, size 0.4cm x 0.3cm x 0.3cm x 0.3cm on the face of the instant species” after conducting the organizational inspection of the instant species. After that, Nonparty 3, the Plaintiff’s doctor Nonparty 3, the main doctor of the instant hospital, was the Plaintiff’s clinical doctor, based on the foregoing organizational pathology test report, prepared a diagnosis report stating the Plaintiff’s final illness as “workplace malinio, Korean Standard Disease Classification Number C20” as the Plaintiff’s new malination of the Plaintiff’s disease at △△ Hospital’s University (hereinafter “Nonindicted 415, 2015”).

G. However, as a result of each medical record appraisal commission for the head of the Silology hospital at the Ilology university, it is reasonable to classify the Plaintiff’s satis as a kind of boundary, “the Plaintiff’s satise is less than 1§¯ in the workplace with the size of its pathy pattern, and the degree of decentralization is less than 1cm in terms of organizationally G1, and the degree of satise is not in the degree of satise in the workplace with the degree of satise,” and “workplace satise in the workplace with the degree of satise, not all of the satise species, but with the 1cm in an organizational aspect, less than 1cm in the workplace and the 1st degree of satise, and without the blood satise, it is reasonable to classify the Plaintiff’s satiseological opinion to the effect that the Plaintiff’s satise pattern should be given 1/1 of this workplace cancer.”

3. We examine this in light of the legal principles as seen earlier.

A. We examine whether the species of the instant case constitute “amam” as stipulated in the terms and conditions of each of the instant insurance contracts.

1) Under the terms and conditions of each of the instant insurance contracts, the term “cancer” refers to the disease classified as malicious Organisms from the Korean Standard Disease and Death Classification; the disease classified as malicious Organisms in attached Table 3 by citing the classification standards and terms of the Korean Standard Disease and Death Classification in attached Table 3 shall be included in the third revised Korean Standard Disease and Death Classification; and the disease shall also be included in the first revised Korean Standard Disease and Death Classification in cases where there is an additional disease, other than the above disease, in addition to the above disease after the fourth revision. The purpose of the provisions of such terms and conditions is to determine whether the disease falls under “Mam” according to the Korean Standard Disease and Death Classification publicly notified at the time of the conclusion of the insurance contract, but at the time of the conclusion of the insurance contract, even if it is not considered as malicious Organisms at the time of the conclusion of the insurance contract, i.e.,, if it is included in the Korean Standard Disease and Death Classification, which is most recently revised and publicly notified as malicious Organisms, it shall be considered to be considered to be a malicious Organism.

2) In accordance with the third amended Korean Standard Disease and Death Classification that stipulate the application of the terms and conditions of each of the instant insurance contracts, we examine whether the instant species constitute “Cance” as stipulated in each of the instant insurance contracts.

In the Sysiology conference of Korea, the size of the species in this case is less than 1cm, limited to the string floor and the string floor and the string floor, which do not have blood leaple, is highly likely to be the type of L-cell-in-fluoration of L-cell-in-fluor specifications, which are subdivided from the type classification of fire extinguishing machinery in 2010 of the World Health Organization, so it is reasonable to regard it as a type of boundary-in-fluoral fluoral fluoral fluoral fluoral fluoral fluoral fluoral fluoral fluoral fluoral fluoral fluoral fluoral fluoral fluoral fluoral fluoral fluoral fluoral fluoral fluoral fluoral fluort.

However, the terms and conditions of each insurance contract of this case refer only to the third revised Korean Standard Disease and Death Classification and the terms and conditions thereof. The third revised Korean Standard Disease and Death Classification does not distinguish specific characteristics, such as the size of species and the degree of invasion, and clearly classify the term “M8240/3” as the type classification number. The term “unexplosion in detail occurring from shock” is not “M8240/1.” In addition, in the third revised Korean Standard Disease and Death Classification, it does not include the classification number by distinguishing information such as the size, invasion, and decentralization of workplace cancer. Accordingly, in the third revised Korean Standard Disease and Death Classification, it is not the case of the third revised Korean Standard Disease Classification and Death Classification, Part 3 and Part 4, which are the category of Madio Madio 28, which is not the case of the category of Madio 30, which is the case of the category of Madio 28, which is the case of the category of Madio 30.

In conclusion, from the perspective of the interpretation of the insurance clauses, the third revised Korean Standard Disease Classification and Death Insurance Classification, which provides for the scope of the amount of insurance accidents or insurance proceeds in each of the terms of the insurance contracts of this case as the criteria for the classification of the terms of the insurance contracts of this case, and the interpretation that the quantity of this case is a disease classified as malicious life is sufficiently possible, and the objectivity and rationality of such interpretation are also recognized.

Therefore, with respect to the scope of the insured events or the amount of insurance proceeds of each insurance contract of this case, “C20” under the terms and conditions of each insurance contract of this case is objectively and objectively interpreted and the meaning of the terms and conditions is not clear. Therefore, applying the principle of disadvantage of the author under Article 5(2) of the Act on the Regulation of Terms and Conditions, it is reasonable to interpret that detailed workplace cancer constitutes “the malicious life of the fire extinguishing agency” under the third revised Korean Standard Disease and Death Classification, and thus, it is reasonable to interpret that the disease classification number is granted.

3) Meanwhile, according to the type classification of new life under the Korean Standard Disease and Death Classification in the 7th Amendment, all “finite disease” regardless of the outbreak level constitutes malicious life. In particular, as the 7th Amendment adds the name of diagnosis of the species in the instant case, “neurendiode rumor grade 1” in the form of Ma8240/3, it is apparent that the species in the instant case correspond to M8240/3, and as long as the behavior pattern classification number is “/3”, the disease classification number should be classified as “C20.”

B. We examine whether there was the diagnosis and confirmation of cancer according to the terms and conditions of each insurance contract of this case. According to each insurance contract of this case, the diagnosis and confirmation of cancer should be based on the current opinion on tissue tests or blood tests by a medical specialist in the event that the diagnosis and confirmation of cancer is possible. A medical specialist in the instant case prepared an organizational pathology report stating that “I do not have any opinion on the crime of cryprising to the species of 1st century” after the clinical doctor in the instant insurance contract. Based on this, the clinical doctor in the Plaintiff’s primary doctor diagnoseds the Plaintiff’s name as the sexual virosis of a workplace falling under the Korean Standard Disease Classification C20. Based on this, if the clinical doctor entered the clinical doctor’s name in the medical report on the basis of pathology’s pathology test, it should be deemed that there was a final diagnosis of crypology as stipulated in each insurance contract of this case.

C. The lower court determined otherwise on the grounds delineated below, that the Plaintiff’s diagnosis and confirmation sick person did not constitute “maid” or “serious cancer” as stipulated in the terms and conditions of each of the instant insurance contracts.

1) The instant type of medical examination only presented only the opinion that it is a workplace cancer, and did not present the opinion that it is crypology. Since the examination of medical records, which is a medical specialist, is classified as a boundary pattern, it is difficult to recognize the fact of diagnosis and determination of cancer only by the medical certificate prepared by a clinical doctor based on the result of the organizational pathology examination report.

2) According to the medical opinion regarding the appraisal of medical records, the instant species ought to be classified into “salvatory species”, which is an uncertain form of behavior of malicious diving, or an unregistered life.

3) “Cratum” stipulated in each of the instant insurance clauses is “a disease classified as a malicious substance from the basic classification of the Korean Standard Disease and Death Classification.” Even according to the Korean Standard Disease and Death Classification in the third, fourth, and seventh amendments, it is difficult to view that the instant species constitute cancer, as it is difficult to deem that the instant species are cultivated or gender-sensitive uncertainty is uncertain, even if they are based on the third, fourth, and seventh amendments.

D. In so determining, the lower court erred by misapprehending the legal doctrine on the interpretation of the terms and conditions of each insurance contract in this case.

4. Therefore, the lower judgment is reversed, and the case is remanded to the lower court for further proceedings consistent with this Opinion. It is so decided as per Disposition by the assent of all participating Justices on the bench.

Justices Park Jung-hwa (Presiding Justice)