In the terms and conditions of comprehensive motor vehicle insurance, the purport of the provision on the exemption of the Industrial Accident Compensation Insurance Act, which provides that “A person who is an employee of the insured with liability for compensation and is entitled to receive accident compensation under the Industrial Accident Compensation Insurance Act: Provided, That where the damage suffered by the person exceeds the scope of compensation under the same Act, such excess damage will be compensated; and where the victim is “persons entitled to accident compensation under the Industrial Accident Compensation Insurance Act” due to the accident caused by the motor vehicle accident, whether the insurer is exempted from liability for compensation pursuant to the aforementioned exemption provision (affirmative in principle) / The standard time to determine whether a person is “persons entitled to accident compensation under the Industrial Accident Compensation Insurance Act” (affirmative at the time of occurrence of the motor vehicle accident) / Whether the victim is “persons entitled to accident compensation under the Industrial Accident Compensation Insurance Act” (affirmative)

Articles 5, 80, and 87 of the Industrial Accident Compensation Insurance Act

Supreme Court Decision 2002Da4429 Decided September 4, 2002 (Gong2002Ha, 2324) Supreme Court en banc Decision 2003Da2802 Decided March 17, 2005 (Gong2005Sang, 586) Supreme Court Decision 2014Du11571 Decided January 15, 2015

National Freight Trucking Federation (Law Firm Southern River, Attorneys Kim Jae-in, Counsel for defendant-appellant)

Plaintiff’s Intervenor (Attorney Jeong-chul et al., Counsel for defendant-appellee)

DB Insurance Co., Ltd. (formerly: Dongbu Fire Insurance Co., Ltd.) (Law Firm Vindication, Attorneys Shin Young-Gyeong et al., Counsel for the plaintiff-appellant)

Seoul Central District Court Decision 2017Na45614 Decided May 10, 2018

The part of the judgment below against the defendant, excluding the part of the claim for reimbursement of litigation costs, shall be reversed, and this part of the case shall be remanded to the Seoul Central District Court Panel Division. The remaining appeal shall be dismissed.

The grounds of appeal are examined.

1. The judgment of the court below

A. The lower court acknowledged the following facts.

(1) The Plaintiff is an automobile insurance company that has entered into an automobile mutual aid agreement with Han-ro Transport Co., Ltd. (hereinafter “instant truck”). The Defendant is an automobile insurance company that has entered into an automobile mutual aid agreement with the Plaintiff’s Intervenor (hereinafter “ Intervenor”) on the instant truck (hereinafter “instant truck”). The Defendant is an automobile insurance company that has entered into a comprehensive automobile mutual aid agreement with the Plaintiff’s auxiliary participant (hereinafter “ Intervenor”) on the instant vehicle (hereinafter “instant vehicle”). The instant insurance agreement is a person who may receive accident compensation pursuant to the Industrial Accident Compensation Insurance Act (hereinafter “Industrial Accident Compensation Insurance Act as an employee liable to compensate”), with the reason for exemption under the instant insurance agreement as follows: Provided, That if the damage suffered by the Plaintiff exceeds the scope of compensation under the said Act, the excess damage will be compensated.”

(2) On October 26, 201, Nonparty 1, while driving the instant truck around 02:30 on or around October 26, 201, caused an accident to shock the instant vehicle driven by Nonparty 2, and thereby, Nonparty 3, who was on board the instant vehicle, was injured (hereinafter “instant accident”).

(3) After compensating the Plaintiff for the damage caused by the instant accident, the Defendant filed a petition for deliberation with the Committee for Deliberation on Disputes over Claims for Reimbursement. The said Committee decided that the rate of negligence of the instant accident was 5% on the part of the Plaintiff, and 45% on the part of the Defendant.

(4) The Plaintiff spent KRW 432,84,190 in total with Nonparty 3’s medical expenses, damages, and litigation costs in the instant lawsuit, according to the judgment of the lawsuit claiming damages filed by Nonparty 3, the victim of the instant accident (Seoul Central District Court Decision 2013Da245088), from February 28, 2012 to March 5, 2015.

(5) At the time of Nonparty 2 and Nonparty 3’s employees, both of the intervenors were involved in the instant accident, and Nonparty 3 was involved in the instant accident. Nonparty 3 did not claim accident compensation for the instant accident to the Korea Workers’ Compensation and Welfare Service, even though the instant accident was an industrial accident for which insurance benefits under the Industrial Accident Insurance Act may be paid.

B. Based on the above findings of fact, the court below determined that the accident of this case constitutes joint tort caused by Nonparty 1’s negligence and the negligence of Nonparty 2, and that the Plaintiff spent damages, etc. as above on the part of Nonparty 3, a victim, as a mutual aid association for the operation of the truck of this case, one of the joint tortfeasor, and that the Defendant, who is the insurer of the other joint tortfeasor, was jointly exempted, the Plaintiff could seek reimbursement for the portion of liability according to the ratio of liability. Furthermore, for the following reasons, the court below did not accept the Defendant’s defense that the exemption clause of this case, which is the industrial accident of this case, should apply to the accident of this case, or that the amount equivalent to the industrial accident insurance benefits that Nonparty 3 would have been entitled to receive from the insurance benefits of this case under the insurance contract of this case, the amount equivalent to the above insurance benefits of this case should not be deducted from the insurance benefits of this case as the beneficiary of the above insurance benefits of this case, and therefore, the amount equivalent to the insurance benefits of this case could not be paid from the Plaintiff’s injury insurance benefits and insurance benefits of this case.

2. However, it is difficult to accept the above determination by the court below for the following reasons.

A. The purport of the provision of this case’s exemption clause in Section Ⅱ is to stipulate various employer’s liability for damages caused by occupational accidents in the labor-management relations between the employer and workers, while establishing an industrial accident insurance system under the Industrial Accident Insurance Act to secure such liability. As such, an insurer is also exempt from liability for damages caused by occupational accidents subject to the industrial accident insurance within the scope of personal liability insurance for the purpose of compensating for damages to a third party to the extent that it can be compensated by industrial accident insurance (see Supreme Court en banc Decision 2003Da2802, Mar. 17, 2005). Therefore, if the automobile insurance accident falls under the category of industrial accident, “the victim is entitled to accident compensation under the Industrial Accident Compensation Insurance Act,” the insurer is not entitled to exemption from liability for damages caused by the industrial accident under the Industrial Accident Compensation Insurance Act, unless there are any special circumstances, to the extent that it is possible to compensate for damages caused by the industrial accident under the Industrial Accident Compensation Insurance Act (see Supreme Court Decision 200Da4294, Apr. 29, 200, 200).

B. However, according to the court below's findings, the accident of this case is clearly industrial accident at the same time as the insurance accident of this case which stipulated the insurance contract of this case. Thus, the non-party 3, the victim of this case, constitutes "persons entitled to accident compensation under the Industrial Accident Insurance Act" as stipulated in the exemption clause of this case. Therefore, the defendant, who is the insurer of this case, is exempted in principle in accordance with the exemption clause of this case. However, if the damage exceeds the part compensated by the Industrial Accident Insurance Act due to the accident of this case, the defendant is liable to pay the insurance money to the non-party 3 only the excess part as stipulated in the insurance contract of this case. This is true even if the non-party 3 was paid damages equivalent to the industrial accident insurance benefits of this case from the plaintiff, the mutual aid business operator of another joint tortfeasor after the accident of this case.

C. If so, the lower court should have acknowledged the Defendant’s duty to pay the insurance proceeds in accordance with the instant insurance contract only for the remainder exceeding the remainder after deducting each of the corresponding insurance benefits from each of the damages, if the actual damages suffered by Nonparty 3 by the instant accident does not exceed the amount of the insurance benefits that the Korea Workers’ Compensation and Welfare Service could have initially received from the Korea Workers’ Compensation and Welfare Service.

3. Nevertheless, the lower court held that Nonparty 3 cannot deduct the amount of damages equivalent to the industrial accident insurance benefits that Nonparty 3 could have been paid out of the insurance benefits that the Defendant had to pay, on the sole basis of the fact that Nonparty 3 was unable to pay the industrial accident insurance benefits corresponding to the damages to Nonparty 3 by receiving compensation for considerable damages from the Plaintiff, a third party after the accident of this case. In so doing, it erred by misapprehending the legal doctrine on the interpretation of the exemption clause of this case, and failing to exhaust all necessary deliberations, thereby adversely affecting the conclusion of the judgment.

4. Meanwhile, the Defendant appealed against the part of the judgment below regarding the claim for reimbursement of litigation costs. However, there is no indication in the petition of appeal as to the grounds for appeal and no statement in the grounds for appeal can be found even in the appellate brief.

5. Therefore, the part of the judgment below against the defendant, excluding the part of the claim for reimbursement of lawsuit costs, is reversed, and that part of the case is remanded to the court below for further proceedings consistent with this Opinion. The remaining grounds of appeal are dismissed. It is so decided as per Disposition by the assent of all participating

Justices Kwon Soon-il (Presiding Justice)