The meaning of the "emergency and remote accident", which is an accident under the terms and conditions of accident insurance, and the burden of proof for such accident (=the claimant for insurance)

As a risk guaranteed in an accident insurance, injury refers to physical damage caused by an unexpected accident from outside. Thus, the cause of the accident refers to the act from outside of the body of the insured, except for internal causes such as physical illness, etc., and the causal relationship between the external nature of such accident and the result of injury or death has the burden of proof against the claimant for insurance.

Article 737 of the Commercial Act, Article 261 of the Civil Procedure Act

[Plaintiff-Appellant] Plaintiff 1 and 1 other (Law Firm Doz., Counsel for plaintiff-appellant)

Plaintiff 1 and two others

rigly Fire Insurance Co., Ltd. (Attorneys Hong Hong-soo et al., Counsel for the plaintiff-appellant)

Jeju District Court Decision 200Na1815 delivered on April 11, 2001

The judgment below is reversed, and the case is remanded to Jeju District Court Panel Division.

We examine the grounds of appeal.

1. On December 30, 1998, the court below determined that the non-party, on the ground that the non-party, on December 30, 1998, entered into an accident insurance contract with the non-party (the non-party)'s legal heir at the time of the death of the insured, from December 16:0 to December 16:00, with the insurance premium of 11:670 won per month, and with the insurance premium of 30 million won upon the death of a general accident, and determined that the non-party's insurance premium was paid in December 30, 1998 and January 20, since the non-party's physical accident caused the non-party's death by the non-party's physical accident (the non-party's physical accident)'s death by the non-party (the non-party)'s physical accident caused by the non-party's death without fault in the Republic of Korea or a rapid and rapid accident (the non-party's physical accident) as the result of the accident, 190-day's death.

2. However, it is difficult to accept the judgment of the court below that the non-party who is the insured died due to the ex officio accident for the following reasons.

As a risk guaranteed in an accident insurance, an injury refers to a physical damage caused by an unexpected accident from the outside. Thus, the cause of the accident means that the cause of the accident act from the outside of the body of the insured, is excluded from the internal cause, such as a physical disease, and the causal relationship between the external nature of the accident and the result of the injury or death, the claimant for insurance bears the burden of proof.

According to the facts duly established by the court below and the records, the non-party was discovered while transporting stones to repair the ploss, and was sent back to the hospital. However, prior to the arrival of the hospital, the deceased's lusium had shown lusium symptoms at the time of the arrival of the hospital, and it is merely true that the non-party could be viewed as a lusium although the accurate cause of death could not be known. The non-party suffered any injury or the cause of the death was unknown until now. In light of these facts, it is difficult to conclude that the death of the non-party who is the insured was the direct result of the injury caused by the lasium accident under the above insurance terms and conditions, and there is no other evidence to prove that there was a proximate causal relation between the non-party's work transporting the stones and his death. In addition, there is no evidence to prove that there is no other evidence to prove that there is a proximate causal relation between them.

If there are these circumstances, the non-party cannot be readily concluded that the accident insurance clauses set forth in the above accident insurance clauses have caused death due to a sudden and incidental accident.

Nevertheless, the court below's finding the non-party's accident as an accident out of the past only after the non-party's moving of stones is erroneous in the legal principles as to the requirements of insurance accidents in the accident insurance, or affected the conclusion of the judgment by lowering the violation of the rules of evidence which recognized the facts without any evidence. The grounds of appeal pointing this out are with merit.

3. Therefore, the lower judgment is reversed, and the case is remanded to the lower court. It is so decided as per Disposition by the assent of all participating Justices on the bench.

Justices Seo-sung (Presiding Justice)