Where a beneficiary under the Industrial Accident Compensation Insurance Act has exempted the perpetrator from the liability for compensation, the scope of the right to claim insurance benefits.

If a beneficiary is exempted from a third person's liability for damages, the Korea Workers' Compensation and Welfare Service shall lose the foundation of subrogation under Article 54 (1) of the Industrial Accident Compensation Insurance Act, and thus, the Korea Workers' Compensation and Welfare Service shall also lose the right to claim insurance benefits. The scope of the right to claim indemnity of the beneficiary, within the limit of insurance benefits, is the same as the scope of the right to claim damages that the beneficiary has against the third person, and as to the portion of the beneficiary's claim for damages which the beneficiary has received from the third person under Article 54 (2) of the same Act without any room for problems of subrogation, "the limit of exemption from the above obligation" refers to the amount calculated by subtracting the damages actually paid from the total civil liability for damages that the third person bears to the victim (in case of partial exemption, it shall be the amount actually exempted from the insurance benefits within the limit of the Korea Workers' Compensation and Welfare Service. Therefore, if the amount of exemption exceeds the amount of damages received by the beneficiary from the industrial accident insurance benefits to the third person, the purport of the exemption from the remaining amount of the insurance benefits cannot be considered to be excluded from the insurance benefits.

Article 54(1) and (2) of the Industrial Accident Compensation Insurance Act

Supreme Court Decision 77Da1641 Decided January 17, 1978 (Gong1978, 10606), Supreme Court en banc Decision 76Da2119 Decided February 14, 1978 (Gong1978, 1068), Supreme Court Decision 85Meu2429 Decided April 8, 1986 (Gong1986, 759), Supreme Court Decision 85Meu2285 Decided March 8, 198 (Gong198, 650)

[Judgment of the court below]

Korea Labor Welfare Corporation

1. On November 27, 1997, the decision of the lump-sum survivors' compensation benefits and the lump-sum survivors' compensation benefits rendered by the defendant against the plaintiff shall be revoked.

2. The costs of lawsuit shall be borne by the defendant.

The same shall apply to the order.

1. Details of the disposition;

[Evidence A 1, 2, 3, 7, 9, 11-2, 12-6, 5, 5]

A. On April 11, 1984, when the Plaintiff’s husband was working as a street cleaners belonging to the Suwon-si Office of Suwon-si from April 1, 1984, the Plaintiff was faced with an occupational accident that was caused by Nonparty 1’s (vehicle number omitted) driving (vehicle number omitted) who was going to the front of the new apartment line located in the Sejong-si Station of Suwon-si in order to conduct cleaning work at around 05:50 on September 3, 1997 while crossing the three-lane road in front of the new apartment line located in the Sejong-si Station of Suwon-si in Suwon-si in order to conduct cleaning work at around 05:50 on September 3, 1997.

B. On October 18, 1997, the Plaintiff filed a claim against the Defendant for the lump-sum survivors' compensation and funeral expenses of this case, but the Defendant rendered the instant disposition to refuse the payment against the Plaintiff on November 27, 1997 on the ground that the Plaintiff’s claim for insurance benefits under the Industrial Accident Compensation Insurance Act (hereinafter referred to as the “Act”) was also extinguished as the Defendant became unable to subrogate the Defendant’s claim for damages due to the Plaintiff’s occurrence of occupational accidents and exemption from the liability for damages.

2. Whether the instant disposition is lawful

A. The plaintiff's assertion

The agreement between the plaintiff and the non-party 1, who is the perpetrator, was limited to a criminal case on the condition that the portion of the bereaved family's benefits and funeral expenses was reserved, and the part that "not raising any objection among the public and criminal areas" in the agreement was caused by mistake, and thus revoked by the service of the notice dated May 13, 199. Thus, the plaintiff's claim for insurance benefits cannot be deemed to have been extinguished by the above agreement.

B. Facts of recognition

[Adoption Evidence: Facts without any dispute, Gap 3, 6 evidence, Eul 4, non-party 2, 3, 4 (part), 5, and the whole purport of oral argument]

(1) On September 13, 1997, Nonparty 1, the perpetrator, was detained on behalf of the Plaintiff on the ground of the instant traffic accident, and Nonparty 4 and Nonparty 3 (the mother of Nonparty 4) agreed on September 30, 1997 that he shall not be punished against Nonparty 1 due to the instant traffic accident, and that he shall not thereafter raise an objection against Nonparty 1 on the grounds of the agreement, upon receiving KRW 17,00,000 from Nonparty 2 and his wife, who are the wife of Nonparty 1, and Nonparty 3 (the mother of Nonparty 4).

(2) At the time all people who agreed to enter in the agreement that they are civil agreements in the proposal of Nonparty 3, read the contents of the agreement, affixed their seals, and did not mention in any separate civil claim for damages or claims for industrial accident insurance benefits other than the above agreed amount.

(3) The deceased’s retirement age is 62 years of age (in principle, it may be extended only to one year at his wishes) and worked for 30 days a month. The average daily wage calculated on the basis of the salary for the three months immediately preceding the death is KRW 55,908.

(4) Meanwhile, the Plaintiff received KRW 38,325,520 out of the deceased’s retirement allowances of KRW 38,794,920.

(c) Markets:

(1) The nature of the instant agreement

(A) In a case where a beneficiary of industrial accident insurance benefits suffers from a disaster due to a third party’s harmful act, the right to claim damages against the third party against the third party is a claim in ordinary tort, and the nature of the right to claim damages against the said third party cannot be said to vary by being entitled to industrial accident insurance benefits. Therefore, the beneficiary may exempt the third party from all or part of the liability for damages that the third party bears to himself/herself in accordance with the principle of private autonomy (see Supreme Court Decision 79Da1668, Dec. 26, 1979

(B) According to the above facts, it is reasonable to view that the Plaintiff exempted Nonparty 1, who is the perpetrator, from the liability for compensation for damages to Nonparty 1 after having reached a civil and criminal agreement in 17,000,000 won with respect to the instant traffic accident, and it is difficult to view that there was any error in the process of the agreement as alleged by the Plaintiff.

In addition, it is reasonable to view that the above amount paid at the time of the agreement of this case was received as compensation for property damage in this case where it can not be seen that there was any special circumstance that the parties received the above amount as consolation money in particular as the pretext of consolation money (see Supreme Court Decision 95Da53942 delivered on September 20, 196, etc.).

(2) Exemption of liability for damages and scope of extinguishment of claim for insurance benefits

(A) Location of the issue

However, as in the case of this case, if the victim exempted a third party's civil liability for damages, it is necessary to examine whether the defendant's claim for insurance benefits (bereaved family's benefits and funeral expenses) ceases to exist, and if it ceases to exist, the scope of such claim should be examined further.

(B) Relevant statutes

Article 54 (1) of the Act provides that where the defendant has paid insurance benefits due to a disaster caused by a third party's act, he/she shall subrogate the person who has received the benefits to claim damages to the third party within the limit of the amount of benefits, and Article 54 (2) of the Act provides that where the beneficiary has received damages equivalent to the amount of insurance benefits under the Act for the same reason from a third party, the defendant shall not pay the insurance benefits under the Act within the limit of

(C) Whether an insurance benefit claim is forfeited

If a beneficiary fully or partially exempted a third party’s liability for damages prior to receiving industrial accident insurance benefits, the Defendant is unable to make a subrogation claim as to the reduced amount amount, and barring any special circumstance, barring any special circumstance, the beneficiary’s right to claim insurance benefits should also be deemed lost (see Supreme Court en banc Decision 76Da2119, Feb. 14, 1978, etc.).

(D) The scope of claim for insurance benefits extinguished

As seen above, if a beneficiary is exempted from a third party's liability for damages, the defendant should lose the foundation of subrogation under Article 54 (1) of the Act, and thus the claim for insurance benefits shall also be extinguished. The scope of the defendant's right to indemnity is identical to the scope of the claim for damages that the beneficiary has against the third party (see Supreme Court Decision 85Meu285, Mar. 8, 198, etc.) within the limit of insurance benefits (see Supreme Court Decision 85Meu285, Mar. 8, 198, etc.) and the part for which the beneficiary received damages from the third party is deducted from insurance benefits under Article 54 (2) of the Act as long as there is no doubt about subrogation, "the limit of exemption" which ceases to exist according to the above exemption shall be interpreted to mean that if the third party actually paid damages from the total amount of civil liability that the third party bears against the victim, the remaining amount after subtracting the claim (hereinafter referred to as "the amount of exemption", but in case of partial exemption, the amount actually exempted).

① Therefore, if the exempted amount exceeds the remaining amount after deducting the damages received by the beneficiary from the amount of industrial accident insurance benefits, the beneficiary would lose the entire claim for insurance benefits (ordinary civil damages would be more than the amount of insurance benefits).

② However, if the amount of exemption is less than the remaining amount after deducting the amount of damages paid from the amount of industrial accident insurance benefits, the beneficiary’s right to claim insurance benefits cannot be considered to be extinguished (if the amount of ordinary industrial accident insurance benefits exceeds the amount of damages under the civil law, it will be the case.)

This is because the purport of Article 54 of the Act is that a beneficiary of insurance benefits is entitled to double transfer by insurance benefits and compensation for damages and that a third party is trying to secure insurance financing by preventing evasion of liability (Supreme Court Decision 89Meu22487 delivered on February 23, 1990). In case a beneficiary is exempted from an offender's liability for compensation for damages, this is not the purport of allowing the defendant to be exempted from all of the obligation to pay insurance benefits to the beneficiary. In addition, the defendant cannot exercise his right to indemnity beyond the scope of the right to claim damages against the perpetrator, so there is no concern that the scope of the difference from the beginning would lose the basis for subrogation.

(3) Sub-decisions

(A) As seen earlier, as to the instant case, the Plaintiff received KRW 17,00,00 from Nonparty 1, the perpetrator, the amount of KRW 17,57,560, which actually incurred the deceased’s property damage (the amount of KRW 1,118,160, which actually contributed to the deceased’s property damage (the amount of KRW 55,908 x 30 x 30 x 2/3 x 2.9752) £« KRW 2,00,000 of the funeral allowance of KRW 439,40,00 of the lost retirement allowance of KRW 439,40 (the amount of retirement allowance of KRW 38,325,520) (the amount of retirement allowance of KRW 38,920 - retirement allowance of KRW 38,325,520). Accordingly, the Plaintiff’s civil damages claim against Nonparty 1 is nothing more than the actual amount of damages.

(B) Meanwhile, even if the Plaintiff received the agreed amount as above from Nonparty 1 and exempted the remainder of civil liability for damages in excess of it, it is clear that the Plaintiff’s claim for insurance benefits is less than the remaining amount after deducting the agreed amount from the industrial accident insurance benefits. Thus, it cannot be deemed that the Plaintiff’s claim for compensation is extinguished within the difference, as long as it is not possible for the Defendant to exercise the right to indemnity against Nonparty 1 in this case (see the above Decision 89∑ 22487, supra), the Defendant’s claim for insurance benefits still falls within the scope of 62,389,360,360 won [the amount of the industrial accident insurance benefits (the bereaved family’s benefits and funeral expenses) per day average wage 5,908 won x 1,420 (130 +1300)] and the exempted amount is less than the remaining amount after deducting the agreed amount from the industrial accident insurance benefits.

(C) Therefore, the instant disposition rejecting the payment on the ground that the Plaintiff’s claim for insurance benefits was entirely extinguished is unlawful.

3. Conclusion

Therefore, the plaintiff's claim of this case shall be accepted on the grounds of its reasoning, and it is so decided as per Disposition.

Judges White-lele (Presiding Judge)