In terms of the terms and conditions of the Workers' Accident Compensation Insurance, an insurer shall be liable to compensate only for the portion exceeding the extent compensated by the Industrial Accident Compensation Insurance Act among the liability for damages to be borne by the insured workers due to occupational accidents caused by the insured workers. In the event that the insurer compensates the damaged workers for losses falling within the scope of compensation, whether the insurer’s obligation to pay the industrial accident insurance benefits by the Korea Workers’ Compensation and Welfare Corporation is extinguished if the insurer and the victimized workers were aware of the fact that the insurer was performing the obligation to pay the industrial accident insurance

Under the terms and conditions of the Workers' Accident Compensation Insurance (hereinafter referred to as "Life Insurance") provided that an insurer is obligated to compensate only for the part exceeding the extent compensated by the Industrial Accident Compensation Insurance Act (hereinafter referred to as the "Industrial Accident Compensation Insurance Act"), which is mandatory insurance, among the liability for damages incurred by the insured workers due to occupational accidents (hereinafter referred to as "Industrial Accident Compensation Insurance Act"), the risk taken over by the insurer is limited to the insured's liability for damages arising from the part exceeding the industrial accident compensation portion, and thus, the insurer is not obligated to pay insurance proceeds for the industrial accident compensation portion. In other words, the Korea Workers' Compensation and Welfare Service bears the obligation to pay the industrial accident insurance benefits (hereinafter referred to as "industrial insurance benefits") for the industrial accident compensation portion among the liability for damages incurred by the business owner for damages caused by occupational accidents, and the insurer of the Industrial Accident Compensation Insurance bears the obligation

Meanwhile, in a case where a third party, who is not a debtor, becomes aware of such circumstances while repaying another person’s debt with the intent of repaying the debt of the third party and receiving the debt of the third party, the obligation of the third party subject to the repayment by the third party pursuant to Article 469 of the Civil Act shall be extinguished, and the third party may claim reimbursement against the debtor. A third party without interest may not make repayment against the debtor’s will. A third party’s objection should be clearly recognizable in light of the objective overall circumstances at the time of the repayment by the third party, and the third party’s objection should be presumed to be null and void by presumptioning the debtor’s

Therefore, in case where the insurer of the industrial accident insurance compensates for the damage equivalent to the industrial accident compensation benefits to the damaged workers, this is the performance of the obligation to pay the industrial accident insurance benefits by the Korea Workers’ Compensation and Welfare Service on behalf of the damaged workers. If such circumstance was known to the insurer of the industrial accident insurance and the damaged workers, the obligation to pay the industrial accident insurance benefits by the Korea Workers’ Compensation and Welfare Service is extinguished pursuant to Article 469 of the Civil Act, and the insurer of the industrial accident insurance can seek reimbursement equivalent to the industrial accident compensation benefits to the Korea Workers’ Compensation and Welfare Service. However, in light of the following various circumstances, the obligation to pay the industrial accident insurance benefits borne by the Korea Workers’ Compensation and Welfare Service differs from the obligation to compensate for damages under the Civil Act, and the Korea Workers’ Compensation and Welfare Service does not have any reason to deny that the Korea Workers’ Compensation and Welfare Service is liable to pay the industrial accident insurance benefits to the damaged workers by deeming the accident insurance benefits to be effective, and thus, the Korea Workers’ Compensation and Welfare Service’s liability to receive further compensation from the Korea Workers’ Compensation and Welfare Service without any justifiable reason.

Article 469 of the Civil Act, Article 719 of the Commercial Act, Articles 1 and 36 of the Industrial Accident Compensation Insurance Act

Supreme Court Decision 87Meu1644 Decided October 24, 1988 (Gong1988, 1464) Supreme Court Decision 2009Da71558 Decided February 11, 2010 (Gong2010Sang, 525) Supreme Court Decision 2009Da8581 Decided January 12, 2012, Supreme Court Decision 2012Da1870 Decided July 10, 2014

Reference Non-Life Insurance Co., Ltd. (Law Firm Cheong & Yang, Attorneys Gyeong Yong-seok et al., Counsel for the defendant-appellant)

Korea Labor Welfare Corporation

Daegu District Court Decision 2016Na307949 Decided November 23, 2016

The appeal is dismissed. The costs of appeal are assessed against the defendant.

We examine the grounds of appeal.

1. As to the ground of appeal on the existence of the Plaintiff’s right to indemnity against the Defendant

A. 1) In the terms and conditions of the Workers’ Accident Compensation Insurance (hereinafter “Re-insurance”) provided that an insurer is obligated to compensate only for the part exceeding the scope compensated by the Industrial Accident Compensation Insurance Act (hereinafter “Industrial Accident Compensation Insurance Act”), which is a mandatory insurance, (hereinafter “Industrial Accident Compensation Insurance Act”), among the liability for damages to be borne by the insured workers due to occupational accidents caused by the insured workers (hereinafter “Industrial Accident Compensation Insurance Act”), the risk taken over by the insurer is limited to the insured’s liability for compensation for the portion exceeding the industrial accident compensation portion, and thus, the insurer is not obligated to pay the insurance amount for the industrial accident compensation portion (see Supreme Court Decisions 2009Da8581, Jan. 12, 2012; 2012Da1870, Jul. 10, 2014). In other words, the Korea Workers’ Compensation and Welfare Service is obligated to pay the industrial accident compensation insurance benefits (hereinafter “industrial insurance benefits”) with respect to the part exceeding the insurance amount paid by an insurer.

2) Meanwhile, in a case where a third party, who is not a debtor, was aware of such circumstances in the course of repaying another person’s obligation with the intent to repay the obligation of the third party and receiving the obligee’s repayment, the obligation of the third party subject to the repayment by the third party pursuant to Article 469 of the Civil Act shall be extinguished, and the third party may claim reimbursement against the obligor (see Supreme Court Decision 2009Da71558, Feb. 11, 2010). A third party without interest may not perform the obligation against the obligor’s will. A debtor’s counterclaim should be clearly recognizable in light of the objective circumstances at the time of the repayment by the third party, and the obligor’s counterclaim should be presumed to have invalidated the effect of the third party by presumptioning the obligor’s objection (see Supreme Court Decision 87Meu1644, Oct. 24, 198).

3) Therefore, in cases where an insurer of a continuing insurance compensates for losses equivalent to the industrial accident compensation portion to the damaged workers, this is the performance of the obligation to pay the industrial accident insurance benefits by the Korea Workers’ Compensation and Welfare Service on behalf of the damaged workers. If such circumstance was known to the insurer of the occupational accident insurance and the damaged workers, the obligation to pay the industrial accident insurance benefits by the Korea Workers’ Compensation and Welfare Service is extinguished pursuant to Article 469 of the Civil Act, and the insurer of the occupational accident insurance can seek reimbursement equivalent to the industrial accident compensation amount to the Korea Workers’ Compensation and Welfare Service. Although the liability to pay the industrial accident insurance benefits is different from the liability to compensate for damages under the Civil Act, in light of the following various circumstances, if the requirements prescribed by the relevant Civil Act are met, the Korea Workers’ Compensation and Welfare Service considers the effective repayment of the damages to the damaged workers, and there is no reason to deny the Korea Workers’ Compensation and Welfare Service from bearing the liability to pay the industrial accident insurance benefits on behalf of the damaged workers. It is difficult to consider the purport of the Korea Workers’ Compensation and Welfare Service’s prompt return of the industrial accident insurance benefits policy without justifiable reason.

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

1) The Plaintiff is an insurer who entered into a probationary insurance contract with a new engineering company that operates mechanical equipment construction business, etc. (hereinafter “newness”). According to the terms and conditions of the probationary insurance contract, the Plaintiff is liable to compensate for losses incurred to the insured workers due to occupational accidents (Article 10(1)). However, when the amount of compensation exceeds the amount of indemnity covered by mandatory insurance, the Plaintiff is liable to compensate only such excess amount (Article 12(1)).

2) On June 24, 2011, the Nonparty, who is an employee of the believers, was crashed and sustained the pressure frame No. 4 in the construction field while going up to the vision on June 24, 201 (hereinafter “instant accident”).

3) Under the Industrial Accident Insurance Act, the Nonparty received a total of KRW 23,129,470 from the Defendant as temporary layoff benefits and medical care benefits during the period from June 24, 2011 to July 21, 2015 pursuant to the Industrial Accident Compensation Insurance Act, and the Nonparty did not claim disability benefits according to his/her professional opinion that no disability is recognized at the time of the instant accident.

4) On December 15, 2011, the Nonparty filed a lawsuit against the Non-Party seeking compensation for damages arising from the instant accident. On October 29, 2013, the first instance court rendered a judgment ordering the Non-Party to pay the total of KRW 58,788,136, and damages for delay, based on the physical assessment result, the Non-Party rendered a judgment ordering the Non-Party to pay the Non-Party a total of KRW 58,78,136, and damages for delay. Although the Nonparty filed a new appeal, the appeal was dismissed on June 25, 2014, and the said judgment became final and conclusive at that time (hereinafter “related civil lawsuit”).

5) On July 3, 2014, the Plaintiff paid KRW 73,622,074 in total to the Nonparty based on the result of the relevant civil lawsuit. Meanwhile, the amount of the insurance money that the Plaintiff paid to the Nonparty included KRW 14,454,00 for lump-sum disability compensation benefits that the Nonparty is entitled to receive from the Defendant pursuant to the Industrial Accident Insurance Act.

C. Examining these facts in light of the legal principles as seen earlier, 14,454,00 won corresponding to disability benefits out of the amount paid by the non-party due to the accident in this case in accordance with the result of the relevant civil litigation is the obligation to pay the defendant. Such circumstances are known as a result of physical appraisal conducted in the process of the pleadings in the relevant civil litigation. The plaintiff may be deemed to have received the amount of damages when recognizing that the amount equivalent to disability benefits was paid by the defendant on behalf of the defendant and the non-party was the obligation to pay disability benefits through physical appraisal. Therefore, even if the plaintiff did not have the obligation to pay to the non-party, the obligation to pay disability benefits equivalent to the amount equivalent to the above 14,454,00 won was extinguished pursuant to Article 469 of the Civil Act, and the plaintiff may claim for reimbursement to the defendant.

D. On the premise that the Plaintiff falls under a third party prescribed in Article 87(2) of the Industrial Accident Insurance Act, the lower court determined that the Plaintiff may exercise the right to reimbursement against the Defendant within the scope of disability benefits that the Defendant exempted the Defendant from paying, on the premise that the Plaintiff was exempted from the obligation to pay insurance money equivalent to the amount of damages. However, the third party prescribed in the main text of Article 87(1) and Article 87(2) of the Industrial Accident Compensation Insurance Act refers to a person who is liable for tort liability against the victimized employee or who is directly liable for damages against the victimized employee, and the said third party is not liable for payment of the industrial accident compensation amount. In that sense, the lower court’s reasoning is somewhat inappropriate. However, the lower court’s conclusion that the Plaintiff could have claimed a reasonable amount of the above disability benefits to the Defendant is justifiable, and contrary to the allegations in the grounds of appeal,

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 court below did not render any judgment on the claim based on the right of subrogation. Accordingly, in this case where only the defendant appealed, as seen earlier, as long as the conclusion of the court below which accepted part of claims based on the right of indemnity is justified, the legitimacy of the defendant's remaining grounds of appeal as to claims based on the right of subrogation does not affect the conclusion of the judgment. Thus, the defendant's above assertion

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 Ahn Jae-chul (Presiding Justice)