Where it is possible to collect an amount equivalent to the amount of insurance benefits paid erroneously from the party who received insurance benefits pursuant to Article 84 (1) 3 of the former Industrial Accident Compensation Insurance Act.

In full view of the contents and purport of Article 84(1) of the former Industrial Accident Compensation Insurance Act (amended by Act No. 10305, May 20, 2010; hereinafter “former Industrial Accident Compensation Insurance Act”) and the unique characteristics of the revocation of beneficial administrative disposition in the field of social security administration, when collecting the amount equivalent to the amount of insurance benefits erroneously paid from the party who received the insurance benefits under Article 84(1)3 of the former Industrial Accident Compensation Insurance Act, the disposition should be taken in full view of the following: (a) whether the party intentionally or by gross negligence was responsible for the payment of the insurance benefits; (b) whether the amount of the insurance benefits erroneously paid can be easily recovered; and (c) the details and degree of disadvantage suffered by the party to the disposition through collecting the amount equivalent to the amount of the insurance benefits erroneously paid; and (d) whether the amount of the insurance benefits paid to the party to the public interest needs to be disposed of; and (d) whether the amount of the insurance benefits paid to the party to the public interest needs to be justified.

Article 84(1)3 of the former Industrial Accident Compensation Insurance Act (Amended by Act No. 10305, May 20, 2010); Article 4(2) of the Administrative Procedures Act

[Judgment of the court below]

Korea Labor Welfare Corporation

Daejeon High Court (Cheongju) Decision 2011Nu120 decided November 23, 2011

The judgment of the court below is reversed, and the case is remanded to Daejeon High Court.

The grounds of appeal are examined.

1. Article 84(1) of the former Industrial Accident Compensation Insurance Act (amended by Act No. 10305, May 20, 2010; hereinafter the same) provides that “Where a person who received insurance benefits falls under any of the following subparagraphs, the Service shall collect the amount equivalent to the amount of the benefits (in cases falling under subparagraph 1, the amount equivalent to twice the amount of the benefits paid). In such cases, the amount that the Service claims and received from the National Health Insurance Corporation, etc. pursuant to Article 90(2) shall be excluded from the amount of the benefits to be collected,” while subparagraph 3 provides that “other cases where there are the insurance benefits paid by mistake.”

On the other hand, the industrial accident compensation insurance system is a social insurance system that copes with the social risks of occupational accidents that occur to workers using the financial resources for insurance premiums paid by the business owner who is an insured to guarantee the livelihood of the affected workers and their family members, and thus, the entitlement to industrial accident compensation insurance under this system belongs to the social security entitlement so-called social security entitlement (see Constitutional Court Order 2011HunBa133, Mar. 29, 2012). However, the public interest to be achieved through the cancellation of the beneficial administrative disposition in the administrative area whose contents are social security benefits is the social security benefits is essentially the financial interest formed through the cancellation of the insurance premium paid by the business owner and the national treasury burden, while the beneficiary is in violation of private interest such as the protection of trust and stability of legal life by the cancellation of the beneficial administrative disposition. Therefore, unless there is any intentional or gross negligence on the part of the beneficiary with respect to the defect in the beneficial administrative disposition, it cannot be concluded that the beneficiary is more important

In full view of the contents and purport of the above provisions and the unique characteristics of the revocation of beneficial administrative dispositions on social security administration, in imposing the amount equivalent to the amount of insurance benefits erroneously paid from the party who received the insurance benefits pursuant to Article 84(1)3 of the former Industrial Accident Compensation Insurance Act, it is reasonable to view that the disposition should be taken to collect the amount equivalent to the amount of insurance benefits erroneously paid from the party who received the insurance benefits, by comparing and comparing the public interest needs to collect the amount equivalent to the amount of the insurance benefits erroneously paid, with the degree of disadvantages suffered by the party due to such disposition, as well as the specific contents of the public interest needs to achieve through the disposition of collecting the amount equivalent to the amount of the insurance benefits erroneously paid, and the content and degree of the disadvantage suffered by the party who received the insurance benefits, and the disadvantages such as the protection of the right to obtain and trust, and infringement of the stability of legal life, only if the public interest needs to justify the disadvantage suffered by the party who received the insurance benefits.

2. A. After compiling the evidence adopted, the lower court acknowledged facts as indicated in its reasoning, and determined that the instant disposition was unlawful solely on the grounds that the Defendant’s determination of the disability grade of this case was erroneously calculated on the ground that some of the disability benefits was erroneously calculated on the ground that part of the disability benefits was erroneously calculated on the ground that the Defendant’s determination of the disability grade of this case was erroneous, and thus, it may be deemed that the Plaintiff’s trust and legal stability as to the initial disposition was infringed on a certain part. However, in light of the content of the relevant statutes, the lower court determined that the instant disposition was not unlawful solely on the grounds that the instant disability grade determination was made by the Defendant,

B. However, in light of the above legal principles and records, it is difficult to accept such judgment of the court of first instance as it is. According to the reasoning of the judgment of the court of first instance as cited by the court below and the record, the plaintiff attached a disability examination statement stating that the exercise scope of the left-hand son at the time of claiming insurance benefits falls under 135 degrees, and this constitutes a limited scope of 1/4 or more, and thus, the judgment of disability grade 12 grade 6 may have been judged pursuant to relevant Acts and subordinate statutes. The defendant presented the opinion of advisory opinion as a result of hearing the opinion of advisory opinion, that the plaintiff's exercise scope of the plaintiff's grandchildren sonship is normal, prudent and obvious, unlike the opinion of the plaintiff's disability examination statement submitted by the plaintiff, and finally, the judgment of disability grade of this case was finally determined by the court of first instance that the plaintiff's disability falls under class 12 grade 6 after requesting a special medical examination of the plaintiff, but in the above special results, the defendant did not inform the plaintiff of the disability grade of this case as one's decision.

In light of these facts in light of the above legal principles, even if there was a mistake by the defendant in the process of determining the disability grade of this case, it is merely an internal situation of the defendant, and it cannot be deemed that there was an intentional or gross negligence on the part of the plaintiff who received the determination of the disability grade of this case upon his request

Therefore, the court below should have determined the legitimacy of the disposition of this case, by carefully examining the following: (a) whether the plaintiff has the disability benefits received according to the defendant's determination of the disability grade of this case; (b) whether the plaintiff has already consumed the remaining amount in trust; and (c) what the public interest needs the defendant want to achieve through the disposition of this case where the amount equivalent to the amount of the insurance benefits erroneously paid is collected; and (d) whether the disposition of this case violates the plaintiff's trust and stability of legal life; and (e) whether the disposition of this case is a case where the public interest needs to be justified.

Nevertheless, the court below determined otherwise only for the reasons stated in its holding. In so doing, the court below erred by misapprehending the legal principles on the principle of protection of trust relating to the interpretation of Article 84(1) of the former Industrial Accident Compensation Insurance Act, thereby failing to exhaust all necessary deliberations, which affected the conclusion of the judgment. The ground of appeal pointing this out is

3. 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 Lee Sang-hoon (Presiding Justice)