Whether Article 6 of the Act on the Regulation of Terms and Conditions of Contracts of Collective Security Insurance Contracts, which provides that a person who has a disease or physical factor suffers from or worsens as a minor external accident, shall not be deemed as an "accident," which is an insured incident that pays the general death insurance proceeds equivalent to ten times the general death insurance proceeds.

In the terms and conditions of collective security insurance contract, the phrase "if a disease or physical handicap is caused by an minor external accident or the symptoms thereof are aggravated, such minor external accident shall not be deemed an accident." The purport of the provision is to exclude minor external factors from an accident under the terms and conditions of insurance as long as the direct external factors of death are caused by disease or physical handicap, even though they were processed. If the external factors of death are serious or directly determined to exist, even if the death were caused by an accident, the insurance proceeds for death are paid to the deceased, so it is difficult to expect the accident in light of the above nature and purpose of the general insurance proceeds for the purpose of paying the insurance proceeds for death of 10 times due to an accident, and as such, it cannot be said that there is a significant change in the terms and conditions of the above insurance contract to the effect that the death rate of the insured can not be determined unilaterally because it conforms with the above subjective factors to the principle of duty of disclosure and thus, it cannot be said that there is a significant increase in the rate of death of the insured as its main reason for death.

Articles 6 and 30(3) of the Regulation of Standardized Contracts Act

Plaintiff 1 and four others, Plaintiffs Kim Sung-soo, Counsel for the plaintiff-appellant-appellee

Samsung Life Insurance Co.

Busan High Court Decision 92Na8057 delivered on May 20, 1993

All appeals are dismissed. The costs of appeal are assessed against the plaintiffs.

We examine the grounds of appeal.

1. In light of the records, the fact-finding of the court below is just and it cannot be said that there is an error of misconception of facts in violation of the rules of evidence against the logical rules and the rules of experience, such as the assertion of arguments, and therefore there is no reason to dispute the fact-finding of the court below concerning the causes of death of the deceased non-party 1

2. Article 2 (3) of the collective guarantee insurance contract concluded between the Busan Southern-gu Office and the defendant who had worked for the deceased non-party 1 provides that "if a cause for the payment of insurance proceeds occurs due to an unforeseen accident (hereinafter referred to as "disaster"), which is subject to the provisions of paragraph (2) of the attached Table 2, the insured shall assume the responsibility pursuant to the terms and conditions of the contract." In attached Table 2, "an unexpected accident that is subject to the accident" is defined as "an unexpected accident (if a person who has a disease or physical constitution and has caused a minor external accident, such minor external accident shall not be deemed an accident)" and Article 6 of the above terms and conditions provide that "if the insured dies due to a cause other than a disaster, the insurance proceeds shall be paid, and if he/she dies directly due to a disaster, the amount equivalent to ten times the general insurance proceeds shall be paid."

In the above terms and conditions, the phrase "if a disease or physical condition is caused by an minor external accident or the symptoms thereof are aggravated, the minor external accident shall not be deemed an accident." The purport of the above terms and conditions is to exclude minor external factors from the accident under the above insurance contract if the direct external factors of death are caused by disease or physical formative factors, even if they were processed by it, unless the direct causes of death are caused by a disease or physical formative factors, and even if the external factors of death are determined to be serious or direct, the above accident death benefit is paid even if the external factors of death are determined to be serious or direct, so it is difficult to expect that it conforms to the above terms and conditions as well as to pay the general death benefit amount 10 times or more times the general death benefit in light of the nature and purpose of the above insurance contract, and the overall circumstances, etc. of the above insurance contract, etc., and if there are significant changes in the rate of death by the above terms and conditions, it can not be deemed that there is a significant increase in the rate of the insurance accident.

In addition, the issue of whether such a death of the insured constitutes an accident, which is the above-mentioned cause, is determined according to the objective cause of death, and it is a legal principle that does not affect the subjective factor that the insured knew of his or her own disease. Thus, even if the insured was unaware of the fact that the disease, which is the main cause of the death, and fulfilled the obligation of disclosure under the Commercial Act, it shall be deemed that the accident is excluded if it falls under the above provision.

Therefore, the above terms and conditions cannot be deemed null and void as a clause which has lost fairness in violation of the principle of good faith under Article 6(1) of the Act on the Regulation of Terms and Conditions. The judgment of the court below which held to the above purport is just, and there is no error of law by misapprehending the legal principles under Article 6 of the same Act.

3. Therefore, all appeals are 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 Lee Jae-soo (Presiding Justice)