[1] Whether a traffic accident victim may claim the amount equivalent to medical expenses under the proviso of Article 3(1)2 of the Enforcement Decree of the Guarantee of Automobile Accident Compensation Act, regardless of whether he/she has contributed to the occurrence of the traffic accident, as a liability insurance amount (affirmative)

[2] In a case where Gap insurance company claimed reimbursement against Eul, an insured vehicle driver of the National Federation of Bus Transport Business Association, after paying medical expenses, etc. to Eul with respect to traffic accidents occurred between the insured vehicle and the insured vehicle, the case holding that Gap company should be deemed to have acquired Eul's liability mutual aid claims against the above Federation under the proviso of Article 3 (1) 2 of the Enforcement Decree of the Guarantee of Automobile Accident Compensation Act by maintaining its identity

[1] Article 3 (1) 2 of the Enforcement Decree of the Guarantee of Automobile Accident Compensation Act / [2] Article 3 (1) 2 of the Enforcement Decree of the Guarantee of Automobile Accident Compensation Act, Article 682 of the Commercial Act

[1] Supreme Court Decision 2006Da82793 Decided December 11, 2008 (Gong2009Sang, 14) Supreme Court Decision 2012Da44563 Decided October 11, 2012

Samsung Fire and Marine Insurance Co., Ltd. (Law Firm Gyeongsung, Attorneys Jeon Sung-jin et al., Counsel for the plaintiff-appellant)

National Federation of Bus Transport Business Cooperatives (Dongba General Law Firm, Attorney Ansan-do, Counsel for the plaintiff-appellant)

Seoul Central District Court Decision 2012Na39171 Decided May 24, 2013

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

The grounds of appeal are examined.

1. Regarding ground of appeal No. 1

The court below is just in light of the relevant legal principles that if the victim of a traffic accident seeks the payment of the mutual aid money to the defendant through a lawsuit, the provision on compensation for medical expenses, which stipulates that the amount shall be compensated for if the amount calculated according to the rate of fault on the part of the victim is less than the amount corresponding to the amount of medical expenses, and that the same applies to the case where the insurer exercises the mutual aid money to the defendant by subrogation of the victim who is the insured, and contrary to what is alleged in the grounds of appeal, there is no error of law by misapprehending the legal principles as to the scope of application of the medical expenses compensation provisions among the mutual aid clauses by the defendant.

2. Regarding ground of appeal No. 2

A. The proviso of Article 3 (1) 2 of the Enforcement Decree of the Guarantee of Automobile Accident Compensation Act provides that where the amount of damage sustained by a victim falls short of the corresponding amount of medical fees calculated according to the standards for medical fees covered by automobile accident insurance under Article 15 (1) of the Guarantee of Automobile Accident Compensation Act, the corresponding amount of medical expenses shall be paid as liability insurance money within the scope of the amount prescribed in [Attachment Table 1]. The purport of the proviso is to interpret the proviso of Article 3 (1) 2 of the Enforcement Decree of the Guarantee of Automobile Accident Compensation Act to include the amount of damage calculated by deducting the amount equivalent to its ratio of negligence from the damage suffered by a traffic accident victim as liability insurance money in order to guarantee medical treatment for the victim of the traffic accident, even if the amount of damage falls short of the corresponding amount of medical expenses under the above provision. Thus, the victim of the traffic accident can claim the corresponding amount of medical expenses under the proviso of subparagraph 2 as liability insurance money under the Guarantee of Automobile Accident Compensation Act, regardless of whether the victim contributed to the traffic accident accident occurred or not.

B. According to the reasoning of the judgment below, with respect to the traffic accident of this case between the insured vehicle (hereinafter “Plaintiff”) and the Defendant’s beneficiary, the Plaintiff paid KRW 24,924,280 as insurance money to the Nonparty, who is the driver of the Plaintiff’s vehicle, and KRW 20,545,770 as insurance money, and received KRW 11,775,680 as mutual-aid money from the Defendant. In light of the records, it is difficult to find any material that can specifically identify the nature of the insurance money that the Plaintiff paid to the Nonparty, the existence or content of the insurer subrogation agreement between the Plaintiff and the Nonparty, and in light of the above facts, it is sufficient to conclude that the Plaintiff and the Nonparty compensates the Nonparty for the damage when the Nonparty, the insured, suffered the injury caused by the traffic accident of the Plaintiff, and in light of the above legal principles, it is sufficient to view that the Plaintiff paid the Nonparty the insurance money to obtain the right of the Nonparty’s third party.

Therefore, the court below should first grasp the nature of the insurance money that the plaintiff paid to the non-party, the existence or content of the subrogation agreement between the plaintiff and the non-party, and then examine where the degree of injury of the non-party falls under the category of [Attached Table 1] under Article 3(1)2 of the Enforcement Decree of the Guarantee of Automobile Accident Compensation Act, determine the scope of the liability mutual aid amount, and examine where the amount of damage calculated by deducting the amount equivalent to the ratio of the non-party's fault reaches the amount of the medical expenses calculated based on the medical fee standard for automobile accident insurance, and take measures such as recognizing the amount equivalent to the medical expenses as the amount of the liability mutual aid amount

Nevertheless, the court below held that the proviso of Article 3 (1) 2 of the Enforcement Decree of the Guarantee of Automobile Accident Compensation Act shall not apply in cases where the insurer who paid the insurance money to the victim instead of the victim of the instant traffic accident, claims the amount of indemnity on behalf of the victim who is the insured. In so doing, the court below erred by misapprehending the legal principles on the interpretation of the proviso of Article 3 (1) 2 of the Enforcement Decree of the Guarantee of Automobile Accident Compensation

3. Conclusion

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 Kim Yong-deok (Presiding Justice)