[1] In the case of a traffic accident by a motor vehicle or a non-insurance motor vehicle, whether the victim's right to claim compensation under Article 30 (1) of the Guarantee of Automobile Accident Compensation Act constitutes a right to claim compensation against a third party under Article 53 (1) of the former National Health Insurance Act (negative)

[2] In a case where the National Health Insurance Corporation provided insurance benefits under the former National Health Insurance Act to the victim of a traffic accident caused by a motor vehicle or an non-insurance motor vehicle, whether the government or the guarantee business operator entrusted with the business of guaranteeing motor vehicle accident compensation under Article 45 (1) of the Guarantee of Automobile Accident Compensation Act has obtained unjust enrichment (negative)

[1] In the case of a traffic accident by a motor vehicle or a non-insurance motor vehicle for which the owner of the motor vehicle is unknown, the right to claim compensation for the guaranteed business owned by the victim under Article 30(1) of the Guarantee of Automobile Accident Compensation Act is a claim specifically recognized by the Act for the relief of the victim, and it cannot be deemed as a right to claim compensation for a third party under Article 53(1) of the former National Health Insurance Act (wholly amended by Act No. 11141, Dec. 31, 201).

[2] Even if the National Health Insurance Corporation provided insurance benefits under the former National Health Insurance Act (wholly amended by Act No. 11141, Dec. 31, 201; hereinafter the same) to the victim of a traffic accident caused by a motor vehicle or an non-life-free motor vehicle, it cannot be deemed that the victim gains a benefit from discharging his/her duty to provide insurance benefits. Accordingly, it cannot be deemed that the guaranteed business operator entrusted by the Minister of Land, Transport and Maritime Affairs with the duties concerning the guaranteed business under Article 45(1) of the Guarantee of Automobile Accident Compensation Act without any legal ground to exempt the victim from liability for compensation for the guaranteed business within the scope of the amount

[1] Article 30(1) of the Guarantee of Automobile Accident Compensation Act; Article 53(1) of the former National Health Insurance Act (wholly amended by Act No. 11141, Dec. 31, 201) (see current Article 58(1)) / [2] Articles 30(1), 36(1), and 45(1) of the Guarantee of Automobile Accident Compensation Act; Article 29 subparag. 7 of the Enforcement Decree of the Guarantee of Automobile Accident Compensation Act

[1] Supreme Court Decision 2003Da62477 Decided April 15, 2005 (Gong2009Ha, 1538) Decided August 20, 2009 / [2] Supreme Court Decision 2004Da35113 Decided April 15, 2005 (Gong2005Sang, 736)

M&C Co., Ltd. (Law Firm Re-S&C, Attorney Doh-won, Counsel for the plaintiff-appellant)

National Health Insurance Corporation

Busan District Court Decision 201Na23580 decided May 10, 2012

The judgment of the court below is reversed, and the case is remanded to Busan District Court Panel Division.

The grounds of appeal are examined.

1. A. Article 53(1) of the former National Health Insurance Act (wholly amended by Act No. 11141, Dec. 31, 2011; hereinafter “former National Health Insurance Act”); and Article 53(1) of the National Health Insurance Act (hereinafter “former National Health Insurance Act”) provides that when a ground for insurance benefits arises due to a third party’s act and the insured or his/her dependent provided insurance benefits to the insured or his/her dependent, the Service shall obtain the right to claim compensation against the third party within the limit of the expenses incurred in relation to the relevant payment. As such, the right to receive insurance benefits from the insured or his/her dependent due to a third party’s act is the right to claim compensation against the third party of the insured or his/her dependent who received the insurance benefits within the limit of the expenses incurred in relation to the payment.

However, the guarantee business under Article 30 of the Guarantee of Automobile Accident Compensation Act (hereinafter “Act”) is a type of social security system, the main purpose of which is to collect a certain amount of the liability insurance premium to be paid by the owner of an automobile from the Government as a contribution and to compensate for the damage of the victim who died or was injured due to an accident caused by the operation of an automobile without an insurance, within the scope of the insurance proceeds, and to supplement the automobile liability insurance system, which is legally enforced for the purpose of protecting the victim of a traffic accident caused by a motor vehicle without an insurance policy (see, e.g., Supreme Court Decisions 2003Da62477, Apr. 15, 2005; 2009Da27452, Aug. 20, 209).

In light of the purpose, purpose, character, etc. of the guaranteed business, in the case of traffic accidents caused by a motor vehicle or a non-insurance motor vehicle, for which the owner of the motor vehicle cannot be identified, the right to claim compensation from the guaranteed business owned by the victim pursuant to Article 30(1) of the Act is the right to claim compensation against the third party under Article 53(1) of the former National Health Insurance Act.

B. Meanwhile, Article 36(1) of the Voluntary Retirement Act provides that “The Government shall not be liable to compensate under Article 30(1) to the extent of the amount of compensation that the victim is liable for damages under Article 30(1) in accordance with the State Compensation Act, the Industrial Accident Compensation Insurance Act, or other Acts prescribed by Presidential Decree.” This provision provides that, “The Government shall not be liable for damages under Article 30(1) within the scope of the amount of compensation that the victim is eligible for relief under other Acts.” This provision provides that, inasmuch as relief under the Guarantee Business is final and minimum and social security systems to relieve the victim of traffic accidents, coordination relations between the payment of compensation under the Guarantee Business and the compensation under other Acts are prescribed in other Acts (see Supreme Court Decision 2004Da35113, Apr. 15, 2005). Thus, the Government shall not be held liable for damages under the National Health Insurance Act within the scope of the amount of compensation or indemnity under Article 30(1) of the Enforcement Decree of the Guarantee of Automobile Accident Compensation Act.”

Therefore, even if the Corporation provided insurance benefits under the former National Health Insurance Act to the victim of a traffic accident caused by a motor vehicle or a non-insurance accident, it cannot be said that the Corporation performed its duty to provide insurance benefits, and thus, the guaranteed business operator entrusted by the Minister of Land, Transport and Maritime Affairs with the duty to provide insurance benefits under Article 45 (1) of the former National Health Insurance Act has gained the benefit of the victim from liability for compensation for the guaranteed business within the scope of the amount of compensation received through the insurance benefits

2. According to the reasoning of the judgment below, the non-party 1, who is not the insured, was involved in the accident of this case where the vehicle (vehicle number omitted) was shocked while driving on the road on December 14, 2009, and the non-party 2, who was on the said vehicle, was hospitalized at the hospital due to the injury and received hospitalized treatment at the hospital. After providing the medical care benefits under the former National Health Insurance Act to the non-party 2, the defendant paid 1,205,700 won to the above hospital, excluding the principal's share, out of the total medical care costs of the non-party 2 caused by the accident of this case.

Examining these facts in light of the legal principles as seen earlier, the right to claim compensation under Article 30(1) of the Act on the Aggravated Punishment, etc. of Non-party 2 cannot be deemed as the right to claim compensation against the third party under Article 53(1) of the former National Health Insurance Act. Thus, the defendant cannot claim compensation against the plaintiff entrusted with the business of guarantee under Article 45(1) of the former National Health Insurance Act pursuant to Article 53(1) of the former National Health Insurance Act, and the insurance benefits provided by the defendant to the non-party 2 cannot be deemed as the benefit of the plaintiff to be exempted from the liability for compensation under the guarantee business without any legal cause. Thus, it cannot be said that the plaintiff can not claim return of unjust enrichment against the plaintiff.

Nevertheless, the court below held that the Plaintiff constitutes a third party under Article 53(1) of the former National Health Insurance Act on the premise that the guaranteed business is a system of the same quality on the extension line of the automobile liability insurance system, and held that the Plaintiff is liable to pay the Defendant’s charges to the Corporation within the insurance amount of liability insurance. In so doing, the court below erred by misapprehending the legal principles on the subject of exercise of the right to indemnity under Article 53(1) of the former National Health Insurance Act, which affected the conclusion of the judgment. The ground of appeal on this point

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 Kim Yong-deok (Presiding Justice)