[1] Where a disposition can be taken to collect an amount equivalent to the amount of insurance benefits paid erroneously by the party who received the insurance benefits under Article 84(1)3 of the Industrial Accident Compensation Insurance Act, and where a disposition to modify or revoke a decision to pay various insurance benefits under the Industrial Accident Compensation Insurance Act is legitimate, whether the disposition of collection based on which the decision should be determined as lawful (negative)

[2] In a case where the Korea Workers' Compensation and Welfare Service paid medical care benefits, etc. to the wife A who died of a traffic accident during the business trip, but confirmed the drinking driving by the Party A, and then revoked the decision for payment of medical care benefits, etc. and collects the already paid insurance benefits as unjust enrichment, the case holding that the disposition to collect the insurance benefits, etc. already paid as unjust enrichment does not constitute a strong case to justify disadvantages suffered by the need of public interest, such as B, etc., due to a serious need for public interest to revoke the decision for payment of medical care benefits, etc.

[1] In full view of the contents and purport of Article 84(1)3 of the Industrial Accident Compensation Insurance Act (hereinafter “Industrial Accident Compensation Insurance Act”) and the characteristics of the cancellation of beneficial administrative disposition in the area of social security administration, when collecting the amount equivalent to the amount of the insurance benefits erroneously paid from the party who received the insurance benefits pursuant to Article 84(1)3 of the Industrial Accident Compensation Insurance Act, the amount equivalent to the amount of the insurance benefits erroneously collected from the party who received the insurance benefits should be determined by considering the following: (a) whether there is a cause attributable to intentional or gross negligence; (b) whether the amount of the insurance benefits erroneously paid can be easily recovered; (c) the specific details of the public interest needs to be achieved through the disposition that collects the amount of the insurance benefits erroneously paid; and (d) the degree of disadvantage suffered by the party to the disposition that collects the amount equivalent to the amount of the insurance benefits erroneously paid; and (d) the need for the public interest, protection of the right to obtain benefits, and stability of legal life, etc.

Furthermore, in the event that a disposition that alters or cancels a decision to pay various insurance benefits, etc. under the Industrial Accident Compensation Insurance Act, and a disposition that collects an amount equivalent to the amount of insurance benefits erroneously paid, based on such disposition, is determined lawful, it cannot be deemed that each circumstance is the same as that of a comparative and comparative disposition. Therefore, a disposition that alters or cancels a decision to pay a payment is lawful, and thus, a collection disposition based on such decision

[2] In a case where the Korea Workers' Compensation and Welfare Service paid medical care benefits, etc. to the wife A who died from a traffic accident during the business trip, but confirmed the driving of the deceased, and then revoked the decision for payment, such as medical care benefits, and collects the insurance benefits already paid as unjust enrichment, the case affirming the judgment below holding that the disposition of unjust enrichment with the insurance benefits already paid does not constitute unjust enrichment where it is justified to the extent that, considering that the above accident is an unlawful disposition where the death of the deceased is a defective disposition, since it cannot be deemed that there is a proximate causal relation between the deceased's duties and the occurrence of the accident as the main cause for drinking operation of the deceased, and thus, the decision for payment of medical care benefits, etc., such as medical care benefits, etc., is serious public interest needs to be revoked. However, the above accident is sufficient to justify the disadvantage of the deceased, such as Eul, due to the importance of the public interest needs to be revoked.

[1] Article 84(1)3 of the Industrial Accident Compensation Insurance Act, Article 4(2) of the Administrative Procedures Act / [2] Articles 37(2) and 84(1)3 of the Industrial Accident Compensation Insurance Act, Article 4(2) of the Administrative Procedures Act

[1] Supreme Court Decision 2011Du31697 Decided April 10, 2014 (Gong2014Sang, 1050)

Plaintiff (Law Firm Cho & Lee, Attorneys Cho Jong-ho et al., Counsel for the plaintiff-appellant)

Korea Labor Welfare Corporation

Seoul High Court Decision 2013Nu21429 decided December 5, 2013

All appeals are dismissed. The costs of appeal are assessed against each appellant.

We examine the grounds of appeal.

1. Legal principles applicable to the instant case

The industrial accident compensation insurance system is a social insurance system that copes with the social risks of occupational accidents that occur to workers with insurance premiums paid by a business owner who is a policyholder to guarantee the livelihood of disaster workers and their family members. Thus, the industrial accident compensation insurance entitlement 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 intended to be achieved through the cancellation of the beneficial administrative disposition in the administrative area whose contents are social security benefits is social security benefits is essentially the financial interest formed through the cancellation of the insurance premium and the national treasury burden paid by the business owner. On the other hand, 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 defects existing in the beneficial administrative disposition, it cannot be readily concluded that the public interest needs to be more important or without permission

In addition, Article 84(1) of the Industrial Accident Compensation Insurance Act (hereinafter “Industrial Accident Compensation Insurance Act”) provides that “If a person who has received insurance benefits falls under any of the following subparagraphs, the Service shall collect an amount equivalent to the amount of the insurance benefits (in cases falling under subparagraph 1, the amount equivalent to twice the amount of the benefits paid).” In such cases, the Service shall exclude the amount of the insurance benefits paid to the National Health Insurance Corporation, etc. pursuant to Article 90(2) from the amount of the benefits to be collected.” In full view of the contents and purport of such provision and the unique characteristics of revocation of beneficial administrative disposition in the area of social security, etc., the amount equivalent to the amount of the insurance benefits paid erroneously from the party who received the insurance benefits pursuant to the said provision should be determined by comparing the amount of the insurance benefits paid erroneously with the amount of the insurance benefits paid to the party who received the insurance benefits, whether the amount of the insurance benefits paid erroneously can be easily restored to the amount of the insurance benefits paid, the amount of the insurance benefits paid to the party who received the insurance benefits should be justified and justified.

Furthermore, in determining whether a disposition to change or revoke a decision to pay various insurance benefits, etc. under the Industrial Accident Compensation Insurance Act, and a disposition to collect an amount equivalent to the amount of insurance benefits erroneously paid based on such disposition, is legitimate, each circumstance to compare or compare cannot be deemed the same. Therefore, a disposition to change or revoke a decision to pay a payment is not necessarily deemed lawful, and the collection disposition based on

2. Plaintiff’s ground of appeal

According to the reasoning of the judgment of the court below, the court below determined that the accident of this case is a case where there is a strong causal relation between the deceased's duties and the occurrence of the accident of this case, and thus, the death of the deceased does not constitute occupational accident, and thus the defendant's decision on the payment of medical care benefits, etc. of this case (hereinafter "prior disposition of this case") against the plaintiff is a defective illegal disposition, and it is unreasonable that the defendant's payment of survivors' benefits is made continuously for a long time in the future for the accident of this case, which is a drinking accident subject to social criticism, which is not an occupational accident.

In light of the aforementioned legal principles and records, the above determination by the court below is just and acceptable. In so doing, it did not err by exceeding the bounds of the principle of free evaluation of evidence against logical and empirical rules, or by misapprehending the legal principles on proximate causal relation of occupational accidents, and ex officio revocation restriction

3. As to the Defendant’s ground of appeal

According to the reasoning of the judgment below, the court below determined that: (a) the accident of this case occurred in a business trip according to the direction of the business owner; (b) the accident occurred in an excessive course due to the duties other than the deceased’s drinking; (c) the vehicle’s age at the time of the accident occurred; (d) the driver of the truck of this case was negligent in stopping the vehicle on the side; (b) the Plaintiff, a bereaved family member of the deceased, was aware of the fact that the deceased was drinking at the time of the accident; (c) the Plaintiff was unaware of the fact that the deceased was drinking; (d) the Plaintiff had to care for three children; and (c) the Defendant made a disposition of collecting the insurance benefits paid by the Defendant on the ground of the defect of the preceding disposition of this case as unjust enrichment; and (e) the Defendant could not be justified to the extent that the above Plaintiff, etc.’s need to collect the insurance benefits already paid by the Defendant on the ground of the defect of the preceding disposition, as unjust enrichment, protection of rights, and stability in legal life, etc.

In light of the aforementioned legal principles and records, the above determination by the court below is just and acceptable. In so doing, it did not err by exceeding the bounds of the principle of free evaluation of evidence against logical and empirical rules, exceeding the bounds of the principle of free evaluation of evidence, or by misapprehending the legal principles on ex officio revocation of

4. Conclusion

Therefore, all appeals are dismissed, and the costs of appeal are assessed against each party. It is so decided as per Disposition by the assent of all participating Justices on the bench.

Justices Park Poe-young (Presiding Justice)