Plaintiff 1 and one other (Attorney Na-jin, Counsel for the plaintiff-appellant)

Han Life Insurance Co., Ltd. and one other (Attorneys Park Jong-sung et al., Counsel for the plaintiff-appellant)

April 19, 2006

Seoul Central District Court Decision 2005Ka63120 Decided October 28, 2005

All appeals by the plaintiffs are dismissed.

The costs of appeal are assessed against the plaintiffs.

The judgment of the first instance shall be revoked.

The defendant Samsung Life Insurance Co., Ltd. shall pay 5,00,000 won for each of the plaintiffs; 7,500,000 won for each of the above amounts; 5% per annum for each of the above amounts from August 1, 2004 to the delivery date of a copy of the complaint of this case; and 20% per annum for each of the above amounts from the next day to the full payment.

1. Basic facts

The following facts are acknowledged as either a dispute between the parties or as a whole by taking account of the overall purport of the arguments in the descriptions of Gap evidence 1 through 5, Gap evidence 7, Eul evidence 1, 3, and 4.

A. Relationship between the deceased Nonparty and the Defendant Life Insurance Co., Ltd. (hereinafter “Defendant Life Insurance”)

On October 30, 1997, the Nonparty entered into a “Asamamama General Insurance Contract (Personal Form)” contract (hereinafter “instant insurance contract”) between the Defendant’s life insurance and the Non-Party agreed to provide a comprehensive guarantee and a special agreement for hospitalization as follows.

(i)Contractor and Main Insured: Non-Party;

Dod Beneficiary: The Non-Party at the time of maturity, hospitalization or injury;

Legal inheritor at the time of death;

Abstract insurance premium on October 30, 1997 and October 30, 2035: 27,800 won per month.

m. Insurance proceeds

(1) Death due to a disaster other than traffic disaster: 20,000,000 won.

(2) In the event of death due to a traffic disaster: 20,000,000 won + ten times each year, respectively.

(v) causes for payment of insurance proceeds;

㈎ 피보험자가 보험기간 중 ‘재해’를 직접적인 원인으로 사망하였을 때 수익자에게 보험금 20,000,000원을 지급하는데(에이스암보험 보통보험 약관 제12조 제1항 제1호, 별표 1 ‘보험금 지급기준표’), 이때의 ‘재해’는 우발적인 외래의 사고로서 운수사고 일체, 추락, 무생물성 기계적 힘에 노출, 가해 등 이 사건 제1 보험계약 약관의 재해분류표(별표 A)에 나열되어 있는 재해를 의미한다.

㈏ 피보험자가 보험기간 중 교통재해를 직접적인 원인으로 사망하였을 때 수익자에게 보험금 30,000,000원(20,000,000원 + 1,000,000원씩 10회)을 지급하는데(에이스암 종합보장특약 약관 제5조 제1항 제1호, 별표 1 ‘보험금 지급기준표’), 이때의 ‘교통재해’는 이 사건 제1 보험계약 약관의 교통재해 분류표(별표 B)에 나열되어 있는 다음의 재해를 의미한다(이하 ‘교통재해 분류표 ①, ②, ③항’ 이라고 한다).

(1) An unexpected accident caused by an insured worker who is not on board a transport agency in operation due to a collision, contact, fire, explosion, escape, etc. of the transport agency in operation.

(2) An accident that is not caused by the insured while on board a transportation agency in operation or while in the platform of the transportation agency having the opening hole as a passenger.

(3) An accident that happens to an insured person due to collapse of buildings, structures, etc. or falling from a structure, structure, etc. while travelling along roads.

B. Relationship between the deceased Nonparty and Defendant Samsung Life Insurance Co., Ltd. (hereinafter “Defendant Samsung Life”)

On September 30, 2003, the non-party Korean Private Taxi Partnership entered into a contract with Defendant Samsung Bio-resources as follows (hereinafter “instant insurance contract”).

(i)Contractor: The beneficiary of the Korean Private Taxis Association: the Nonparty;

Dod Beneficiary: Nonparty, upon maturity or injury, or inheritor upon death;

Consolidated insurance period: the insurance premium on September 30, 2003 through September 30, 2013: 31,200 won per month.

x Insurance Money: 45,000,000 won

General Disaster Death Insurance Money 30,000,000

(v) causes for payment of insurance proceeds;

㈎ 피보험자가 보험기간 중 교통재해로 인하여 사망하였을 때 교통재해사망보험금 45,000,000원을 지급한다(약관 제15조 제3호).

In this case, the meaning of “traffic disaster” is prescribed in the traffic disaster classification table (attached Table 4), which is the same as the meaning of “traffic disaster” in the insurance contract of this case.

㈏ 피보험자가 보험기간 중 교통재해 이외의 재해로 인하여 사망하였을 때 일반재해사망보험금 30,000,000원을 지급한다(약관 제15조 제4호).

At this time, the term "disaster" refers to a contingency accident, and is prescribed in the Disaster Classification Table (Attached Table 2), and is the same as attached Table A of the Insurance Contract No. 1 of this case.

C. The reason why the deceased Nonparty died

The deceased Nonparty, at night on May 13, 2004, driven a taxi for private use (vehicle number omitted) owned by the deceased Nonparty on his/her own, with his/her name-free passengers aboard, and went to the front of the extreme Donggll located in 195, Jinyang-si, Jinyang-si, Jinyang-si around 22:34 on the same day. Around that time, the deceased Nonparty died of both chests, eyebrows, and knife with lethally weapons presumed to have a knife from passengers on his/her name in the above taxi (hereinafter “instant accident”). At around 00:45 on the 14th of the same month, he/she died from the knife (hereinafter “the instant accident”).

D. Inheritance relationship of the deceased Nonparty

According to the death of the Nonparty, the Plaintiffs jointly inherited the deceased’s property.

(e) Payment of insurance money;

The Defendants viewed the instant accident as a traffic disaster not a traffic disaster, and paid the insurance proceeds to the Plaintiffs, the beneficiary, in accordance with the instant insurance contract Nos. 1 and 2 (payment of KRW 20,000,000 for Defendant Samsung Bio-resources, and KRW 30,000 for Defendant Samsung Bio-resources).

2. The parties' assertion

A. The plaintiffs' assertion

(1) For the following reasons, the instant accident constitutes an “accident caused by the insured while on board a transport vehicle in operation” as stipulated in the terms and conditions of the instant insurance contract Nos. 1 and 2.

㈎ 교통재해 분류표 ①항은 ‘교통기관의 충돌, 접촉, 화재, 폭발, 도주 등’을 그 재해 발생 원인으로 명시하고 있는데 반하여, ②항은 그 재해 발생의 원인을 제한하고 있지 않다.

㈏ 교통재해 분류표 ①, ②, ③ 항을 유기적으로 연관지어 해석하면 다음과 같다.

1) Paragraph (1) is limited to “insured who is not on board a transport institution” and the cause of the occurrence of the disaster is limited to “coverage, contact, fire, explosion, escape, etc. of the transport institution”.

(2) Paragraph (2) covers “insured who are on board a transport facility” and there is no limitation on the grounds of the occurrence of the disaster.

(3) Paragraph (3) is subject to “insured who are on board a transport institution” (i.e., paragraph (2). However, it does not necessarily require “transport institution”) and the requirement is that the disaster is “disaster that occurred from outside the transport institution to the transport institution”.

㈐ 이 사건 제1, 2 보험계약 약관의 교통재해 분류표에서는 ‘교통기관과 유사한 기관으로 인한 불의의 사고일지라도 도로상에서 사람 또는 물건의 운반에 사용되고 있는 동안이나 도로상을 주행 중에 발생한 사고는 교통재해로 본다’고 규정하고 있는데, 이 경우에도 교통재해의 개념 요소로 ‘사람이나 물건의 탑승 또는 적재, 운행’만을 요구할 뿐 재해 발생의 원인을 제한하고 있지 않다.

㈑ 위와 같은 여러 가지 사정들 및 약관 내용이 명백하지 못하거나 의심스러울 때에는 고객에게 유리하게 해석하여야 한다는 약관 해석의 원칙을 종합하면, 교통재해 분류표 ② 항은 ‘운행 중인 교통기관에 탑승하고 있는 동안’ 피보험자가 불의의 사고를 입기만 하면 ‘그 재해의 원인이 무엇인지에 관계없이’ ‘교통 재해’에 해당하는 것으로 해석되어야 한다.

D. Accordingly, the Defendants have the duty to pay the Plaintiffs the death insurance amount resulting from a traffic accident (for the Defendant’s life, KRW 30,000,000, and KRW 45,000,00 in the case of Defendant Samsung Bio-resources) in accordance with the terms and conditions of the instant insurance contract. As such, the Defendants paid the death insurance amount resulting from a general accident to the Plaintiffs by deeming the instant accident as a general accident, the Defendants are obligated to additionally pay the amount equivalent to the difference.

B. The defendants' assertion

The instant accident constitutes “general disaster” under the terms and conditions of the instant insurance contract and does not constitute “transport disaster”.

3. Determination

Therefore, we examine whether the instant accident can be seen as “traffic disaster” as stipulated in the terms and conditions of the instant insurance contract.

A. Examining the traffic disaster classification table of the terms and conditions of the insurance contract Nos. 1 and 2 of the instant case, ① Unlike paragraph (2), the clause comprehensively provides that “an unforeseen accident that is caused by the insured while boarding a transportation agency in operation,” and does not explicitly stipulate that there exists causation between the boarding of the transportation agency and the accident.

B. However, in full view of the above provisions, the insurance accidents are classified into “traffic disaster” and “disaster other than traffic disaster, i.e., general traffic disaster,” and the general disaster includes both “integrative, fall, and non-biological force,” the traffic accident classification table 1 and 2) among the accidents that can be understood as “traffic disaster” under generally accepted social norms, the traffic accident classification table 1 and 3) and the “in the event of an accident in connection with other general traffic facilities without boarding any specific transport facilities in operation,” and the “in the event of an accident in connection with the operation of a specific transport facilities in operation.”

Therefore, in order to fall under the traffic disaster of the above paragraph (2), it should be at least related to the traffic "traffic" or "operation of transport facilities".

C. However, the instant accident does not constitute “traffic disaster” as stipulated in the terms and conditions of the instant insurance contract, inasmuch as the location where the instant accident was committed by robbery was likely to occur, and there is no connection with “transport” or “operation of transport facilities.”

4. Conclusion

Therefore, the plaintiffs' respective claims against the defendants under the premise that the accident of this case constitutes "traffic disaster" are dismissed without any justifiable grounds to examine the remainder of the claims. Thus, the judgment of the court of first instance is justifiable in this conclusion, and it is so decided as per Disposition by the court below.

Judges Lee Ba-so (Presiding Judge)