In a case where a disposition can be taken to collect an amount equivalent to the amount of 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, and whether a collection disposition based on which the payment decision of the insurance benefits under the Industrial Accident Compensation Insurance Act has been lawfully revoked should be determined as lawful (negative)

Article 84(1)3 of the Industrial Accident Compensation Insurance Act

Supreme Court Decision 2011Du31697 Decided April 10, 2014 (Gong2014Sang, 1050), Supreme Court Decision 2013Du27159 Decided July 24, 2014 (Gong2014Ha, 1746), Supreme Court Decision 2012Du17186 Decided October 27, 2014 (Gong2014Ha, 2270)

Plaintiff (Law Firm LLC, Attorneys Lee Han-sik et al., Counsel for the plaintiff-appellant)

Korea Labor Welfare Corporation

Seoul High Court Decision 2014Nu40588 decided June 12, 2014

The appeal is dismissed. The costs of appeal are assessed against the defendant.

The grounds of appeal are examined.

1. Article 84(1) of the Industrial Accident Compensation Insurance Act (hereinafter “Industrial Accident Compensation Insurance Act”) provides, “Where a person who has received insurance benefits falls under any of the following subparagraphs, the Corporation shall collect the amount equivalent to the amount of the benefits (in the case of subparagraph 1, the amount equivalent to twice the amount of the benefits paid)” and subparagraph 3 provides, “other cases where there are the insurance benefits paid erroneously.”

Meanwhile, the industrial accident compensation insurance system is a social insurance system that copes with the social risks of occupational accidents that occur to workers using the financial resources for insurance premiums paid by the business owner who is a policyholder to guarantee the livelihood of the affected workers and their family members, and thus, the entitlement to industrial accident compensation insurance under this system belongs to the social security entitlement so-called social security entitlement (see Constitutional Court en banc Decision 2011Hun-Ba133, Mar. 29, 2012). However, the public interest intended to be achieved through the cancellation of the beneficial administrative disposition in the administrative sector whose contents are social security benefits is social security benefits is essentially a financial interest formed through the insurance premium paid by the business owner and the national treasury burden, while 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 the defect existing in the beneficial administrative disposition, it cannot be readily concluded that the beneficiary is more important or larger

In full view of the contents and purport of the above provisions and the unique characteristics of the revocation of beneficial administrative dispositions on social security, when imposing the amount equivalent to the amount of insurance benefits erroneously paid from the party who received the insurance benefits pursuant to Article 84(1)3 of the Industrial Accident Compensation Act, restitution of the amount is harsh to the party concerned in light of whether there is any cause attributable to intention or gross negligence with respect to the supply and demand of the insurance benefits, the interval between the amount of the insurance benefits payment and the date of the collection disposition, and the time and the date of the payment of the insurance benefits, etc., and the amount of the insurance benefits again shall be determined by taking into account the following circumstances: (a) the specific details of the necessity of the public interest to be achieved through the collection of the amount of the insurance benefits erroneously paid to the party concerned; and (b) the details and degree of the disadvantage suffered by the party concerned due to the disposition; and (c) the need to collect the amount of the insurance benefits erroneously paid to the party concerned; and (d) the amount equivalent to the amount of the insurance benefits paid by the party concerned shall be determined by Supreme Court Decision 2017Du1614.

Furthermore, the criteria for determining whether the determination of the payment of various insurance benefits, etc. under the Industrial Accident Compensation Insurance Act is legitimate and the criteria for determining whether the collection of an amount equivalent to the already paid insurance benefits is legitimate cannot be said to be the same as the criteria for determining whether the payment of the insurance benefits is legitimate. Therefore, the collection disposition based on the fact that the payment decision has been lawfully revoked does not necessarily mean that the payment decision is lawful (see Supreme Court Decision 2013Du27159, Jul. 24,

2. In full view of the evidence duly admitted, the lower court determined that the need for public interest to obtain the insurance benefits already paid by the Defendant as unjust enrichment on the ground of the defect in the prior payment disposition does not constitute a case where it is strong enough to justify disadvantages, such as the right to obtain benefits, protection of trust, and infringement of legal stability in legal life, etc., that the Plaintiff is responsible for the Defendant’s authority, the Plaintiff’s trust in the legitimacy and validity of the prior payment disposition, and there was no reason attributable to the Plaintiff, and the Plaintiff was living dependent on the deceased’s revenues because he did not engage in any particular economic activity as an older person in 1946, and the Plaintiff appears to have consumed all the insurance benefits already received from the prior payment disposition as funeral expenses and living expenses without negligence.

In light of the above legal principles and records, the above determination by the court below is just, and there is no error of law by misapprehending the legal principles on the disposition of unjust enrichment collection and the principle of trust protection under the Industrial Accident Compensation Insurance Act, or omitting all necessary deliberations.

3. Therefore, the appeal is 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 Kim Yong-deok (Presiding Justice)