2016Da206550 (main office) Confirmation of the existence of an obligation

2016Da206567 (Counterclaim Insurance Money)

person

Case Non-Life Insurance Co., Ltd.

1. A;

2. B

Jeonju District Court Decision 2015Na1386, 2015Na1393 Decided January 14, 2016

(Counterclaim) Judgment

June 9, 2016

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

The grounds of appeal are examined (to the extent of supplement in case of supplemental appellate briefs not timely filed).

1. The term “overgoing accident” among the “overgoing accident,” which is the requirement of the instant insurance accident under the instant insurance clause means that the cause of injury or death means all the physical defects of the insured, i.e., disease or physical physical factors, and the causal relationship between the external nature of the accident and the result of injury or death, and the claimant for insurance bears the burden of proof (see, e.g., Supreme Court Decision 2013Da210466, Jul. 10, 2014).

2. In light of the following circumstances, the court below accepted the judgment of the court of first instance, and determined that, in light of the following circumstances, it is reasonable to deem that the deceased suffered bodily injury due to a cerebral virus rapidly activated at a natural spreading speed above the natural progress speed and the death of the deceased due to the decline of the satise’s physical immunity due to external factors such as overwork and stress, etc., it constitutes an insurance accident secured by each accident insurance of this case.

① At the time of the death of the instant virus infection, the Deceased was a healthy youth of 20 years of age, who was a representative of the Ulst-gun of the Republic of Korea in the past, and was equipped with the physical conditions and physical strength to the extent that he/she would act as a superior in the past. On the other hand, there was no king related to brain infection.

(2) The Deceased has been suffering from overwork and stress because he/she could not receive timely treatment or rest for reasons such as continuing cruel training and participation in the Games, burden on the results of the games, training, preparation for the Games, etc.

③ In general, it is reasonable to view that brain infection is related to the outbreak of cerebral infection through a cerebral virus due to overwork, stress, etc. due to a astronomical disease.

④ According to medical opinions, naturally induced brain viruss appear to have been able to overcome it by the deceased’s smooth physical strength and immunodeficiency power. However, there is a high probability that the brain infection in this case occurred due to the decline by overwork and stress in the absence of sufficient rest and appropriate medical measures.

3. However, it is difficult to accept such a determination by the lower court for the following reasons.

A. Review of the reasoning of the lower judgment and the reasoning of the first instance judgment as cited by the lower court, and the record reveals the following circumstances.

① According to the medical opinion, the intrusion of the instant brain virus appears to have been naturally transmitted through the air, etc., as in other pathogens. The Deceased appears to have been infected with a virus while living together with other players under his/her jurisdiction, such as accommodation training and participation in the competition, and there is no special circumstance to recognize the outpatient in the process of infection, such as infection by any other special vehicle.

② The Deceased’s overwork and stress seems to have been continuously proceeding for a long time due to the long-term accommodation training, the participation in the racing, etc. It is difficult to find out external circumstances to deem that there were training, etc. that the overwork and stress of the Deceased immediately before the outbreak of brain infection sharply increased compared to the previous ones, or that there were more serious training and stress than those of other players who seem to have been extinguishing the schedule of the participation in the racing.

(3) In light of physical conditions and physical strength, it seems that the deceased’s brain infection caused by virus was due to the degradation. Even if overwork and stress functioned as one of the inducements of immunodeficiency force, other inducements causing such infections, such as physical degradation, intrinsic factors, and other diseases, may not be ruled out.

B. Examining the above circumstances in light of the legal principles as seen earlier, it cannot be readily concluded that the death of the deceased was caused by a sudden and unexpected accident. Nevertheless, the lower court determined otherwise solely for the reasons indicated in its reasoning. In so doing, the lower court erred by misapprehending the legal doctrine on the requirements for recognition of insurance accidents and the burden of proof thereof, or by failing to exhaust all necessary deliberations, thereby adversely affecting the conclusion of the judgment. The allegation contained in the grounds of appeal on this point is with merit.

4. Therefore, without further proceeding to decide on the remaining grounds of appeal, 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 Park Sang-ok

Justices Lee Sang-hoon

Justices Kim Chang-tae, Counsel for the defendant

Justices Cho Jong-hee