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(영문) 대법원 2004. 11. 25. 선고 2004다28245 판결
[보험금][공2005.1.1.(217),5]
Main Issues

[1] The case holding that Article 729 of the Commercial Code and Article 6 of the Regulation of Standardized Contracts Act do not violate Article 729 of the Commercial Code and Article 6 of the Regulation of Standardized Contracts Act, which stipulates that the standardized contract to pay only the amount of the insurance money stipulated in the standardized contract to be deducted from the amount

[2] The grounds for recognizing the duty of explanation and explanation of the insurance terms and conditions and the insurer's duty of explanation is exempted

[3] In a case where the insurer does not explain the terms and conditions that the insurer should pay only the amount obtained by deducting the amount entitled to compensation for personal injury, such as automobile insurance, etc., the other party's automobile insurance purchased at the time of the conclusion of the insurance contract, as the insurance money, if the insured's actual loss remains even after receiving compensation for personal injury, such as automobile insurance, etc., in which the other party's automobile is subscribed, whether the insurer may claim the deduction of the insurance money under the above provisions (negative

Summary of Judgment

[1] The case holding that Article 729 of the Commercial Code and Article 6 of the Regulation of Standardized Contracts Act do not violate Article 729 of the Commercial Code and Article 6 of the Regulation of Standardized Contracts Act, which stipulates that a clause to pay only the amount of the insurance money stipulated in the terms and conditions that the other party shall receive compensation

[2] The insurer's recognition of the duty to specify and explain the insurance terms and conditions is based on the fact that the policyholder is not aware of the important matters of the terms and conditions, which are the contents of the contract, and is able to avoid unexpected disadvantages to the policyholder. Thus, even if the contents of the insurance terms and conditions are stipulated in the insurance terms and conditions, it cannot be said that the insurer has the duty to specify and explain the matters that the policyholder could have sufficiently anticipated without any separate explanation, because they are common and common in the transaction, or that are merely about the extent that the policyholder has returned or added to the matters already stipulated in the Acts and subordinate statutes. In addition, if the policyholder or his agent has already been well aware

[3] The terms and conditions stipulate that "only the amount obtained by deducting the amount of compensation for personal injury, such as automobile insurance purchased by the other party from the insurance money stipulated in the terms and conditions of insurance shall be paid as the insurance money for his own physical accident, not as to the calculation method of insurance money for his own physical accident insurance, but as to the payment of insurance money in the case of an insurance accident with other vehicles. In the case where the amount of compensation which can be paid from the other vehicle's personal injury exceeds the agreed insurance amount, the insured's actual loss shall not be paid even if the amount of compensation exceeds the agreed insurance amount, so such matters are important matters of the insurance contract that may affect the conclusion of the insurance contract, and it shall not be deemed that the insured could have sufficiently anticipated even if there was no separate explanation, so if the insurer did not explain the above terms and conditions of the insurance contract at the time of the conclusion of the insurance contract, the insurer cannot claim the deduction of insurance

[Reference Provisions]

[1] Article 729 of the Commercial Code, Article 6 of the Regulation of Standardized Contracts Act / [2] Article 638-3 (1) of the Commercial Code, Article 3 of the Regulation of Standardized Contracts Act / [3] Article 638-3 (1) of the Commercial Code, Article 3 of the Regulation of Standardized Contracts

Reference Cases

[1] Supreme Court Decision 200Da21833 decided Sep. 7, 2001 (Gong2001Ha, 2178) / [2] Supreme Court Decision 99Da5533 decided Jul. 27, 2001 (Gong2001Ha, 1925) Supreme Court Decision 2003Da15556 decided May 30, 2003 (Gong2003Ha, 1441), Supreme Court Decision 2003Da7302 decided Apr. 27, 2004 (Gong204, 875)

Plaintiff, Appellant

Kim Jin-hun et al. (Attorney Yu-jin et al., Counsel for the defendant-appellant)

Defendant, Appellee

Samsung Fire and Marine Insurance Co., Ltd. (Law Firm C & C, Attorneys White-chul et al., Counsel for the plaintiff-appellant)

Judgment of the lower court

Seoul Central District Court Decision 2003Na44195 Decided April 30, 2004

Text

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

Reasons

1. Summary of the judgment below

According to the judgment of the court of first instance cited by the court below, the court below rejected the above plaintiff's insurance contract and the insured's 30th of June 30, 200 with the above plaintiff's 32ma213 of the game owned by the above plaintiff's 1, the insurance period from July 9, 200 to July 9, 201, 1 liability insurance (personal compensation) - 20,000, 30, 300, 30,000, 30, 30, 100, 30, 100, 30, 100, 100, 100, - 1,740, 60, 300, 60, 1,000, 60, 100, 100, 140, 201, 10,000, 10,000.

2. The judgment of this Court

A. As to the allegation in the grounds of appeal that the provision of this case violates Article 729 of the Commercial Act and Article 6 of the Act on the Regulation of Terms and Conditions

A self-physical accident insurance is developed in order to prepare for the case where the insured is unable to receive insurance benefits due to a collision with his own own single accident or non-insurance vehicle while operating an insured vehicle. In the collision with another vehicle, if the other vehicle is entitled to receive the insurance proceeds due to a collision with the automobile insurance (including a mutual aid agreement; hereinafter the same shall apply), it is not a development that makes duplicate compensation or compensates for the remainder of the insurance proceeds that are not compensated with the insurance proceeds that the other vehicle has bought. Therefore, the provision of this case does not stipulate the contents of the payment of the insurance proceeds in the event of an insurance accident with another vehicle that has subscribed to the automobile insurance for the purpose of realizing this purport, nor does it be deemed that the insurer subrogation against the

However, although the terms and conditions of this case can be the same result as allowing the insurer to subrogate in advance by applying them, the purport and meaning of the terms and conditions of this case cannot immediately be viewed as changing Article 729 of the Commercial Act, which prohibits the insurer subrogation in principle, to the insured in the case of personal life insurance, to the disadvantage of the insured, and the meaning of the terms and conditions of this case is not clear (see Supreme Court Decision 2000Da21833, Sept. 7, 2001).

Furthermore, considering the purport of the development of the terms and conditions of this case as seen earlier, its content and insurance premium amount, and the fact that the terms and conditions of this case should be seen as subject to the duty of explanation and explanation as seen below, the terms and conditions of this case cannot be deemed null and void pursuant to Article 6 of the Act on the Regulation of Terms and Conditions as a provision that limits fundamental rights to the extent that the terms and conditions of this case unfairly unfavorable to customers or that it is impossible to achieve the purpose of the insurance

In the same purport, the decision of the court below which rejected the plaintiffs' assertion that the validity of the terms of this case should be denied under Article 729 of the Commercial Act and Article 6 of the Regulation of Standardized Contracts Act is just, and there is no error of law such as misunderstanding of legal principles as to the validity of the terms of this case as otherwise

B. Of the grounds of appeal, as to the allegation that the provision of this case violates Articles 658 and 663 of the Commercial Act

In the case of a collision with another vehicle, the terms and conditions of the contract of this case intend to determine the insurance proceeds for personal injury insurance to be paid after examining whether or not the insurer receives the insurance proceeds from the personal injury insurance purchased by the other vehicle and the amount thereof. Thus, it cannot be deemed that the terms and conditions of this case stipulate the insurance amount to be paid without delay after the insurer is notified of the occurrence of the insurance accident and the insurance amount to be paid to the insured or the beneficiary within 10 days from the fixed date in violation of Article 658 of the Commercial Act.

In the same purport, the decision of the court below which rejected the plaintiffs' assertion that the Clause of this case is invalid in violation of Articles 658 and 663 of the Commercial Act is just, and there is no error in the misapprehension of legal principles as to Article 658 of the Commercial Act as otherwise alleged in the ground of

C. As to the assertion that the terms and conditions were in violation of the duty of explanation

In general, when concluding an insurance contract, the insurer and the persons engaged in the conclusion or solicitation of the insurance contract are obliged to provide the policyholder or the insured with specific and detailed explanation and explanation of the important contents of the insurance contract, such as the content of the insurance contract, the system of insurance premium rates, changes in the entries in the written application for insurance, the reasons for exemption from liability of the insurer, etc. If the insurer concludes the insurance contract in violation of such duty to specify and explain the terms and conditions, the insurer cannot assert the contents of the terms and conditions as the content of the insurance contract. As such, the insurer’s explanation and explanation of the terms and conditions can not be asserted as the content of the insurance contract if it is concluded in violation of such duty to explain and explain the contents of the terms and conditions. As such, the insurer’s explanation and explanation of the terms and conditions is based on the fact that the insurer is not aware of the important matters of the terms and conditions that are prescribed in the terms and conditions, even if they are defined in the terms and conditions of the insurance contract, it cannot be said that the insurer has any further explanation and explanation of the terms and conditions.

The terms and conditions of this case concerning whether insurance money is paid and the contents of payment of insurance money in an insurance accident with another vehicle, not with regard to the calculation method of insurance money in a self-physical accident insurance, and where compensation which can be paid in compensation for personal injury of the other vehicle exceeds the agreed insurance amount (in accordance with the facts recognized by the original trial, insurance money for death and late disability in this case shall be KRW 30 million per capita), it shall not be paid insurance money even if the actual loss of the insured remains, so such matters shall be deemed an important matter of the insurance contract that may affect the conclusion of the insurance contract, and it shall not be deemed that the policyholder could have sufficiently anticipated even if there was no separate explanation, so if the defendant did not explain the terms and conditions of this case at the time of the conclusion of the insurance contract of this case, the defendant cannot assert the deduction of insurance money pursuant to the provisions of this case.

Nevertheless, the judgment of the court below that the contract provisions of this case cannot be deemed to be invalid on the ground that the contract provisions of this case are not unfair clauses under the Regulation of Standardized Contracts Act, and the risk of self-physical accidents are added thereto. Thus, even if the plaintiff Kim Jong-woo knew of the terms of this case at the time of entering into the insurance contract of this case, the contract provisions of this case did not constitute unfair clauses under the Regulation of Standardized Contracts Act, and therefore, it is difficult to make important matters subject to the duty of explanation and explanation. The judgment of the court below is erroneous in the misapprehension of legal principles as to the duty of explanation of insurance clauses, which affected the conclusion of the judgment. Accordingly, the ground of appeal pointing this out has merit.

3. Conclusion

Therefore, the judgment of the court below is reversed and the case is remanded to the court below for a new trial and determination. It is so decided as per Disposition by the assent of all participating Justices.

Justices Kim Young-ran (Presiding Justice)

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심급 사건
-서울중앙지방법원 2004.4.30.선고 2003나44195
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