2020 oldest 61488 Revocation of Disposition of Non-approval for Medical Care

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June 23, 2021

July 7, 2021

1. The Defendant’s disposition of granting medical care benefits to the Plaintiff on February 27, 2020 is revoked.

2. The costs of the lawsuit are assessed against the defendant.

The same shall apply to the order.

1. Details of the disposition;

A. On November 20, 2019, the Plaintiff was an employee Co., Ltd. C, and was on duty at around 09:38 on November 20, 2019, and was on duty aboard the electric kickboard without a motorcycle driver’s license, and * ○○○○-ro** When green lights such as pedestrian signal, etc. in front of ○○ building are on-and-off, crossing the crosswalk by entering the crosswalk. After the pedestrian signal, etc. was changed to a red light, the Plaintiff was subject to a traffic accident that conflicts with the cargo vehicle, which began on the three-lane way of the road along the green light of vehicle signal, etc. (see attached Form 2; hereinafter referred to as the “accident”).

B. As a result, the Plaintiff was diagnosed as “the mincated mincture of the upper upper part of the top part, the left part slot, and the outer half-yearly mincture, the tear in the left part, the side mincture within the left part, the lower part of the lower part of the left part, and the Plaintiff applied for medical care benefits to the Defendant on January 6, 2020.

C. On February 27, 2020, the defendant approved the application for medical care benefits of this case on the ground that "the accident of this case was caused by gross negligence falling under Article 3 (2) 1 (f) of the Act on Special Cases Concerning the Settlement of Traffic Accidents, and therefore, it cannot be viewed as an occupational accident under the Industrial Accident Compensation Insurance Act" (hereinafter "the disposition of this case").

[Ground of recognition] Facts without dispute, Gap evidence Nos. 1 through 4, Eul evidence Nos. 1, 2 and 3, the purport of the whole pleadings

2. Whether the disposition is lawful;

A. The plaintiff's assertion

The instant accident is an accident caused by competition between the Plaintiff and the truck driver’s negligence, and cannot be deemed an accident caused by the Plaintiff’s criminal act. Therefore, the instant disposition taken on a different premise should be revoked as it is unlawful.

B. Determination

1) The main text of Article 37(2) of the Industrial Accident Compensation Insurance Act (hereinafter “Industrial Accident Insurance Act”) provides that “The injury, disease, disability, or death of a worker is not considered an occupational accident.” ① The purpose of the Industrial Accident Insurance Act is to compensate rapidly and fairly for occupational accidents of workers through the implementation of the industrial accident compensation insurance business and to contribute to the protection of workers by installing and operating insurance facilities necessary to promote the rehabilitation of workers suffering from occupational accidents and their return to society, and by carrying out disaster prevention and other projects to promote workers’ welfare (Article 1); ② The industrial accident compensation insurance system functions as a minimum social safety net for the safety and health of workers who can be excluded in the course of economic and industrial development; ③ The requirements for the interpretation of the Industrial Accident Compensation Insurance Act (amended by Act No. 6093, Dec. 31, 199; see Article 201(1) of the Addenda to the National Health Insurance Act, which is an intentional act or gross negligence of workers who committed an occupational injury, etc., which is included in the Act.

2) Examining the aforementioned evidence and the following circumstances revealed by the evidence evidence Nos. 5 and 6, in light of the aforementioned legal principles, the Plaintiff’s operation of the electric kickboard cannot be deemed to constitute a criminal act stipulated in the main sentence of Article 37(2) of the Industrial Accident Insurance Act, and the instant accident that occurred during work constitutes occupational accidents. Accordingly, the Plaintiff’s above assertion is reasonable, and the Defendant’s disposition of the instant case on a different premise is unlawful.

A) Considering that the proviso of Article 3(2) and the proviso of Article 4(1)1 of the Act on Special Cases concerning the Settlement of Traffic Accidents are essential to drive a motor vehicle in daily life, a special case on criminal punishment shall be given to a driver who has committed a crime of injury caused by occupational negligence by traffic in order to facilitate prompt recovery from damage caused by traffic accident by inducing the driver to enter into an agreement or comprehensive insurance contract with the victim, without instituting a public prosecution in the event of an agreement or comprehensive insurance contract with the victim. However, in the case of traffic signal violations, the legislative purport of the provision on the Special Cases concerning the Settlement of Traffic Accidents is different from that of the main sentence of Article 37(2) of the Industrial Accident Insurance Act, which provides for the grounds for exclusion from occupational accidents. In addition, the legislative purport of the proviso of Article 3(2)1 of the Act on Special Cases concerning the Settlement of Traffic Accidents is that a driver who has committed an accident, such as traffic accident, should not immediately be determined by comprehensively considering the situation where the driver violated the proviso of Article 37(2)1).

B) When green light of a pedestrian signal, etc. is on-and-off, pedestrians shall not start crossing, and pedestrians crossing shall promptly complete crossing, stop crossing, and return to the sidewalk (Article 6(2) [Attachment 2] of the former Enforcement Rule of the Road Traffic Act (amended by Ordinance of the Ministry of Public Administration and Security No. 217, Dec. 10, 2020). The crosswalk is the part of the road indicated with safety signs to allow pedestrians to cross the road. However, in the case of the driver of the electric kickboard, pedestrians can walk along the crosswalk only when they get off the kickboard, and they shall not walk the crosswalk. [Article 2 subparag. 12, 13-2, (6), and (1) of the former Road Traffic Act (amended by Act No. 17311, May 26, 2020; hereinafter the same shall apply].

As seen earlier, the Plaintiff is on-and-off a green light of the pedestrian signal, etc.

On the other hand, the pedestrian signal, etc. has been changed to the red light before crossing the crosswalk, and then the collision occurred with the cargo vehicle which started to drive according to the green light such as the vehicle signal. It is sufficiently recognized that there was negligence on the plaintiff.

① However, when the accident occurred, the number of users of the kick on the road, compared to the rapid increase of the kick on the road at the time of the accident, and the legal and institutional devices to regulate it were somewhat confusion. ② With respect to the accident in this case, the driver of the kick on the road is not prosecuted or punished for any other crime except for the plaintiff's violation of the Road Traffic Act. ③ It is difficult to see that the act of the plaintiff's operation of the kick on the kick on the kick is to be excluded from the object of protection of the Industrial Accident Insurance Act. ④ The driver of the kick on the kick on the kick on the kick on the kick on the kick on the 3rd on the kick on the kick on the kick on the kick on the kick on the kick on the kick on the kick on the kick on the kick on the kick on the kick on the kick on the k.

C) The defendant asserts that the accident of this case occurred due to gross negligence falling under Article 3(2)7 of the Act on Special Cases concerning the Settlement of Traffic Accidents (unlicensed Driving). However, the above circumstances are as follows: ① Article 154 subparag. 2 of the former Road Traffic Act provides that the driver without a license shall be punished by a fine not exceeding 300,000 won or penal detention; ② the driver with no license of the Seoul ○○ District Prosecutors' Office is relatively lower than the driver without a license; ② the prosecutor with no license of this case has suspended the indictment in consideration of these circumstances; ③ the fact relevance of the defendant's act without a license of this case constitutes a direct cause for the worker's injury; ③ the defendant's act without a license of this case cannot be viewed as a new ground for revocation of the above disposition without a license of this case (see, e.g., Supreme Court Decision 200Du5160, Apr. 16, 2017).

3. Conclusion

Therefore, the plaintiff's claim of this case is reasonable, and it is so decided as per Disposition by admitting it.