Workbear재주넘는곰
대법원 96다39080

Claim for Reimbursement (구상금)구상금

Decided1997. 01. 24. Court대법원Korea Workers' Compensation and Welfare Service (근로복지공단, successor to the insurance corporation) won
AI-generated English translation (summary, key points, decision summary and full text) for reference only — not an official translation and without legal effect. The Korean original below is authoritative.
AI Easy read — AI summary of this decision
AI-generated summary for reference only — the Korean original below is authoritative.

This case confirms that when the Industrial Accident Compensation Insurance Corporation (산업재해보상보험공단) pays insurance benefits to an injured worker and then seeks reimbursement (구상권) from a third party, it may recover the full amount from the third party even if the insured employer and the third party jointly committed the tortious act, regardless of the employer's share of fault. However, the scope of reimbursement must be calculated separately for active damages (적극적 손해, e.g., medical expenses) and passive damages (소극적 손해, e.g., lost income), as these are treated as distinct causes of action (소송물).

Key takeaways
  • CaseAfter paying industrial accident insurance benefits to an injured worker, the insurer sought reimbursement from a third party who, along with the insured employer, was jointly liable for the accident.
  • OutcomeThe Supreme Court held that the insurer could claim full reimbursement from the third party regardless of the employer's fault ratio, but the reimbursement amount must be computed separately for active and passive damages.
  • LessonEmployers and insurers should recognize that joint fault does not reduce a third party's reimbursement liability, and that medical costs and lost income claims must be calculated and asserted independently in reimbursement disputes.
Issues
  • Whether and to what extent the insurer may exercise its right of reimbursement (구상권) against a third party when the third party and the insured employer are joint tortfeasors
  • The standard for calculating the scope of the industrial accident insurance reimbursement claim
  • Whether active damages and passive damages should be treated as separate causes of action (소송물) for reimbursement purposes
Key reasoning

Under the Industrial Accident Compensation Insurance Act (산업재해보상보험법), the insurer's right of reimbursement can be exercised in full against a joint tortfeasor third party, irrespective of the insured employer's proportion of fault in the joint tort. The scope of this reimbursement right is limited to the amount of the worker's damage claim that corresponds to the same cause of action as the insurance benefit paid. Since active damages and passive damages are legally distinct causes of action, the reimbursement amount must be calculated separately for each category rather than as a single lump sum. This ensures that the insurer's recovery does not exceed what the worker could have claimed under each specific type of damage.

Summary of Decision (English, AI translation)

[1] The term "third party," who is the counterparty to the exercise of the right of indemnity as prescribed in Article 15(1) of the former Industrial Accident Compensation Insurance Act (산업재해보상보험법) (before its full amendment by Act No. 4826 of December 22, 1994), refers to a person who has no industrial accident compensation insurance relationship with the injured worker and who bears liability for accident compensation to the injured worker due to a tort or other cause. However, such right of indemnity may also be exercised where the accident arose from a joint tort committed by the third party and the insured party or its employees, and in such a case, the right of indemnity may be exercised without regard to the portion of liability borne by the insured party or its employee according to the ratio of negligence. It is not to be held that, in anticipation that the third party who has responded to the claim for indemnity may later re-claim indemnity from the insured party for its portion of liability according to the ratio of negligence, the right of indemnity cannot be exercised with respect to the insured party's portion of liability.

[2] Where the Korea Workers' Compensation and Welfare Service (근로복지공단), which has paid industrial accident compensation insurance benefits to an injured worker, exercises its right of indemnity against the insured party and a third party who is a joint tortfeasor, the scope of the indemnity is limited to the amount of the injured worker's claim for damages against the third party, which shares the same subject matter of litigation as the insurance benefits.

[3] Where a loss of life or bodily injury is caused by a tort, active damages and passive damages constitute different subject matters of litigation from each other.

Full text (English, AI translation) 6,206 chars

[Plaintiff, Appellee] Republic of Korea, litigation successor Korea Workers' Compensation & Welfare Service
[Defendant, Appellant] Honam Petrochemical Corporation (Attorneys Jang Han-gak and 1 other, Counsel for the defendant)
[Intervenor for the Defendant] Samsung Heavy Industries Co., Ltd.
[Judgment Below] Seoul High Court Decision 96Na1681 decided July 24, 1996

[Order]

The appeal is dismissed. The costs of the appeal are to be borne by the Defendant.

[Reasoning]

The grounds of appeal are examined.

1. The "third party" against whom the right of indemnity may be exercised under Article 15(1) of the former Industrial Accident Compensation Insurance Act (산업재해보상보험법) (before its full amendment by Act No. 4826 of December 22, 1994) refers to a person who has no industrial accident compensation insurance relationship with the injured worker but who bears liability for compensation for the injury on the basis of tort or otherwise. However, it is the settled view of this Court that such right of indemnity may be exercised even where the injury arose from a joint tort committed by the third party and the insured employer or its employee, and that in such a case the right of indemnity may be exercised without regard to the portion of liability attributable to the insured employer or its employee according to their respective fault ratios, and it should not be held that, because the third party who has responded to the indemnity claim may in the future seek re-indemnification from the insured employer for the portion attributable to it according to the fault ratio, the right of indemnity cannot be exercised as to the insured employer's portion of liability in anticipation thereof (see Supreme Court Decisions 87Da카3109 decided September 26, 1989; 92Da23360 decided December 8, 1992; and 95Da19751 decided January 26, 1996).

The court below, in the same vein, determined that the Defendant is obligated to respond to the indemnity claim for the entire amount for which the Plaintiff was released from liability as a result of the insurance benefits paid, and this determination is justified; it cannot be said that there is any error of law of misapprehending the legal principles as argued in the grounds of appeal. Therefore, this ground of appeal is without merit.

2. Where the Plaintiff, having paid industrial accident compensation insurance benefits to the injured worker, exercises the right of indemnity against the Defendant as a joint tortfeasor, the scope of the indemnity must be viewed as limited to the amount of the worker's claim for damages against the Defendant that shares the same subject matter of the litigation as the insurance benefits (see Supreme Court Decisions 88Da카5041 decided April 25, 1989; 89Da5997 decided February 13, 1990), and where a person has suffered injury to life or body as a result of a tort, positive damages (적극적 손해) and passive damages (소극적 손해) constitute different subject matters of litigation from each other (see Supreme Court Decisions 76Da1313 decided October 12, 1976; 94Da20730 decided August 23, 1996).

Nevertheless, the court below, on the premise that where a person who has paid insurance benefits to the injured worker subrogates the worker's claim for damages against the third party, the entire amount of the insurance benefits may be indemnified so long as it falls within the scope of the worker's claim for damages, and that the items or amounts of the insurance benefits are not bound by those of the said claim for damages, found as fact that the total of the funeral expenses and other insurance benefits paid with respect to the deceased Nonparty 1, and the total of the medical care benefits, temporary disability benefits, and other insurance benefits paid with respect to the deceased Nonparty 2, each did not exceed the amount obtained by deducting the amount corresponding to each deceased's fault ratio from their respective passive damages, and on that basis directly ordered reimbursement of the full amount of insurance benefits paid by the Plaintiff. However, since the amounts paid as the above funeral expenses and medical care benefits relate to positive damages, which constitute a different subject matter of litigation from passive damages, the above determination of the court below in this regard is erroneous.

However, on the other hand, according to the description in Eul Evidence No. 9 (Judgment), it can be seen that, with respect to the deceased Nonparty 2, in addition to the amount of KRW 8,826,930 paid as medical care benefits up to April 9, 1994, medical expenses of KRW 829,750 were separately incurred, and thereafter medical expenses of KRW 22,347 per week continued to be required; thus, even after deducting the amount corresponding to the 10% fault ratio of the deceased as found by the court below from the said total amount, it is clear that the amount still exceeds the above medical care benefits. Furthermore, considering the description in Gap Evidence No. 13 (Bereaved Family and Funeral Expense Assessment Report) and the income, family relations, and other circumstances of the deceased Nonparty 1 as appearing in the record, together with the fact that funeral expenses paid as insurance benefits are uniformly calculated on the basis of 120 days' worth of average wages pursuant to the provisions of the Industrial Accident Compensation Insurance Act (산업재해보상보험법), it cannot be said that the funeral expenses paid with respect to the said deceased are excessive even taking into account his 10% fault ratio. Accordingly, the judgment of the court below, which upheld the claim for indemnity for the full amount of the said insurance benefits, is justified in its conclusion, and the above error of the court below cannot be said to have had any effect on the judgment. Therefore, this ground of appeal is also without merit.

3. Accordingly, the appeal is dismissed, and the costs of the appeal are to be borne by the losing party. This judgment is rendered as stated in the Order by the unanimous opinion of the Justices participating in the decision.

Justice Ahn Yong-deuk (Presiding Justice), Cheon Gyeong-song, Ji Chang-gwon, Shin Seong-taek (Justice in charge)

【판결요지】

[1] 구 산업재해보상보험법(1994. 12. 22. 법률 제4826호로 전문 개정되기 전의 것) 제15조 제1항에 규정된 구상권 행사의 상대방인 제3자라 함은 피해 근로자와의 사이에 산업재해보상보험관계가 없는 자로서 피해 근로자에 대하여 불법행위 등으로 인한 재해배상책임을 지는 자를 말하나, 그 구상권은 제3자와 보험가입자 또는 그 소속 근로자의 공동불법행위로 인하여 발생한 경우에도 행사할 수 있고, 이 경우에도 보험가입자 또는 그 피용자의 과실 비율에 따른 부담 부분에 관계없이 구상권을 행사할 수 있으며, 구상에 응한 제3자가 장차 보험가입자에게 그 과실 비율에 따라 그 부담 부분의 재구상을 할 것까지 미리 예상하여 보험가입자의 부담 부분에 대하여는 구상권을 행사할 수 없다고 볼 것은 아니다.

[2] 피해 근로자에게 산업재해보상보험금을 지급한 근로복지공단이 보험가입자와 공동불법행위자인 제3자를 상대로 구상권을 행사하는 경우, 구상의 범위는 그 보험급여와 소송물을 같이 하는 피해 근로자의 제3자에 대한 손해배상청구권의 금액을 한도로 한다.

[3] 불법행위로 인하여 생명 또는 신체의 손상을 입은 경우에 있어서 적극적 손해와 소극적 손해는 소송물을 서로 달리하는 것이다.

【참조조문】

[1] 구 산업재해보상보험법(1994. 12. 22. 법률 제4826호로 전문 개정되기 전의 것) 제15조 제1항( 현행 제54조 제1항 참조)

[2] 구 산업재해보상보험법(1994. 12. 22. 법률 제4826호로 전문 개정되기 전의 것) 제15조 제1항, 민법 제750조, 상법 제682조

[3] 민법 제750조, 제751조, 민사소송법 제234조

【참조판례】

[1] 대법원 1989. 9. 26. 선고 87다카3109 판결(공1989, 1548), 대법원 1992. 2. 25. 선고 91다28726 판결(공1992, 1134), 대법원 1992. 12. 8. 선고 92다23360 판결(공1993상, 424), 대법원 1996. 1. 26. 선고 95다19751 판결(공1996상, 737) /[2] 대법원 1989. 4. 25. 선고 88다카5041 판결(공1989, 810), 대법원 1990. 2. 13. 선고 89다5997 판결(공1990, 631) /[3] 대법원 1976. 10. 12. 선고 76다1313 판결(공1976, 9390), 대법원 1996. 8. 23. 선고 94다20730 판결(공1996하, 2795)

【주문】·【이유】 전문 2,334자 · 펼쳐 보기

【원고,피상고인】 대한민국 소송수계인 근로복지공단

【피고,상고인】 호남석유화학 주식회사 (소송대리인 변호사 장한각 외 1인)

【피고보조참가인】 삼성중공업 주식회사

【원심판결】 서울고법 1996. 7. 24. 선고 96나1681 판결

【주문】

상고를 기각한다. 상고비용은 피고의 부담으로 한다.

【이유】 상고이유를 본다.

1. 구 산업재해보상보험법(1994. 12. 22. 법률 제4826호로 전문 개정되기 전의 것) 제15조 제1항에 규정된 구상권 행사의 상대방인 제3자라 함은 피해 근로자와의 사이에 산업재해보상보험 관계가 없는 자로서 피해 근로자에 대하여 불법행위 등으로 인한 재해배상책임을 지는 자를 말하나, 그 구상권은 제3자와 보험가입자 또는 그 소속 근로자의 공동불법행위로 인하여 발생한 경우에도 행사할 수 있는 것이고, 이 경우에도 보험가입자 또는 그 피용자의 과실 비율에 따른 부담 부분에 관계없이 구상권을 행사할 수 있으며, 구상에 응한 제3자가 장차 보험가입자에게 그 과실 비율에 따라 그 부담 부분의 재구상을 할 것까지 미리 예상하여 보험가입자의 부담 부분에 대하여는 구상권을 행사할 수 없다고 볼 것은 아니라고 함 이 이 법원의 확립된 견해이다( 대법원 1989. 9. 26. 선고 87다카3109 판결, 1992. 12. 8. 선고 92다23360 판결, 1996. 1. 26. 선고 95다19751 판결 참조).

원심이 이와 같은 취지에서, 피고는 원고의 보험급여로 인하여 면책받은 금액 전부에 대하여 구상에 응할 의무가 있다고 판단한 것은 정당하고, 거기에 소론이 지적하는 바와 같은 법리오해의 위법이 있다고 할 수 없으므로, 논지는 이유 없다.

2. 피해 근로자에게 산업재해보상보험금을 지급한 원고가 공동불법행위자인 피고를 상대로 구상권을 행사하는 경우에 있어서의 구상의 범위는, 그 보험급여와 소송물을 같이하는 근로자의 피고에 대한 손해배상청구권의 금액을 한도로 한다고 보아야 할 것이며( 대법원 1989. 4. 25. 선고 88다카5041 판결, 1990. 2. 13. 선고 89다5997 판결 참조), 불법행위로 인하여 생명 또는 신체의 손상을 입은 경우에 있어서 적극적 손해와 소극적 손해는 소송물을 서로 달리하는 것이다( 대법원 1976. 10. 12. 선고 76다1313 판결, 1996. 8. 23. 선고 94다20730 판결 참조).

그럼에도 원심은, 피해 근로자에게 보험급여를 한 자가 근로자의 제3자에 대한 손해배상청구권을 대위하는 경우 그 보험급여액이 근로자의 손해배상청구권의 범위 내라면 보험급여액 전부를 구상할 수 있는 것이고, 그 보험급여의 항목이나 액수는 위 손해배상청구권의 그것에 구애받지 않는 것이라는 전제하에, 망 소외 1에 대하여 지급된 장의비와 다른 보험급여의 합계 및 망 소외 2에 대하여 지급된 요양급여와 휴업급여 등 보험급여의 합계는 각 위 망인들의 소극적 손해액에서 그들의 과실 비율에 해당하는 금액을 감한 금액을 초과하지 아니하는 사실을 확정하고, 이로부터 바로 원고가 지급한 보험급여 전액에 대한 상환을 명하였는바, 위 장의비와 요양급여로 지급된 금액은 적극적 손해에 관한 것으로서 소극적 손해와는 소송물을 달리하는 것이므로 이에 관한 원심의 위 판단은 잘못이라 할 것이다.

그러나 한편 을 제9호증(판결)의 기재에 의하면 망 소외 2에 대하여는 요양급여로 1994. 4. 9.까지 금 8,826,930원이 지급된 이외에 치료비로 금 829,750원이 별도로 지출되었으며 그 이후로도 주당 금 22,347원의 치료비가 소요됨을 알 수 있으므로, 위 합계액으로부터 원심이 확정한 망인의 과실 비율 10% 상당액을 공제하더라도 위 요양급여액을 초과함이 분명할 뿐더러, 갑 제13호증(유족 및 장의비 사정서)의 기재와 기록에 나타난 망 소외 1의 수입과 가족 관계 기타의 사정에다가 보험급여로 지급되는 장의비는 산업재해보상보험법의 규정에 따라 평균임금 120일분을 기준으로 일률적으로 산정되는 것인 점 등을 감안하면 위 망인에 대하여 지급된 장의비는 그의 과실 비율 10%를 참작하더라도 과다한 금액이라고 할 수 없다고 할 것이므로, 결국 위 보험급여 전액에 대한 구상청구를 인용한 원심판결은 결과에 있어서 정당하고, 원심의 위와 같은 잘못은 판결에 아무런 영향을 미쳤다고 할 수 없으니, 이 점에 관한 논지도 이유 없음에 돌아간다.

3. 그러므로 상고를 기각하고, 상고비용은 패소자의 부담으로 하기로 하여 관여 법관의 일치된 의견으로 주문과 같이 판결한다.

대법관 안용득(재판장) 천경송 지창권 신성택(주심)

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