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대법원 2005다39884

Damages (Automobile Accident) Case손해배상(자)

Decided2005. 11. 10. Court대법원Case reversed and remanded to the High Court (plaintiff's position upheld on appeal)
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 concerns a commercial auto insurance policy (업무용 자동차보험) clause stating that for workers covered by industrial accident insurance (산재보험), the insurer would not compensate for damages exceeding the industrial accident insurance coverage limits. The Supreme Court ruled this clause invalid, finding it unfairly disadvantageous to policyholders and contrary to the fundamental purpose of insurance, thus void under the Act on the Regulation of Terms and Conditions (약관규제법). The Court overturned the lower court's ruling against the plaintiff and remanded the case to the High Court.

Key takeaways
  • CaseA worker injured in a work-related auto accident sought damages exceeding what industrial accident insurance covered, but the auto insurer refused based on a policy exemption clause.
  • OutcomeThe Supreme Court ruled the exemption clause invalid, holding that insurers cannot avoid liability for damages beyond industrial accident insurance coverage.
  • LessonInsurance clauses that unfairly limit coverage beyond statutory industrial accident benefits may be struck down as void, protecting policyholders' rights to full compensation.
Issues
  • Validity of the exemption clause in commercial auto insurance terms related to industrial accident insurance (산재보험)
  • Whether an auto insurer can be exempted from liability for damages that exceed the coverage scope of industrial accident insurance
Key reasoning

A clause that exempts the insurer from liability for damages exceeding the industrial accident insurance coverage limit is unfairly disadvantageous to the insured party. Such a clause improperly shifts risk that should be borne by the insurer onto the customer, violating the Act on the Regulation of Terms and Conditions (약관규제법). This type of exemption clause also contradicts the essential purpose of automobile insurance, which is to guarantee compensation for liability arising from accidents. Because the clause undermines the core function of insurance coverage, it cannot be given legal effect.

Full text (English, AI translation) 9,883 chars

[Plaintiff, Appellant] Park Gil-seon (Attorney Kim Jae-kyung, counsel for the plaintiff)
[Defendant, Appellee] Ssangyong Fire & Marine Insurance Co., Ltd. (Attorney Hyun Jong-chan, counsel for the defendant)
[Judgment Below] Seoul High Court Decision 2004Na15302 rendered on June 15, 2005

[Order]

The part of the judgment below against the Plaintiff is reversed, and this part of the case is remanded to the Seoul High Court.

[Reasoning]

1. Judgment of the court below

Based on the evidence it adopted, the court below found the following facts: Park Yong-seop, who operates a building ventilation facility installation business with one or more regular employees under the trade name "Hwasin Engineering," entered into a comprehensive business automobile insurance contract with the Defendant regarding his Grace van with license plate number Seoul 6-Woo-4240 (hereinafter "the instant vehicle"); Article 11, Paragraph 2, Item 4 of the General Terms and Conditions of Business Automobile Insurance applicable to the above insurance contract provides that where a person injured in an accident during the operation of the insured vehicle is an employee of the insured who bears liability for damages and is eligible to receive industrial accident compensation, the Defendant is exempted from liability for the portion exceeding the scope covered by liability insurance; on June 1, 2001, at approximately 07:40, Eom Ki-yong, while driving the instant vehicle with the Plaintiff seated in the front passenger seat, was traveling along Lane 1 of a two-lane road (one lane each direction) located at Dongsin-ri, Angbo-myeon, Anseong-si, at the Anseong Public Sports Ground, heading from Jukssan toward Anseong, when he rear-ended a small cargo vehicle with license plate number Gyeonggi 93-Go-6279 traveling ahead in the same direction, thereby causing the Plaintiff to suffer injuries including a right tibial fracture and lacerations to the right lower leg; Park Yong-seop had subcontracted, for a contract price of 3,000,000 won, the factory ventilation facility installation portion of a construction project from DIO Co., Ltd., which had entered into a facility construction contract with MEMC Korea Co., Ltd. for a total contract amount of 62,700,000 won; and the Plaintiff, who, like Eom Ki-yong, was a worker temporarily employed by Park Yong-seop, was riding in the instant vehicle driven by Eom Ki-yong on the way to the construction site for the ventilation facility installation work when the instant accident occurred.

Based on these facts, the court below determined as follows: the instant accident occurred during the performance of duties for the business operated by Park Yong-seop and thus constitutes an industrial accident; the business operated by Park Yong-seop, having one or more regular employees, is a workplace naturally subject to the application of the former Industrial Accident Compensation Insurance Act (before amendment by Act No. 7049 of December 31, 2003; hereinafter "the Industrial Accident Insurance Act") pursuant to Article 5 thereof; although the ventilation facility installation work subcontracted to Park Yong-seop had a total contract amount of only 3,000,000 won and thus falls under a business excluded from application of the Industrial Accident Insurance Act under Article 3, Paragraph 1, Item 3 of the former Enforcement Decree of the Industrial Accident Compensation Insurance Act (before amendment by Presidential Decree No. 17977 of May 7, 2003), the original contractor, DIO Co., Ltd., had received the facility construction contract for a total contract price of 62,700,000 won from the ordering party, MEMC Korea Co., Ltd., and had subcontracted the ventilation facility installation portion thereof to Park Yong-seop; therefore, this constitutes a case where the business is performed through multiple levels of subcontracting as provided in Article 9, Paragraph 1 of the Industrial Accident Insurance Act, and thus the original contractor, DIO Co., Ltd., must be deemed the business owner of a business subject to the Industrial Accident Insurance Act; accordingly, the instant accident, which occurred while riding in the instant vehicle owned by Park Yong-seop and driven by Eom Ki-yong on the way to the ventilation facility installation construction site, constitutes an industrial accident occurring at a business at least subject to the industrial accident insurance in which DIO Co., Ltd. was enrolled; this falls under the case set forth in Article 11, Paragraph 2, Item 4 of the General Terms and Conditions of Business Automobile Insurance, whereby a person injured in an accident during the operation of the insured vehicle is an employee of the insured bearing liability for damages who is eligible to receive industrial accident compensation; and therefore, liability is exempted for the portion exceeding the scope covered by liability insurance.

2. Judgment of the Supreme Court

However, this determination by the court below is difficult to accept for the following reasons.

According to the record, Article 11, Paragraph 2, Item 4 of the General Terms and Conditions of Business Automobile Comprehensive Insurance applicable to the instant insurance contract provides: "Compensation shall not be provided for a person who is an employee of the insured bearing liability for compensation and who is eligible to receive disaster compensation under the Industrial Accident Insurance Act (compensation shall not be provided even where damages arise exceeding the scope of compensation under the said Act)." The purpose of the exemption clause in the Bodily Injury Liability Coverage II section of the Business Automobile Comprehensive Insurance Terms and Conditions, which states that "compensation shall not be provided for a person who is an employee of the insured bearing liability for compensation and who is eligible to receive disaster compensation under the Industrial Accident Insurance Act," should reasonably be interpreted as follows: since, for damages arising from industrial accidents occurring within the labor relationship between an employer and an employee, the Labor Standards Act (근로기준법), which governs labor relations, provides for various types of employer compensation liability, while the Industrial Accident Insurance Act establishes the industrial accident insurance system to guarantee such compensation liability, the purpose is to have damages suffered by an injured worker due to a work-related automobile accident subject to industrial accident insurance compensated through industrial accident insurance, and to exclude such damages, to the extent compensable through industrial accident insurance, from the scope of bodily injury liability coverage under automobile insurance, which is intended to cover liability for damages to third parties. However, if the insurer were exempted from liability under the exemption clause even where the damages suffered by an injured worker due to a work-related automobile accident exceed the scope of compensation under the Industrial Accident Insurance Act, this would mean that, notwithstanding the fact that the business owner, who is the insured under the automobile insurance, still bears liability for damages to the injured worker under the Automobile Compensation Guarantee Act (자동차손해배상보장법) or the Civil Act, etc., the insurer would be exempted from liability, effectively causing the insured to bear the liability for damages substantially by itself. This would run contrary to the purpose of automobile insurance, which is to cover the liability for damages that the insured bears toward a third party due to an accident involving the insured vehicle, and would be unfairly disadvantageous to the policyholder and the insured, who are the customers, under Article 6, Paragraphs 1 and 2, Item 1, and Article 7, Item 2 of the Act on the Regulation of Terms and Conditions (약관의 규제에 관한 법률), and would also constitute a transfer to the customer of risk that should be borne by the insurer, who is the business operator; therefore, the "portion in parentheses" of the exemption clause stating "compensation shall not be provided even where damages arise exceeding the scope of compensation under the Industrial Accident Insurance Act" is invalid pursuant to the respective provisions of the aforesaid Act (see Supreme Court en banc Decision 2003Da2802 rendered on March 17, 2005).

Nevertheless, the court below, premising that the parenthetical portion of the exemption clause under Article 11, Paragraph 2, Item 4 of the Business Automobile Comprehensive Insurance Terms and Conditions applicable to the instant insurance contract, stating that "compensation shall not be provided even where damages arise exceeding the scope of compensation under the Industrial Accident Insurance Act," is valid, determined that liability is exempted for the portion exceeding the scope covered by liability insurance, without conducting any examination whatsoever as to whether the Plaintiff suffered damages exceeding the scope of compensation under the Industrial Accident Insurance Act due to the instant accident. The judgment below thus contains an error of law in failing to exhaust the examination of the case due to a misunderstanding of the legal principles regarding the validity of the disaster compensation exemption clause in comprehensive automobile insurance, and it is clear that this error affected the outcome of the judgment.

3. Conclusion

Therefore, the part of the judgment below against the Plaintiff is reversed, and that part of the case is remanded to the court below for further hearing and determination, and it is so decided as set forth in the Order by the unanimous opinion of the participating Justices.

Presiding Justice Kim Young-ran
Justice Kang Shin-wook
Justice Ko Hyun-chul (Presiding Reporting Justice)

【참조조문】

약관의 규제에 관한 법률 제6조 제1항, 제2항 제1호, 제7조 제2호, 상법 제663조, 산업재해보상보험법 제5조

【참조판례】

대법원 2005. 3. 17. 선고 2003다2802 전원합의체 판결(공2005상, 586)

【주문】·【이유】 전문 3,490자 · 펼쳐 보기

【원고, 상고인】 박길선 (소송대리인 변호사 김재경)

【피고, 피상고인】 쌍용화재해상보험 주식회사 (소송대리인 변호사 현종찬)

【원심판결】 서울고법 2005. 6. 15. 선고 2004나15302 판결

【주 문】

원심판결 중 원고 패소 부분을 파기하고, 이 부분 사건을 서울고등법원에 환송한다.

【이 유】1. 원심의 판단

원심은 그 채용 증거에 의하여, ‘화신엔지니어링’이라는 상호로 상시근로자 수가 1인 이상인 건물환기시설 설치공사업체를 운영하는 박용섭은 그 소유인 서울6투4240호 그레이스 승합차(이하 ‘이 사건 자동차’라 한다)에 관하여 피고와 사이에 업무용 자동차종합보험계약을 체결하였는데, 위 보험계약에 적용되는 업무용 자동차보험보통약관 제11조 제2항 제4호는 피보험 자동차 운행중의 사고로 인하여 다친 사람이 손해배상책임을 부담하는 피보험자의 피용자로서 산재보상을 받을 수 있는 경우, 피고는 책임보험으로 보상되는 범위를 넘은 부분에 대하여는 보상책임을 면하는 것으로 규정하고 있는 사실, 엄기용은 2001. 6. 1. 07:40경 이 사건 자동차 조수석에 원고를 태우고 안성시 보개면 동신리 소재 안성공설운동장 편도 2차선 도로를 1차로를 따라 죽산 방면에서 안성 방면으로 진행하던 중, 전방에서 같은 방향으로 진행하고 있는 경기93고6279호 소형화물차량을 추돌하는 바람에 원고로 하여금 우측경골골절, 우측하지열상 등의 상해를 입게 한 사실, 박용섭은 엠이엠씨코리아 주식회사와 총공사금액 6,270만 원인 시설공사 도급계약을 체결한 디오이 주식회사로부터 그 시설공사 중 공사금액 300만 원인 공장 환기시설 설치공사를 하도급받았는데, 엄기용과 마찬가지로 박용섭에게 일시 고용된 근로자인 원고는 환기시설 설치공사 공사현장에 가기 위하여 엄기용이 운전하는 이 사건 자동차에 탑승하였다가 이 사건 사고를 당한 사실을 인정하였다.

원심은 이러한 사실에 기초하여, 이 사건 사고는 박용섭이 운영하는 업체의 업무 수행중 발생한 것으로서 업무상 재해에 해당하고, 박용섭이 운영하던 사업은 상시근로자 수가 1인 이상으로서 구 산업재해보상보험법(2003. 12. 31. 법률 제7049호로 개정되기 전의 것, 이하 ‘산재보험법’이라 한다) 제5조의 규정에 의하여 당연히 산재보험법의 적용을 받는 사업장에 해당할 뿐만 아니라, 박용섭이 하도급받은 환기시설 설치공사는 총공사금액이 300만 원에 불과하여 구 산업재해보상보험법 시행령(2003. 5. 7. 대통령령 제17977호로 개정되기 전의 것) 제3조 제1항 제3호 소정의 산재보험법 적용제외사업에 해당하나, 원수급인인 디오이 주식회사는 도급인인 엠이엠씨코리아 주식회사로부터 총공사대금 6,270만 원에 시설공사를 도급받아 그 중 환기시설 설치공사를 박용섭에게 하도급주었으므로, 산재보험법 제9조 제1항 소정의 사업이 수차의 도급에 의하여 행하여지는 경우에 해당하여 그 원수급인인 디오이 주식회사를 산재보험법의 적용을 받는 사업의 사업주로 보아야 하고, 따라서 환기시설 설치공사 현장에 가기 위하여 엄기용이 운전하는 박용섭 소유의 이 사건 자동차를 타고 가다가 발생한 이 사건 사고는 적어도 디오이 주식회사가 가입한 산재보험의 적용 사업장에서 발생한 업무상 재해로서, 업무용 자동차보험보통약관 제11조 제2항 제4호에서 규정하고 있는 피보험 자동차 운행중의 사고로 인하여 다친 사람이 손해배상책임을 부담하는 피보험자의 피용자로서 산재보상을 받을 수 있는 경우에 해당하여, 책임보험으로 보상되는 범위를 넘은 부분에 대하여는 보상책임을 면하는 것으로 보아야 한다고 판단하였다.

2. 대법원의 판단

그러나 이러한 원심의 판단은 다음과 같은 이유로 수긍하기 어렵다.

기록에 의하면, 이 사건 보험계약에 적용되는 업무용 자동차종합보험 보통약관 제11조 제2항 제4호는 “배상책임의무가 있는 피보험자의 피용자로서 산재보험법에 의한 재해보상을 받을 수 있는 사람에 대하여는 보상하지 아니한다(동법에 의한 보상범위를 넘어서는 손해가 발생한 경우에도 보상하지 아니한다).”고 규정하고 있는바, 업무용 자동차종합보험약관 중 대인배상 Ⅱ에서 “배상책임 있는 피보험자의 피용자로서 산재보험법에 의한 재해보상을 받을 수 있는 사람에 대하여는 보상하지 아니한다.”는 면책조항을 규정한 취지는, 사용자와 근로자의 노사관계에서 발생한 업무상 재해로 인한 손해에 대하여는 노사관계를 규율하는 근로기준법에서 사용자의 각종 보상책임을 규정하는 한편, 이러한 보상책임을 담보하기 위하여 산재보험법으로 산재보험제도를 설정하고 있으므로, 산재보험 대상인 업무상 자동차사고에 의한 피해 근로자의 손해에 대하여도 산재보험에 의하여 전보받도록 하고, 이처럼 산재보험에 의한 전보가 가능한 범위에서는 제3자에 대한 배상책임을 전보하는 것을 목적으로 하는 자동차보험의 대인배상 범위에서 이를 제외하려는 데 있는 것으로 해석함이 상당하며, 그렇지 아니하고 업무상 자동차사고에 의한 피해 근로자의 손해가 산재보험법에 의한 보상범위를 넘어서는 경우에도 면책조항에 의하여 보험자가 면책된다고 한다면 자동차보험의 피보험자인 사업주의 피해 근로자에 대한 자동차손해배상보장법 또는 민법 등에 의한 손해배상책임이 남아 있음에도 불구하고 보험자의 면책을 인정하여 피보험자에게 실질적으로 손해배상책임을 부담하게 하는 것이 되는바, 이는 피보험자동차의 사고로 인하여 피보험자가 타인에 대하여 부담하는 손해배상책임을 담보하기 위한 자동차보험의 취지에 어긋나는 것으로서, 약관의 규제에 관한 법률 제6조 제1항, 제2항 제1호 및 제7조 제2호 소정의, 고객인 보험계약자 및 피보험자에게 부당하게 불리할 뿐만 아니라, 사업자인 보험자가 부담하여야 할 위험을 고객에게 이전시키는 것이 되므로, “산재보험법에 의한 보상범위를 넘어서는 손해가 발생한 경우에도 보상하지 아니한다.”는 면책조항의 ‘괄호 안 기재 부분’은 위 같은 법률의 각 조항에 의하여 효력이 없다 ( 대법원 2005. 3. 17. 선고 2003다2802 전원합의체 판결 참조).

그럼에도 불구하고, 이 사건 보험계약에 적용되는 업무용 자동차종합보험약관 제11조 제2항 제4호의 면책조항 중 “산재보험법에 의한 보상범위를 넘어서는 손해가 발생한 경우에도 보상하지 아니한다.”는 취지의 괄호 안 기재 부분이 유효함을 전제로 하여, 이 사건 사고로 인하여 원고가 산재보험법에 의한 보상범위를 넘어서는 손해를 입었는지 여부에 관하여 전혀 심리하지 아니한 채, 책임보험으로 보상되는 범위를 넘은 부분에 대하여는 보상책임을 면한다고 판단한 원심판결에는, 자동차종합보험의 재해보상 면책약관의 효력 등에 관한 법리를 오해한 나머지 심리를 다하지 않은 위법이 있고, 이는 판결 결과에 영향을 미쳤음이 명백하다.

3. 결 론

그러므로 원심판결 중 원고 패소 부분을 파기하고, 그 부분 사건을 다시 심리·판단하게 하기 위하여 원심법원에 환송하기로 하여 관여 법관의 일치된 의견으로 주문과 같이 판결한다.

대법관 김영란(재판장) 강신욱 고현철(주심)

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87가합1670 · 인천지법 1988-07-14
Damages (Industrial Accident)
#4
2007나33803 · 서울중앙지방법원 2008-04-08
Damages (Other)
#5
94다40543 · 대법원 1994-12-27
Damages (Industrial Accident) Case

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Cross-check the original: 국가법령정보센터 (auxiliary link)