[Plaintiff, Appellant] Republic of Korea
[Defendant, Appellee] Defendant 1 and 3 others
[Judgment Below] Seoul High Court, Judgment of July 22, 1976, Case No. 76Na1643
[Order]
The part of the judgment below against the Plaintiff is reversed, and the case is remanded to the Seoul High Court.
[Reasoning]
The Plaintiff's litigation representative's grounds of appeal are examined.
According to the reasoning of the judgment below, the court below found the following facts: the deceased Non-party, who worked as the chief of the ○○ factory of Korea Hwaseong Industrial Co., Ltd., a business establishment under the jurisdiction of the Masan Office of the Labor Office (노동청) under the Plaintiff, died on August 22, 1969 in an airplane crash while aboard an aircraft owned by non-party Segi Aviation Co., Ltd.; that the Defendants, as the bereaved family of the said deceased Non-party, filed a damages claim lawsuit against the said non-party aviation company, and on January 15, 1970 entered into a court settlement (법정화해) under which they were to receive KRW 3,011,788, and did in fact receive that amount; that thereafter, when the Defendants filed a claim with the Masan Office of the Labor Office under the Plaintiff for industrial accident compensation insurance benefits under the Industrial Accident Compensation Insurance Act (산업재해보상보험법) for the said accident, they falsely reported that they had received only KRW 2,511,788 from the aviation company, an amount KRW 500,000 less than what they had actually received; and that as a result, on April 29, 1970, out of the KRW 6,126,454 recognized by the Masan Office of the Labor Office as the industrial accident compensation insurance benefit for the said deceased, the Defendants received KRW 3,614,666, being the amount remaining after deducting the KRW 2,511,788 reported as the amount received as the court settlement money.
The Plaintiff argued as follows: although the Defendants had obtained a favorable judgment of KRW 16,034,272 in the damages claim lawsuit against the said non-party aviation company, they entered into a court settlement for KRW 3,011,788 as described above, thereby waiving their right to claim the remainder of the damages for which they had prevailed; since this made it impossible for the Plaintiff to exercise subrogation of the right to claim damages against the third party, the Defendants' right to claim industrial accident insurance benefits corresponding to the waived portion exceeding the settlement amount should likewise be deemed extinguished as a matter of course; therefore, the Defendants' receipt of industrial accident insurance benefits in excess of the settlement amount constituted unjust enrichment without legal cause, and the Plaintiff sought its return.
As to this argument, the court below held as follows and rejected the Plaintiff's argument: under the Industrial Accident Compensation Insurance Act, when an insured accident occurs, the State is subrogated, within the limit of the amount of the benefit paid, to the beneficiary's right to claim damages against a third party, and if the beneficiary receives damages from the third party for the same cause, the State is exempted from its obligation to pay the insurance benefit within the limit of the amount of such damages. In a case such as the present, where the beneficiary entered into a court settlement with the said non-party aviation company and waived the remainder of the right to claim damages, the portion of the damages claim exceeding the court settlement amount, which the State would have subrogated, is indeed extinguished; however, this does not mean that the scope of the Defendants', as beneficiaries', right to claim industrial accident insurance benefits against the State is thereby necessarily reduced to the amount of the court settlement. The Defendants still retain the right to receive the remainder of the industrial accident insurance benefit after deducting the amount received as the court settlement money.
Upon examination: where a beneficiary of compensation insurance benefits under the Industrial Accident Compensation Insurance Act suffers an injury due to a tortious act of a third party, the right to claim damages held against that third party is an ordinary tort claim, and the fact that insurance under the Industrial Accident Compensation Insurance Act has been taken out with respect to the accident does not affect the nature of the said right to claim damages. Accordingly, in general, in light of the principle of private autonomy, the beneficiary may release the third party from all or part of the damages obligation owed to the beneficiary. (Article 16(2) of the said Act provides that the right to receive insurance benefits may not be assigned or seized; however, considering this together with Article 9(2) of the said Act, which provides that insurance benefits are paid upon the beneficiary's claim, although the right to receive insurance benefits may not be assigned or seized, this cannot be interpreted to mean that the right to receive insurance benefits itself must necessarily be exercised by the beneficiary personally. Furthermore, although Article 15(1) of the said Act provides for the Director of the Labor Office's subrogation of the beneficiary's right to claim damages against a third party, this cannot be interpreted to mean that, prior to the exercise of such subrogation, the beneficiary's aforementioned right to release the obligation is restricted. Therefore, it cannot be said that Articles 16(2) and 15(1) of the said Act restrict the beneficiary's right to release the third party from all or part of the damages obligation owed to the beneficiary.)
The industrial accident compensation insurance system has as its purpose the compensation, upon claim, of the injury suffered by the beneficiary (Articles 1 and 9(2) of the said Act). Article 15(2) of the said Act provides that where the beneficiary receives damages from a third party for the same cause, the Director of the Labor Office (the State) shall not pay insurance benefits to the extent of the amount of such damages received by the beneficiary. Where the beneficiary's right to claim insurance benefits arises due to an injury caused by the act of a third party, the beneficiary's right to claim insurance benefits stands in a mutually complementary relationship with the beneficiary's right to claim damages against the third party, such that the amount of insurance benefits received by the beneficiary must be deducted from the amount of damages claimed against the tortfeasor third party (see Supreme Court Judgment of July 16, 1974, Case No. 74Da565). Moreover, in light of the purport of Article 15(2) of the said Act—that the Director of the Labor Office shall not pay insurance benefits to the extent that the beneficiary receives damages from a third party for the same cause—it follows a fortiori that where the beneficiary has released the third party from all or part of the damages that the beneficiary would otherwise be entitled to receive, the Director of the Labor Office likewise shall not pay insurance benefits to the extent of such release. Considering these points comprehensively, before the Director of the Labor Office subrogates the right to claim damages against the third party pursuant to Article 15(1) of the said Act, the beneficiary may personally release the third party from all or part of the damages obligation owed to the beneficiary, and where the beneficiary has thereby lost the right to claim damages to the extent of such release, then, absent special circumstances such that the release cannot be recognized as such, the beneficiary must be deemed to have lost the right to claim industrial accident insurance benefits to the extent of such release. Accordingly, it is reasonable to interpret that the Director of the Labor Office (the State) is exempted from the obligation to pay insurance benefits to the beneficiary to the extent of the portion so released.
To be sure, if interpreted in this manner, there is a concern that a beneficiary's careless or insincere settlement, etc., could result in the loss of the right to receive insurance benefits, contrary to the purpose of the industrial accident insurance system, which is to provide prompt and fair compensation to beneficiaries. However, as explained above, this conclusion is unavoidable in light of the interpretation of the provisions of the Industrial Accident Compensation Insurance Act and the principle of private autonomy. Such potentially undesirable results can be prevented or minimized as far as possible by raising beneficiaries' awareness of the industrial accident insurance system, promptly paying insurance benefits, and carefully examining whether a release of the damages obligation reflects the beneficiary's genuine intent, in particular whether it was made due to mistake, fraud, or duress.
Given this, in the present case, as found by the court below, the Defendants, as beneficiaries, made no argument or presented no evidence disputing the validity of the released portion in the settlement made with the tortfeasor third party, the non-party aviation company; and in particular, since the release was made through a court settlement, and the Defendants cannot make an argument that would contravene the res judicata effect of that settlement, the Defendants' release, as beneficiaries, must be deemed to reflect their genuine intent, as explained above. Accordingly, with respect to the portion so released, the right to claim industrial accident insurance benefits against the Director of the Labor Office must be deemed to have been lost. Nevertheless, the court below held that the Defendants, as beneficiaries, still retained the authority to claim insurance benefits even with respect to the portion of the damages amount released in the court settlement. This determination reflects a misunderstanding of the legal principles concerning claims for insurance benefits under the Industrial Accident Compensation Insurance Act, and this error affected the outcome of the judgment. Accordingly, the argument on this point—that the right to claim insurance benefits was lost—is well-founded, and the part of the judgment below against the Plaintiff cannot avoid reversal.
Therefore, the part of the judgment below against the Plaintiff is reversed, and this part of the case is remanded to the Seoul High Court for further hearing and determination. This judgment is rendered by the unanimous opinion of all participating Justices as stated in the Order, except for the dissenting opinion of Justices Kim Yeong-se, Min Mun-gi, Im Hang-jun, Lee Il-gyu, Kang An-hui, Kim Yong-cheol, and Jeong Tae-won set forth below.
The dissenting opinion of Justices Kim Yeong-se, Min Mun-gi, Im Hang-jun, Lee Il-gyu, Kang An-hui, Kim Yong-cheol, and Jeong Tae-won is as follows.
The industrial accident compensation insurance system has as its purpose the protection of workers (Article 1 of the Act), and provides that insurance benefits shall be paid to a worker or the worker's bereaved family when a worker prescribed by the Act suffers injury or death in the course of employment (Article 9 of the Act). The financial resources for the insurance program are not collected from workers, but are funded by the compulsorily insured business owners and the National Treasury (Article 2-2 of the Act). Furthermore, in order to protect workers' rights to receive insurance benefits, the Act provides that the right to receive insurance benefits may not be assigned or seized (Article 16(2) of the Act), and that no taxes or other public charges may be imposed on insurance benefits (Article 17 of the Act). It can thus be seen that the overall spirit of the provisions of the Industrial Accident Compensation Insurance Act is directed toward thoroughgoing protection of workers. Under such a system, a worker's right to receive insurance benefits may be lost or extinguished only in cases expressly provided by the Act, such as where the statute of limitations prescribed by the Act has run (Article 30 of the Act), or where the worker has already received damages from a third party for injury caused by the third party's tortious act (Article 15(2) of the Act). It is self-evident that, absent an express statutory provision, a worker's right to receive insurance benefits cannot be forfeited. Just as it is a clear legal principle that even ordinary private rights cannot be restricted or forfeited without an express statutory provision, it is all the more improper, without such an express provision, to lightly declare forfeited the right to receive insurance benefits under this special statute, which is intended to confer a unilateral benefit upon workers for social policy purposes; such a determination cannot but be regarded as a departure from the law. The majority opinion, citing Articles 15(1) and (2) of the Act, appears to take the position that because the Defendants in this case waived their right to receive damages from non-party Segi Aviation Co., Ltd., thereby preventing the Director of the Labor Office under the Plaintiff from exercising subrogation of the Defendants' right to claim damages against the said aviation company, the right to claim insurance benefits was accordingly lost. However, no provision of the Act states that insurance benefits shall not be paid where a beneficiary releases or waives the right to claim damages against a tortfeasor third party; Article 15(2) merely provides that where the beneficiary has received damages from a third party, insurance benefits shall not be paid to that extent. It thus appears that the majority opinion has reached its conclusion by analogical interpretation of this provision. However, there is no legal principle by which another person's right may be forfeited through analogical interpretation of a statute; and even assuming such a principle existed, the said provision merely provides that where damages have already been paid to the worker by the tortfeasor third party, insurance benefits shall not be doubly paid; it cannot be said to follow, by such an extravagant analogical interpretation, that even where the worker has not received damages from the third party, if the worker has merely waived the right to claim such damages, the right to claim insurance benefits is thereby extinguished, for the following reasons. That is, under the industrial accident compensation insurance system, even where a worker's injury or death is caused by the tortious act of a third party, insurance benefits are not paid using the damages received by the Director of the Labor Office through the exercise of the subrogation right under Article 15(1) of the Act; rather, it is clear from the provisions of the Act that insurance benefits are to be paid regardless of whether damages are received through the exercise of such subrogation right. This being so, there is no legal connection whatsoever between the Director of the Labor Office's obligation to pay insurance benefits and the subrogation right under Article 15(1) of the Act. On what legal basis, then, can it be said that the worker's right to receive insurance benefits is forfeited by an act on the worker's part that causes the Director of the Labor Office to lose the subrogation right? This is nothing more than a retaliatory line of reasoning without any basis in law—namely, that because the worker caused the Director of the Labor Office to lose a right, the Director of the Labor Office should likewise cause the worker to lose some other right. If one were to remain faithful to the law, it might rather be a separate question whether the worker bears an obligation to compensate the Director of the Labor Office for the loss of the subrogation right caused by the worker's act; but even if the worker bears such an obligation to compensate the Director of the Labor Office, there can be no legal principle by which the worker's right to receive insurance benefits under the Industrial Accident Compensation Insurance Act is thereby forfeited.
In the end, the majority opinion, through an analogical interpretation contrary to legal principle, has erroneously reversed the lawful judgment below on the ground that it is unlawful.
Justices Min Bok-gi (Presiding Justice), Lee Yeong-seop, Ju Jae-hwang, Kim Yeong-se, Min Mun-gi, Yang Byeong-ho, Han Hwan-jin, Im Hang-jun, An Byeong-su, Kim Yun-haeng, Lee Il-gyu, Kang An-hui, Ra Gil-jo, Kim Yong-cheol, Yu Tae-heung, Jeong Tae-won