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대법원 88다카5041

Claim for Reimbursement (구상금)구상금

Decided1989. 04. 25. Court대법원Case reversed and remanded (파기환송) — the lower court's method of calculation was overturned in favor of allowing full reimbursement to the State
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 addresses how comparative negligence (과실상계) should be calculated when a worker who received industrial accident insurance benefits (산업재해 보험급여) files a damages claim against a third party. The Supreme Court ruled that comparative negligence must first be applied to the total damage amount, and only then should the insurance benefits be deducted — negligence offsetting cannot be applied a second time to the insurance benefit amount. As a result, the State (Korea Workers' Compensation & Welfare Service) is entitled to seek reimbursement from the third party for the full amount of insurance benefits paid.

Key takeaways
  • CaseA worker who received industrial accident insurance benefits also sought damages from a third party responsible for the accident, and a dispute arose over how to calculate the offset for the worker's own negligence.
  • OutcomeThe Supreme Court held that negligence offsetting must be applied to the total damages first, then insurance benefits deducted — meaning the State can recover the full insurance benefit amount from the third party.
  • LessonEmployers, insurers, and third parties involved in workplace accident disputes should apply comparative negligence to the total loss before deducting insurance payouts, as benefits themselves are not subject to a second round of negligence reduction.
Issues
  • The scope of the State's subrogation rights (구상권) against a third party under the Industrial Accident Compensation Insurance Act (산업재해보상보험법)
  • The correct order of operations between comparative negligence offsetting (과실상계) and deduction of insurance benefits when the victim shares some fault
Key reasoning

When calculating damages, the court must first apply comparative negligence offsetting (과실상계) to the total loss, and only afterward subtract the insurance benefits already paid to the worker. Applying comparative negligence a second time to the insurance benefit portion would improperly reduce the third party's liability, allowing the wrongdoer to unfairly escape part of their responsibility. Since the deducted insurance benefit amount is not itself subject to further negligence offsetting, the State's right of subrogation (구상권) against the third party extends to the entire insurance benefit amount paid, not a reduced portion.

Summary of Decision (English, AI translation)

When a victim who has received insurance benefits under the Industrial Accident Compensation Insurance Act (산업재해보상보험법) files a claim for damages against a third party, and the victim's own negligence has contributed to the occurrence of the damage, the amount of damages first calculated must be offset for comparative negligence, and thereafter the insurance benefits must be deducted therefrom; comparative negligence may not be applied again to the insurance benefits so deducted. Therefore, the scope of the State's right of indemnity against the third party under Article 15(1) of the Industrial Accident Compensation Insurance Act is the full amount of the insurance benefits paid.

Full text (English, AI translation) 3,874 chars

[Plaintiff, Appellant] Republic of Korea
[Defendant, Appellee] Samjo Transportation Co., Ltd., Attorney Kim In-gyu, Litigation Counsel
[Judgment Below] Daegu High Court Decision 87Na911 rendered on January 19, 1988

[Order]

The part of the judgment below concerning the Plaintiff's losing portion with respect to temporary disability benefits and disability benefits is reversed, and that part of the case is remanded to the Daegu High Court.
The Plaintiff's remaining appeal is dismissed.
The costs of the appeal with respect to the dismissed portion shall be borne by the Plaintiff.

[Reasoning]

We examine the grounds of appeal.

Where a victim who has received insurance benefits under the Industrial Accident Compensation Insurance Act (산업재해보상보험법) files a claim for damages against a third party, and the victim's own negligence is a concurrent cause of the occurrence of the damage, so that comparative negligence must be applied, the comparative negligence deduction must first be applied to the calculated amount of damages, and thereafter the insurance benefits must be deducted therefrom (see this Court's Decisions 80Da3277 rendered on June 9, 1981; 73Da337 rendered on October 23, 1973, etc.), and comparative negligence may not be applied a second time to the insurance benefits that are so deducted. Therefore, the scope of the State's right of indemnity against the third party under Article 15(1) of the Industrial Accident Compensation Insurance Act shall also be the full amount of the insurance benefits paid. If this were not done, and it were held that the State could seek indemnity only for the amount remaining after applying comparative negligence a second time to the amount of the insurance benefits, this would bring about the unjust result that, with respect to the portion of the benefits corresponding to the victim's proportion of negligence, the third party would be relieved of liability for compensation at the expense of the State.

Nevertheless, the court below erred in judging that the Plaintiff could seek indemnity from the Defendant only for the amount obtained by applying comparative negligence a second time to the insurance benefits paid to the victim, after having applied comparative negligence to the victim's total amount of lost income damages. This constitutes a misunderstanding of the legal principles concerning the scope of the State's right of indemnity under Article 15(1) of the Industrial Accident Compensation Insurance Act, which affected the outcome of the judgment, and this falls under the grounds for reversal set forth in Article 12(2) of the Act on Special Cases Concerning Expedition of Legal Proceedings (소송촉진 등에 관한 특례법).

The argument pointing this out is also well-founded.

However, according to the judgment below, the court below made the error of, while treating the scope of the Plaintiff's right of indemnity as being based on the victim's claim against the Defendant for damages for lost income, nonetheless partially granting the Plaintiff's claim exercising the right of subrogation also with respect to medical care benefits, which constitute a different subject matter of litigation from the aforementioned claim; however, since the Defendant did not appeal against this point, the Plaintiff's appeal on this point is ultimately without merit.

Therefore, the part of the judgment below concerning the Plaintiff's losing portion with respect to temporary disability benefits and disability benefits is reversed, and that part of the case is remanded to the court below; the Plaintiff's remaining appeal is dismissed; and the costs of the appeal with respect to the dismissed portion shall be borne by the Plaintiff. It is so decided by the unanimous opinion of the participating Justices, as set forth in the Order.

Justice Ahn U-man (Presiding Justice), Kim Deok-ju, Yun Gwan, Bae Man-woon

【판결요지】

산업재해보상보험법에 따라 보험급여를 받은 피해자가 제3자에 대하여 손해배상청구를 하고 그 손해발생에 피해자의 과실이 경합된 때에는 먼저 산정된 손해액에다 과실상계를 한 후 거기에서 보험급여를 공제하여야 하고 그 공제되는 보험급여에 대하여는 다시 과실상계 할 수 없으므로 국가가 산업재해보상보험법 제15조 제1항에 의하여 제3자에게 구상하는 범위도 보험급여를 한 전액이다.

【참조조문】

산업재해보상보험법 제15조 제1항

【주문】·【이유】 전문 1,194자 · 펼쳐 보기

【원고, 상고인】 대한민국

【피고, 피상고인】 주식회사 삼조교통 소송대리인 변호사 김인규

【원심판결】 대구고등법원 1988.1.19. 선고 87나911 판결

【주 문】

원심판결 중 휴업급여와 장애급여에 관한 원고의 패소부분을 파기하고, 그 부분 사건을 대구고등법원에 환송한다.

원고의 나머지 상고를 기각한다.

상고가 기각된 부분의 상고비용은 원고의 부담으로 한다.

【이 유】 상고이유를 본다.

산업재해보상보험법에 따라 보험급여를 받은 피해자가 제3자에 대하여 손해배상청구를 하고 그 손해발생에 피해자의 과실이 경합되어 과실상계를 할 때에는 먼저 산정된 손해액에다 과실상계를 한 후 거기에서 보험급여를 공제하여야 하고(당원 1981.6.9. 선고 80다3277 판결; 1973.10.23. 선고 73다337 판결 등 참조) 그 공제되는 보험급여에 대하여는 다시 과실상계를 할 수 없다고 할 것이므로 국가가 산업재해보상보험법 제15조 제1항에 의하여 제3자에게 구상하는 범위도 보험급여를 한 전액이라고 할 것이다. 만일 그렇게 하지 아니하고 보험급여액에 대하여 다시 과실상계를 한 금액만을 구상할 수 있다고 한다면 그 급여 중 피해자의 과실비율에 상응하는 금액에 대하여는 국가의 손해아래 제3자가 그 배상책임을 면하는 부당한 결과를 가져오기 때문이다.

그런데도 원심이 피해자의 총일실손해금에다 과실상계를 한 후 피해자에게 지급한 보험급여에 대하여 다시 과실상계를 한 금액만을 원고가 피고에게 구상할 수 있다고 판단한 것은 산업재해보상보험법 제15조 제1항에 따른 국가의 구상범위에 관한 법리를 오해하여 판결결과에 영향을 미쳤다 하겠고 이는 소송촉진 등에 관한 특례법 제12조 제2항의 파기사유에 해당한다.

이 점을 지적하는 주장도 이유 있다.

다만 원심판결에 의하면, 원심은 원고의 구상범위를 피해자의 피고에 대한 일실수익손해배상청구로 하면서도 그와 소송물을 달리하는 요양급에 대하여도 대위권을 행사하는 원고의 청구를 일부 인용한 잘못이 있으나 이에 대하여는 피고의 불복이 없으므로 결국 이에 관한 원고의 상고는 이유 없다.

그러므로 원심판결 중 휴업급여와 장애급여에 관한 원고의 패소부분을 파기하여 그 부분 사건을 원심법원에 환송하고, 원고의 나머지 상고를 기각하며 상고기각부분에 대한 상고비용은 원고의 부담으로 하여 관여 법관의 일치된 의견으로 주문과 같이 판결한다.

대법관 안우만(재판장) 김덕주 윤관 배만운

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