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대법원 2003다2802

Claim for Damages (Automobile Accident) (손해배상(자))손해배상(자)

Decided2005. 03. 17. Court대법원Reversed and remanded (파기환송) – the insurance company's exemption defense was rejected, ruling in favor of the claimant (bereaved family/worker's side)
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.

A worker died in an accident involving a company vehicle used for business purposes. The automobile insurance policy contained an exemption clause (면책약관) stating that the insurer would not cover any damages exceeding the compensation scope of industrial accident insurance (산재보험). The Supreme Court ruled that this portion of the exemption clause was invalid, establishing that automobile insurance must cover losses not compensated by industrial accident insurance.

Key takeaways
  • CaseA worker died in a business-related car accident, and the auto insurer refused to pay damages exceeding what industrial accident insurance covered, citing an exemption clause.
  • OutcomeThe Supreme Court held that the exemption clause excluding coverage for damages beyond industrial accident insurance limits was invalid as an unfair contract term.
  • LessonEmployers and insurers cannot use exemption clauses to shift the full burden of workplace accident damages onto the insured; automobile insurance must supplement gaps left by industrial accident insurance.
Issues
  • The scope and validity of exemption clauses (면책약관) in commercial automobile insurance policies
  • Whether automobile insurance can be exempted from covering damages exceeding the compensation limits of industrial accident insurance (산재보험)
  • The effect of unfair contract terms under the Act on the Regulation of Terms and Conditions (약관의규제에관한법률)
Key reasoning

If automobile insurance exempted the insurer from liability even for damages not covered by industrial accident insurance, the insured (employer) would end up bearing substantial actual liability for damages, which contradicts the very purpose of automobile insurance. Such a clause effectively shifts risk that should be borne by the insurer onto the customer (insured/policyholder). Under the Act on the Regulation of Terms and Conditions (약관의규제에관한법률), a clause that unfairly transfers the insurer's risk to the customer constitutes an unfair contract term and is therefore void. Consequently, the lower court's decision recognizing the insurer's exemption from liability could not stand.

Summary of Decision (English, AI translation)

[1] The purpose of the exemption clause in the Comprehensive Automobile Insurance for Business Use Policy (업무상 자동차종합보험약관), under Personal Liability Coverage II (대인배상 Ⅱ), which provides that "no compensation shall be paid to an employee of the insured who is liable for damages, if such employee is entitled to receive compensation for the injury under the Industrial Accident Compensation Insurance Act (산업재해보상보험법, hereinafter the 'Industrial Accident Compensation Insurance Act')," should be interpreted as follows: Since, with respect to damages arising from occupational accidents occurring in the labor relationship between an employer and an employee, the Labor Standards Act (근로기준법), which governs labor relations, provides for various compensation liabilities of the employer, and the Industrial Accident Compensation Insurance Act establishes the industrial accident compensation insurance system to secure such compensation liabilities, damages suffered by an injured employee due to an occupational automobile accident that falls within the scope of industrial accident insurance are to be compensated through industrial accident insurance; and to the extent that such compensation is available through industrial accident insurance, it is reasonable to interpret the clause as intending to exclude such damages from the scope of personal liability coverage under automobile insurance, which is designed to cover liability for damages owed to third parties. However, if the exemption clause were interpreted to exempt the insurer from liability even where the damages suffered by an injured employee due to an occupational automobile accident exceed the scope of compensation under the Industrial Accident Compensation Insurance Act, then, despite the fact that the business owner, who is the insured under the automobile insurance policy, still bears liability for damages toward the injured employee under the Automobile Damage Compensation Guarantee Act (자동차손해배상보장법) or the Civil Act (민법), recognizing the insurer's exemption in such a case would in effect impose the liability for damages on the insured. This result would contravene the purpose of automobile insurance, which is to cover the liability for damages that the insured owes to a third party arising from an accident involving the insured vehicle. Such an outcome would be unfairly disadvantageous to the policyholder and the insured, who are the customers, and would also shift risks that should be borne by the insurer, who is the business operator, onto the customer, in violation of Article 6, Paragraphs 1 and 2, Subparagraph 1, and Article 7, Subparagraph 2 of the Act on the Regulation of Terms and Conditions (약관의규제에관한법률). Therefore, the "parenthetical portion" of the exemption clause providing that "no compensation shall be paid even where damages exceed the scope of compensation under the Industrial Accident Compensation Insurance Act" is invalid pursuant to the respective provisions of the aforementioned Act.

[2] In a case where a person who had entered into a comprehensive automobile insurance contract for business use with an insurance company, and who operated a business with one regular employee at all times, was driving a vehicle for business purposes with a day laborer seated in the front passenger seat, and collided with the left rear portion of a large freight truck parked on the shoulder of an expressway, resulting in the deaths of both persons, the court held that the "parenthetical portion" of the exemption clause in the Comprehensive Automobile Insurance for Business Use Policy, which provides that "no compensation shall be paid even where damages exceed the scope of compensation under the Industrial Accident Compensation Insurance Act," is invalid, and accordingly reversed the judgment of the court below, which had recognized the insurer's exemption from liability.

Full text (English, AI translation) 8,865 chars

[Plaintiffs, Appellants] Plaintiff 1 and 6 others (Attorney Lee Bo-heon, Counsel for the plaintiffs)
[Defendant, Appellee] △△△ Insurance Co., Ltd. (Attorneys Jeong Gu-hun and 1 other, Counsel for the defendant)
[Judgment Below] Daejeon High Court Decision 2001Na8439 rendered on December 12, 2002

[Order]

The judgment below is reversed, and the case is remanded to the Daejeon High Court.

[Reasoning]

The grounds of appeal are examined.

1. Facts found and determination by the court below

A. The court below, based on the evidence adopted, found the following facts: Nonparty 1, who operated a gas alarm installation business under the trade name "○○ Industry" while regularly employing one full-time employee, entered into a commercial automobile comprehensive insurance contract with the Defendant on or about July 14, 2000, with respect to the cargo truck (registration number omitted) owned by him (hereinafter "the instant vehicle"). The commercial automobile comprehensive insurance policy terms and conditions applicable to said insurance contract provide, under Bodily Injury Liability Coverage II, that "no compensation shall be paid to an employee of the insured who is liable, where such employee is entitled to receive accident compensation under the Industrial Accident Compensation Insurance Act (산업재해보상보험법)" (Article 11, Paragraph 2, Item 4 of the General Terms and Conditions; hereinafter "the instant exemption clause"), and the parenthetical portion of the instant exemption clause provides that "compensation shall not be paid even where the damage exceeds the scope of compensation under the Industrial Accident Compensation Insurance Act" (hereinafter "the parenthetical provision"). It was further found that on August 29, 2000, Nonparty 1, in order to perform gas alarm installation work subcontracted from the Korea Tobacco & Ginseng Corporation, had Nonparty 2 and Nonparty 3 (hereinafter "Nonparty 2 et al."), whom he had employed as daily workers at a daily wage of 50,000 won, ride in the passenger seat beside the driver's seat of the instant vehicle, and was driving from Cheongju to the Korea Tobacco & Ginseng Corporation located in Sintanjin when, at around 10:25 on the same day, at a point 89.4 km from the Seoul starting point on the northbound Gyeongbu Expressway, the vehicle veered from the third lane onto the shoulder and collided with the rear left portion of a large cargo truck that happened to be parked on the shoulder due to expressway widening construction, resulting in the deaths of Nonparty 2 et al. along with Nonparty 1.

B. Based on these facts, the court below determined that the instant accident occurred while Nonparty 2 et al. were riding in the vehicle provided by Nonparty 1 on their way to the construction site to perform the construction work subcontracted to Nonparty 1, and therefore constituted an industrial accident; that since Nonparty 1's business had one or more regular employees, it fell under a workplace subject to the Industrial Accident Compensation Insurance Act (hereinafter "Industrial Accident Insurance Act," and the insurance thereunder is likewise referred to as "industrial accident insurance") pursuant to Article 5 thereof; and that, therefore, industrial accident insurance benefits are payable as a matter of law with respect to industrial accidents suffered by Nonparty 1's employees, regardless of whether Nonparty 1 actually enrolled in industrial accident insurance. Accordingly, the court below determined that the Defendant's obligation to pay insurance proceeds under Bodily Injury Liability Coverage II to the Plaintiffs, who are the parents and siblings of Nonparty 2 et al., was exempted pursuant to the instant exemption clause. The court below further determined that the instant exemption clause was intended to exclude, from the scope of bodily injury liability coverage of automobile insurance—whose purpose is to indemnify liability for damages owed to third parties—accident compensation arising in labor-management relations, which is ultimately to be indemnified through industrial accident insurance, and therefore does not violate Article 663 of the Commercial Act (상법) nor constitute a clause transferring to the customer a risk that the business operator should bear, as provided in Article 7, Item 2 of the Act on the Regulation of Terms and Conditions (약관의 규제에 관한 법률). The court below further determined that this legal reasoning does not change merely because the amount of damages caused by the automobile accident exceeds the scope of compensation under the Industrial Accident Insurance Act, and thus rejected the Plaintiffs' argument that the "parenthetical provision" of the instant exemption clause is invalid.

2. Judgment of this Court

A. The purport of the instant exemption clause in Bodily Injury Liability Coverage II of the commercial automobile comprehensive insurance terms, which provides that "no compensation shall be paid to an employee of the insured who is liable, where such employee is entitled to receive accident compensation under the Industrial Accident Insurance Act," should reasonably be construed as follows: With respect to damage arising from industrial accidents occurring in the labor-management relationship between an employer and an employee, the Labor Standards Act (근로기준법), which governs labor-management relations, provides for various compensation liabilities of the employer, while the Industrial Accident Insurance Act establishes the industrial accident insurance system to secure such compensation liabilities. Accordingly, the clause is intended to have damage suffered by an employee injured in a work-related automobile accident subject to industrial accident insurance be indemnified through industrial accident insurance, and to exclude, from the scope of bodily injury liability coverage of automobile insurance—whose purpose is to indemnify liability for damages owed to third parties—cases to the extent that indemnification through industrial accident insurance is possible. However, if it were held that the insurer is exempted from liability under the instant exemption clause even where the damage suffered by an employee injured in a work-related automobile accident exceeds the scope of compensation under the Industrial Accident Insurance Act, this would mean that, even though the insured business owner (as the insured under the automobile insurance) still bears liability for damages owed to the injured employee under the Act on Guarantee of Compensation for Loss Caused by Motor Vehicles (자동차손해배상보장법) or the Civil Act (민법), the insurer would nevertheless be exempted from liability, thereby effectively imposing the liability for damages on the insured. This runs counter to the purpose of automobile insurance, which is to indemnify the insured's liability for damages owed to third parties arising from an accident involving the insured vehicle, and constitutes a provision that is unfairly disadvantageous to the customer, i.e., the policyholder and the insured, and that transfers to the customer a risk that the business operator, i.e., the insurer, should bear, in violation of Article 6, Paragraphs 1 and 2, Item 1, and Article 7, Item 2 of the Act on the Regulation of Terms and Conditions.

Accordingly, the "parenthetical provision" of the instant exemption clause, which states that "compensation shall not be paid even where the damage exceeds the scope of compensation under the Industrial Accident Insurance Act," is invalid pursuant to the aforementioned provisions of that Act.

The Supreme Court Decisions 93Da23107 rendered on November 9, 1993, and 97Da4746 rendered on April 25, 1997, and other decisions to the contrary, are hereby modified to the extent that they conflict with the view expressed in this judgment.

B. In conclusion, the court below's determination that the "parenthetical provision" of the instant exemption clause is valid was erroneous, in that it misapprehended the legal principles concerning the validity of the accident compensation exemption clause in commercial automobile comprehensive insurance, thereby affecting the outcome of the judgment. The ground of appeal pointing this out is well-founded.

3. Conclusion

Accordingly, without examining the remaining grounds of appeal, the judgment below is reversed, and the case is remanded to the court below for further hearing and determination. This judgment is rendered by the unanimous opinion of the Justices participating in the decision, as set forth in the Order.

Chief Justice Choi Jong-yeong (Presiding Justice), Justice Yu Ji-dam, Justice Yoon Jae-sik, Justice Lee Yong-woo, Justice Bae Ki-won (Justice in charge), Justice Kang Shin-wook, Justice Lee Gyu-hong, Justice Lee Kang-guk, Justice Park Jae-yun, Justice Ko Hyun-chul, Justice Kim Yong-dam, Justice Kim Young-ran

【판결요지】

[1] 업무상 자동차종합보험약관 중 대인배상 Ⅱ에서 "배상책임 있는 피보험자의 피용자로서 산업재해보상보험법(이하 ‘산재보험법’이라 한다)에 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 전보 받도록 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, 약관의규제에관한법률 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.

[2] 보험회사와 사이에 업무용 자동차종합보험계약을 체결하고 상시 1명의 정규직원을 두고 사업을 하던 자가 업무를 위해 자동차 운전석 옆자리에 일용직 근로자를 탑승시켜 운행하다가 고속도로의 갓길에 주차되어 있던 대형화물차량의 좌측 뒷부분을 들이받음으로써 모두 사망한 경우, 업무상 자동차종합보험약관 중 "산업재해보상보험법에 의한 보상범위를 넘어서는 손해가 발생한 경우에도 보상하지 아니한다."는 면책약관의 ‘괄호 안 기재 부분’은 효력이 없다고 하여, 면책을 인정한 원심판결을 파기한 사례.

【참조조문】

[1] 약관의규제에관한법률 제6조 제1항, 제2항 제1호, 제7조 제2호, 상법 제663조, 산업재해보상보험법 제5조

[2] 약관의규제에관한법률 제6조 제1항, 제2항 제1호, 제7조 제2호, 상법 제663조, 산업재해보상보험법 제5조

【참조판례】

[1] 대법원 1993. 11. 9. 선고 93다23107 판결(공1994상, 76)(변경), 대법원 1997. 4. 25. 선고 97다4746 판결(변경)

【주문】·【이유】 전문 3,090자 · 펼쳐 보기

【원고, 상고인】 원고 1 외 6인 (소송대리인 변호사 이보헌)

【피고, 피상고인】 △△△보험 주식회사 (소송대리인 변호사 정구훈 외 1인)

【원심판결】 대전고법 2002. 12. 12. 선고 2001나8439 판결

【주 문】

원심판결을 파기하고, 사건을 대전고등법원에 환송한다.

【이 유】 상고이유를 본다.

1. 원심판결의 인정 사실과 판단

가. 원심은 채용 증거에 의하여, 상시 1명의 정규직원을 두고 ‘○○산업’이라는 상호로 가스경보기설치업을 운영하던 소외 1이 2000. 7. 14.경 그 소유인 (차량등록번호 생략) 화물차량(이하 ‘이 사건 자동차’라 한다)에 관하여 피고와 사이에 업무용 자동차종합보험계약을 체결하였는데, 위 보험계약에 적용되는 업무용 자동차종합보험계약약관 중 대인배상 Ⅱ에는 "배상책임 있는 피보험자의 피용자로서 산업재해보상보험법에 의한 재해보상을 받을 수 있는 사람에 대하여는 보상하지 아니한다."(보통약관 제11조 제2항 제4호, 이하 ‘이 사건 면책조항’이라 한다)고 규정되어 있고, 이 사건 면책조항의 괄호안에는 "산업재해보상보험법에 의한 보상범위를 넘어서는 손해가 발생한 경우에도 보상하지 않는다."(이하 ‘괄호 안 기재 부분’이라 한다)고 규정되어 있는 사실, 소외 1은 2000. 8. 29. 담배인삼공사로부터 도급받아 시행하던 가스경보기 설치작업을 하기 위하여 이 사건 자동차의 운전석 옆자리에, 일당 5만 원씩에 일용직 근로자로 고용한 소외 2와 소외 3(이하 ‘소외 2 등’이라 한다)을 탑승하게 하고 청주에서 신탄진 소재 담배인삼공사로 가던 중, 같은 날 10:25경 경부고속도로 상행선 서울기점 89.4㎞ 지점에 이르러 3차로에서 갓길로 접어드는 바람에 때마침 고속도로 확장공사를 위하여 도로의 갓길에 주차되어 있던 대형화물차량의 좌측 뒷부분을 들이받음으로써 소외 2 등과 함께 사망한 사실을 각 인정하였다.

나. 원심은 이러한 사실에 터잡아, 이 사건 사고는 소외 2 등이 소외 1이 도급받은 공사의 시행을 위하여 소외 1이 제공한 차량에 탑승하여 공사현장으로 가던 길에 발생한 것이므로 업무상 재해에 해당하며, 소외 1이 운영하던 사업은 상시근로자의 수가 1인 이상이어서 산업재해보상보험법(이하 ‘산재보험법’이라 하고, 이에 따라 위 법에 의한 보험도 ‘산재보험’이라 한다) 제5조의 규정에 의하여 위 법의 적용을 받는 사업장에 해당하므로, 소외 1의 피용자가 입은 업무상 재해에 대하여는 소외 1이 실제로 산재보험에 가입하였는지 여부와는 관계없이 법률상 당연히 산재보험금이 지급된다 할 것이어서, 소외 2 등의 부모형제들인 원고들에 대한 피고의 대인배상 Ⅱ에 의한 보험금지급의무는 이 사건 면책조항에 따라 면책된다고 판단하고, 나아가 이 사건 면책조항은 노사관계에서 발생하는 재해보상에 대하여는 궁극적으로 산재보험에 의하여 전보받도록 하고 제3자에 대한 손해배상책임을 전보하는 것을 목적으로 한 자동차보험의 대인배상범위에서는 이를 제외한 취지이어서 상법 제663조에 위반된다거나 약관의규제에관한법률 제7조 제2호에서 규정하고 있는 사업자가 부담하여야 할 위험을 고객에게 이전시키는 조항에도 해당되지 아니하고, 이와 같은 법리는 자동차사고로 인한 손해액이 산재보험법에 의한 보상범위를 넘어선다고 하여 달라질 것은 아니라고 판단하여 이 사건 면책약관의 ‘괄호 안 기재 부분’이 무효라는 원고들의 주장을 배척하였다.

2. 이 법원의 판단

가. 업무상 자동차종합보험약관 중 대인배상 II에서 "배상책임 있는 피보험자의 피용자로서 산재보험법에 의한 재해보상을 받을 수 있는 사람에 대하여는 보상하지 아니한다."는 이 사건 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 전보 받도록 하고, 이처럼 산재보험에 의한 전보가 가능한 범위에서는 제3자에 대한 배상책임을 전보하는 것을 목적으로 하는 자동차보험의 대인배상 범위에서 이를 제외하려는 데 있는 것으로 해석함이 상당하다. 그렇지 아니하고 업무상 자동차사고에 의한 피해 근로자의 손해가 산재보험법에 의한 보상범위를 넘어서는 경우에도 이 사건 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, 약관의규제에관한법률 제6조 제1항, 제2항 제1호 및 제7조 제2호 소정의, 고객인 보험계약자 및 피보험자에게 부당하게 불리할 뿐만 아니라, 사업자인 보험자가 부담하여야 할 위험을 고객에게 이전시키는 것이 된다.

따라서 "산재보험법에 의한 보상범위를 넘어서는 손해가 발생한 경우에도 보상하지 아니한다."는 이 사건 면책조항의 ‘괄호 안 기재 부분’은 위 같은 법률의 각 조항에 의하여 효력이 없다고 할 것이다.

이와 다른 취지의 대법원 1993. 11. 9. 선고 93다23107 판결 및 대법원 1997. 4. 25. 선고 97다4746 판결 등은 이 판결의 견해와 저촉되는 범위에서 이를 변경하기로 한다.

나. 결국, 이 사건 면책조항의 ‘괄호 안 기재 부분’이 유효하다고 본 원심의 판단에는 자동차종합보험의 재해보상 면책약관의 효력 등에 관한 법리를 오해함으로써 판결 결과에 영향을 미친 위법이 있다고 할 것이다. 이 점을 지적하는 상고이유의 주장은 이유 있다.

3. 결 론

그러므로 나머지 상고이유에 관한 판단을 생략한 채 원심판결을 파기하고, 사건을 다시 심리·판단하게 하기 위하여 원심법원에 환송하기로 하여 관여 대법관의 일치된 의견으로 주문과 같이 판결한다.

대법원장 최종영(재판장) 유지담 윤재식 이용우 배기원(주심) 강신욱 이규홍 이강국 박재윤 고현철 김용담 김영란

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