[Plaintiff, Appellant] Daejin Taxi Co., Ltd., Litigation Representative Attorney Kim Dong-ho
[Defendant, Appellee] Republic of Korea
[Judgment Below] Busan District Court, Judgment rendered June 25, 1993, Case No. 93Na2954
[Order]
The judgment below is reversed, and the case is remanded to the Panel Division of the Busan District Court.
[Reasoning]
We examine the grounds of appeal.
1. The summary of the reasoning of the judgment below is as follows.
A. The Plaintiff's cause of action
(1) The deceased Nonparty 1 (hereinafter referred to as "the Deceased"), who was a taxi driver employed by the Plaintiff, entrusted the taxi for repair to ○○ Automobile Repair Workshop on December 17, 1988, and while drinking at a nearby location during the repair period, attempted to go to a restroom but mistakenly fell into an underground storage area and died. As the Plaintiff was a business subject to the Labor Standards Act (근로기준법) and was enrolled in insurance (hereinafter "industrial accident insurance") under the Industrial Accident Compensation Insurance Act (산업재해보상보험법, hereinafter "Industrial Accident Insurance Act"), the Deceased's wife, Nonparty 2, filed a claim for survivor benefits and funeral expenses with the Busan Bukbu Regional Labor Office, but the claim was rejected on the ground that the incident could not be recognized as an occupational accident.
(2) Accordingly, the Deceased's survivors filed a lawsuit against the Plaintiff seeking survivor compensation and funeral expenses under the Labor Standards Act. In this lawsuit, it was recognized that the Deceased died due to an occupational accident, and a judgment was rendered ordering payment of KRW 13,481,120. Accordingly, the Plaintiff paid KRW 15,000,000, including delay damages under the said judgment.
(3) Therefore, the Plaintiff seeks reimbursement from the Defendant of the amount equivalent to the above expenditure, on the ground that the Defendant bears the primary obligation to pay industrial accident insurance benefits to the survivors, and the Plaintiff extinguished the Defendant's obligation by fulfilling that obligation; alternatively, the Plaintiff seeks return of unjust enrichment in the same amount, on the ground that due to the Plaintiff's expenditure, the Defendant was relieved of its obligation to pay the above industrial accident insurance benefits to the Deceased's survivors and thereby obtained unjust enrichment in the equivalent amount; alternatively, the Plaintiff, as a party with an interest in performance, seeks payment of the above expended amount under the principle of subrogation by a person making payment, on the ground that the Plaintiff performed the Defendant's above obligation by subrogation; and alternatively, the Plaintiff seeks compensation for damages equivalent to the above expenditure suffered by the Plaintiff, on the ground that although the Deceased's death was due to an occupational accident, the Defendant breached its obligation under the industrial accident insurance contract with the Plaintiff by rejecting the claim for industrial accident insurance benefits on the ground that it was not an occupational accident.
B. The judgment of the court below
Benefits under the Industrial Accident Insurance Act have the nature of the State directly compensating the worker, in the position of an insurer, for damage arising from an occupational accident suffered by the worker, which the employer would otherwise be obligated to compensate under the Labor Standards Act; however, they do not have the nature of liability insurance covering the liability that the employer would bear for damage arising from such accident. Therefore, even if the Plaintiff paid accident compensation to the Deceased's survivors, it cannot be said that the Plaintiff thereby acquired by subrogation the survivors' right to claim insurance benefits against the Defendant, or that the Plaintiff acquired a right of reimbursement against the Defendant. Furthermore, even if, as a result of the Plaintiff, as employer, compensating for the damage based on civil liability for damages, the Defendant was relieved of its obligation to pay insurance benefits within the scope of that amount, the Plaintiff merely performed its own legal obligation and cannot be said to have suffered damage. Therefore, there is no room for the Plaintiff to seek return of unjust enrichment regarding the insurance benefits, or to claim damages, against the Defendant.
2. The accident compensation system under the Labor Standards Act has as its purpose to require the employer, who places the worker providing labor under its control and operates a business inherently carrying accident risk, to compensate for damage suffered by the worker due to the occurrence of an accident, regardless of fault (see this Court's en banc Decision 81Daka351, delivered October 13, 1981). However, it must also be understood as having the character of guaranteeing livelihood, in addition to compensating for damage from a worker's occupational accident. Thus, while the employer bears the obligation to provide accident compensation to the worker under the Labor Standards Act when the worker suffers an occupational accident, the Industrial Accident Insurance Act, enacted as Act No. 1438 on November 5, 1963, established the industrial accident insurance system in order to promptly and fairly compensate workers for occupational accidents (Article 1).
3. According to the provisions of Chapter 8 of the Labor Standards Act, accident compensation includes medical care compensation (Article 78), temporary disability compensation (Article 79), disability compensation (Article 80), survivor compensation (Article 82), and funeral expenses (Article 83). Article 87 of the same Act provides that where a person entitled to compensation receives, for the same cause, money or goods equivalent to the accident compensation under the same Act pursuant to the Civil Act (민법) or other statutes, the employer is relieved of liability for compensation to the extent of the value thereof. The Industrial Accident Insurance Act provides that the industrial accident insurance program is administered by the Minister of Labor (Article 2, Paragraph 1); that, except for businesses prescribed by Presidential Decree, the business owner automatically becomes an insured person (Article 6); that the Minister of Labor collects insurance premiums from insured persons (Article 19); and that the types of insurance benefits, originally corresponding to accident compensation under the Labor Standards Act, were medical care benefits, temporary disability benefits, disability benefits, survivor benefits, and funeral expense benefits, to which an injury and disease compensation pension was added upon amendment by Act No. 3631 on December 31, 1982 (Chapter 3). Except for the injury and disease compensation pension, benefits are to be paid, upon the claim of the person entitled to receive insurance benefits (hereinafter "beneficiary"), when a cause for accident compensation prescribed in Articles 78 through 80, 82, and 83 of the Labor Standards Act arises (Article 9). Article 11, Paragraphs 1, 2, and 3 of the same Act (Industrial Accident Insurance Act) provided that where a beneficiary receives insurance benefits under the same Act, the insured person (employer) is relieved of all accident compensation liability under the Labor Standards Act for the same cause, and is relieved of liability for damages under the Civil Act or other statutes to the extent of that amount; and that where a beneficiary receives, for the same cause, money or goods equivalent to insurance benefits under the same Act pursuant to the Civil Act or other statutes, insurance benefits shall not be paid to the extent of that amount. This was later amended by Act No. 4641 on December 27, 1993, changing the provision so that where a beneficiary has received or is entitled to receive insurance benefits under the same Act, the insured person is relieved of accident compensation liability for the same cause.
In light of the above various provisions, the industrial accident insurance system is not, in form, directly derived from the accident compensation system under the Labor Standards Act, but rather is a separate system coexisting on the common basis of the legal principle of an employer's compensation liability for a worker's occupational accident. Nevertheless, insurance benefits under the Industrial Accident Insurance Act have the nature of the State, in the position of an insurer, directly compensating the worker for damage from an occupational accident that the employer would otherwise be obligated to compensate under the Labor Standards Act; and while they do not have the nature of liability insurance regarding the civil liability for damages that the employer would bear due to the accident (see this Court's Decision 88Daka28204, delivered November 14, 1989), given that the causes and types of insurance benefits and the standards for calculating benefit amounts are identical or similar to those for accident compensation, and given that mutual adjustment provisions exist based on the functional identity of loss compensation, it is reasonable to view that, in addition to having the character of guaranteeing the worker's livelihood, industrial accident insurance also has the nature of liability insurance with respect to the employer's accident compensation under the Labor Standards Act, and performs that liability-insurance function as well.
4. Therefore, whether this is the case after the amendment of the above Industrial Accident Insurance Act is a separate matter to be discussed, but at least prior to that amendment, a worker who suffered an accident held both a right to claim accident compensation against the employer and a right to claim industrial accident insurance benefits against the State. Although industrial accident insurance has the character of liability insurance, and it is generally desirable for the claim for industrial accident insurance benefits to be given priority since industrial accident insurance is generally more advantageous to the worker than accident compensation, a worker cannot be prevented from choosing to claim accident compensation instead. Accordingly, the beneficiary may selectively exercise either claim, and the employer cannot be relieved of accident compensation liability unless it asserts and proves that the right to claim industrial accident insurance benefits has concretely arisen (see this Court's Decision 70Da2144, delivered November 24, 1970).
However, this position is to be understood as applying to the relationship between the accident-affected worker and the employer and the State; it does not necessarily follow that the same applies to the relationship between the employer and the State. In light of the relationship between accident compensation and industrial accident insurance discussed above, the nature of industrial accident insurance, the fact that the business owner is compelled to enroll in industrial accident insurance and pay premiums, and the fact that the pre-amendment Industrial Accident Insurance Act provided that where a beneficiary receives insurance benefits, the insured person (employer) is relieved of all accident compensation liability for the same cause, while on the other hand providing that insurance benefits shall not be paid only where the beneficiary has received, for the same cause, money or goods equivalent to insurance benefits under the Civil Act or other statutes, without any provision stating that insurance benefits shall not be paid where accident compensation has been paid, it must be interpreted, with respect to the relationship between the business owner and the State, that the State ultimately bears the compensation liability. Otherwise, this would deprive the business owner of the benefit of insurance, run contrary to the liability-insurance nature of industrial accident insurance with respect to accident compensation, and be inconsistent with the purpose for which the industrial accident insurance system was established, which cannot but be regarded as unreasonable.
Therefore, prior to the amendment of the above Industrial Accident Insurance Act, where industrial accident insurance benefits were provided before accident compensation, the employer is relieved of all accident compensation liability for the same cause, and the State naturally cannot seek reimbursement from the employer. However, where the worker first received accident compensation from the employer, the State has no obligation to pay insurance benefits to the worker within the scope of that amount, and it is reasonable to view that, where the requirements for industrial accident insurance benefits are satisfied, the business owner (employer) may seek reimbursement from the State within the scope of that amount.
6. Turning back to the present case, although the Deceased's wife first filed a claim for industrial accident insurance benefits, which was rejected by the Busan Bukbu Regional Labor Office, and she did not raise an objection to this but instead filed a claim for accident compensation against the Plaintiff, with the Plaintiff losing that lawsuit and paying accident compensation, the fact that an administrative disposition has become final and can no longer be disputed as to its effect does not mean that the factual relationship or legal determination underlying that disposition becomes conclusively fixed such that the parties or the court are bound thereby and cannot make contradictory assertions or determinations (see this Court's Decision 93Nu5437, delivered August 7, 1993). Therefore, the above circumstances cannot be said to constitute an obstacle to the Plaintiff seeking reimbursement from the Defendant.
7. According to Article 35 of the Enforcement Decree of the Industrial Accident Insurance Act (as amended by Presidential Decree No. 11960, August 27, 1986), where a business owner has paid in advance to a beneficiary, for the same cause as a cause for insurance benefits under the same Act, money or goods equivalent to insurance benefits pursuant to the Civil Act or other statutes, and such money or goods may be deemed to have been paid in advance on behalf of insurance benefits, the business owner, in order to receive the corresponding amount from the Minister of Labor, must apply to the Minister of Labor with documents proving that money or goods equivalent to insurance benefits were paid in advance for the same cause as a cause for insurance benefits. This provision is a special provision permitting such treatment in cases where payment may be deemed to have been made in advance on behalf of industrial accident insurance benefits, and it cannot be said that the employer's method of exercising the right of reimbursement is thereby limited.
8. The judgment below is erroneous in that it misunderstood the nature of accident compensation and industrial accident insurance as provided by the Labor Standards Act and the Industrial Accident Insurance Act; therefore, the argument pointing out this error is well-founded.
Accordingly, without examining the remaining grounds of appeal, the judgment below is reversed and the case is remanded, by the unanimous opinion of the participating Justices, as stated in the Order.
Justice Kim Seok-su (Presiding Justice), Bae Man-un (Justice in Charge), Kim Ju-han, Jeong Gui-ho