[Plaintiff, Appellant]
[Defendant, Appellee] Head of the Seoul Dongbu Regional Labor Office
[Judgment Below] Seoul High Court Decision 92Gu13105, decided October 8, 1992
[Order]
The judgment below is reversed, and the case is remanded to the Seoul High Court.
[Reasoning]
The grounds of appeal are examined.
(1) According to the reasoning of the judgment below, the court below noted that Article 3 of the Act on Industrial Accident Compensation Insurance Affairs and Examination (산업재해보상보험업무및심사에관한법률) provides that a person who has an objection to insurance benefits under the Industrial Accident Compensation Insurance Act (산업재해보상보험법) may request an examination from the Industrial Accident Compensation Insurance Examiner, and a person who has an objection to the decision thereon may request a re-examination from the Industrial Accident Compensation Insurance Examination Committee, and a person who has an objection to the ruling thereon may file an administrative litigation (Paragraph 1); and that the request for examination under Paragraph 1 is governed by Article 18 of the Administrative Appeals Act (행정심판법), while a request for re-examination may be filed within 60 days from the date on which the person became aware of the decision on the request for examination (Paragraph 2). In light of these provisions, the court below premised that where a person who has received a decision on insurance benefits from the head of a local labor office fails to pursue remedies such as a request for examination within the prescribed period, or, even having pursued remedies such as requests for examination and re-examination, fails to file an administrative litigation within the prescribed period, the decision on insurance benefits becomes final, and the party can no longer dispute the insurance benefit relationship based on the same grounds. On this premise, with respect to the plaintiff's action in this case seeking revocation of the disposition of November 28, 1991 disapproving re-treatment, the court below dismissed the action as unlawful, reasoning that since the plaintiff had requested examination and re-examination of the prior disposition of November 27, 1989 revoking approval of re-treatment, received a decision of dismissal, and failed to file an administrative litigation, the disposition revoking approval of re-treatment—to the effect that the plaintiff had no right to claim re-treatment benefits—had become final, and therefore the plaintiff could no longer dispute the re-treatment benefit relationship based on the same grounds.
(2) The Industrial Accident Compensation Insurance Act provides only that the right to receive insurance benefits shall be extinguished by prescription if not exercised within three years, and contains no other provision restricting the exercise of that right. The Act on Industrial Accident Compensation Insurance Affairs and Examination was enacted for the purpose of ensuring fairness in insurance benefits by providing for matters concerning the examination of objections to insurance benefits under the Industrial Accident Compensation Insurance Act. This Act merely provides special rules, different from the Administrative Appeals Act applicable to general administrative dispositions, regarding the period and procedure for objection and the examination (re-examination) authorities that a person who has an objection to a decision on insurance benefits must go through; it contains no special provision, different from the Administrative Appeals Act, concerning the effect of a disposition relating to insurance benefits or of an examination (re-examination) decision on such disposition. Accordingly, there is no indication that a disposition relating to industrial accident compensation insurance benefits, or an examination (re-examination) decision thereon, which has become final due to the expiration of the period for objection, has any special finality different from that which attaches when a general administrative disposition or an administrative appeal ruling becomes final.
(3) However, in general, when an administrative disposition or an administrative appeal ruling becomes final due to the expiration of the period for objection, such finality merely means that the person whose legal interests were infringed by the disposition can no longer dispute the effect of the disposition or ruling; it does not go so far as to grant res judicata effect as in the case of a judgment, such that the factual relationship or legal determination underlying the disposition becomes fixed and the parties or the court are bound thereby and precluded from making contradictory assertions or determinations.
(4) Therefore, even if the prior disposition revoking approval of industrial accident treatment benefits became final due to the expiration of the period for objection, this does not mean that the legal relationship to the effect that there is no right to claim treatment benefits has thereby become fixed. The plaintiff may, so long as the claim is not barred by extinctive prescription, again request treatment benefits, and if such request is refused, this constitutes a new refusal disposition, the illegality of which may be challenged in litigation. Nevertheless, the court below denied this and dismissed the action, and such judgment below contains an error of misapprehending the legal principles concerning the Industrial Accident Compensation Insurance Act or the Act on Industrial Accident Compensation Insurance Affairs and Examination, and the legal principles concerning the effect of a final general administrative disposition or administrative appeal ruling, and it is clear that this error affected the judgment. The argument is well-founded.
(5) Accordingly, the judgment below is reversed, and the case is remanded to the court below. This judgment is rendered by the unanimous opinion of the participating Justices, as stated in the Order.
Justice Choi Jae-ho (Presiding Justice), Bae Man-un, Kim Seok-su (Justice in charge), Choi Jong-yeong