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대법원 2021다252472

Damages Claim (Motor Vehicle Accident) (손해배상(자))손해배상(자)

Decided2022. 04. 14. Court대법원Worker (bereaved family) won
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 involved the bereaved family of a worker who died in an industrial accident (산재) caused by a third party's wrongful act, seeking damages from the insurance company of the at-fault third party. The Supreme Court of Korea (대법원) ruled that damages must be calculated using the 'deduction-then-comparative-negligence' method (공제 후 과실상계), meaning industrial accident insurance benefits should first be deducted from the damages before applying comparative negligence offsets. The Court also confirmed that the Korea Workers' Compensation and Welfare Service's (근로복지공단) right of subrogation is limited to the portion of insurance benefits corresponding to the third party's share of liability.

Key takeaways
  • CaseA worker died in an industrial accident caused by a third party's negligence, and the bereaved family sought damages from the third party's insurer.
  • OutcomeThe Supreme Court ruled that insurance benefits must be deducted from damages before applying comparative negligence, and limited the Workers' Compensation Service's subrogation rights accordingly.
  • LessonWhen calculating damages involving industrial accident insurance benefits, always deduct the benefits first before applying any comparative negligence offset to protect the injured party's recovery.
Issues
  • The scope of the Workers' Compensation and Welfare Service's (근로복지공단) subrogated right to claim damages when industrial accident insurance benefits are paid
  • The proper method of applying comparative negligence (과실상계) when an injured worker or their family claims damages against a third party
  • How to apply the wage peak system (임금피크제) when calculating lost future income (일실수입)
  • Whether the wage peak system should be applied when calculating lost retirement pay (일실퇴직금)
Key reasoning

The Supreme Court held that the scope of the Workers' Compensation and Welfare Service's subrogated claim for damages is limited to the amount of insurance benefits that corresponds to the third party's proportional liability, not the full amount of benefits paid. In calculating the injured worker's (or their family's) damages claim against the third party, the court must first deduct the insurance benefits from the portion of damages that overlaps in nature with those benefits, and only then apply comparative negligence (과실상계) to the remaining amount. This 'deduction-then-comparative-negligence' approach ensures that the injured party is not unfairly disadvantaged by having comparative negligence applied before the insurance benefit deduction, which would otherwise reduce their recoverable damages more than necessary. The Court also addressed how the wage peak system (임금피크제) should be factored into calculating lost future income (일실수입) and lost retirement pay (일실퇕직금), clarifying the proper method of applying wage reductions under such a system to these calculations.

Full text (English, AI translation) 8,968 chars

[Plaintiffs, Appellees] Plaintiff 1 and 1 other (Attorneys of Law Firm Samhyeon, Seo Jung-seok and 1 other, of counsel)
[Defendant, Appellant] DB Insurance Co., Ltd. (Attorney Heo Geum-tak and 1 other, of counsel)
[Judgment Below] Seoul Central District Court Judgment 2021Na885, decided June 25, 2021

[Order]

All appeals are dismissed. The costs of the appeal shall be borne by the Defendant.

[Reasoning] The grounds of appeal (to the extent supplemented by the brief submitted after the deadline for submission of the grounds of appeal brief) are examined as follows.

1. As to Grounds of Appeal Nos. 1 and 2

The court below, taking into account the circumstances stated in its reasoning, determined the deceased Non-Party (hereinafter “the Deceased”)’s earned income of KRW 83,248,790, as reported to the competent authority for the year 2017, the year immediately preceding the accident in this case, as the basis for calculating lost income, and treated the amount obtained by dividing this by 12 months, i.e., KRW 6,937,399, as the average monthly wage. However, applying the wage peak system, the court below calculated the average monthly wage from the month following the Deceased’s attainment of age 55 until age 60, the retirement age, by successively reducing it by 5% each year, and thereafter, until age 65, calculated income based on the amount equivalent to the income of a regular employee with a university degree, i.e., KRW 4,014,000 per month, as indicated in the Report on the Survey of Working Conditions by Employment Type published by the Ministry of Employment and Labor. After deducting living expenses, the court below calculated the total lost income of the Deceased as KRW 938,487,302.

Examining this in light of the relevant legal principles and the record, the above determination by the court below does not, as argued in the grounds of appeal, exceed the limits of the principle of free evaluation of evidence in violation of the rules of logic and experience, nor did the court below fail to conduct necessary examination or misapprehend the legal principles concerning the scope of income serving as the basis for calculating lost income, thereby affecting the judgment.

2. As to Grounds of Appeal Nos. 3 and 4

The court below, as stated in its reasoning, did not accept the Defendant’s argument that the wage peak system should also be applied in calculating lost retirement benefits, on the grounds that the wage peak system presupposes that wages have reached their maximum amount, but at the time of the accident in this case, the Deceased was only 35 years and 4 months old, with a considerable period remaining until retirement age, such that applying the wage peak system to modify the average wage amount at the time of the accident would result in an unjustly reduced average wage amount for the Deceased. Accordingly, the court below calculated the Deceased’s lost retirement benefits based on the average wage amount at the time of the accident.

Examining this in light of the relevant legal principles and the record, this determination by the court below does not, as argued in the grounds of appeal, exceed the limits of the principle of free evaluation of evidence in violation of the rules of logic and experience, nor did the court below fail to conduct necessary examination or misapprehend the legal principles concerning lost retirement benefits and the wage peak system, thereby affecting the judgment.

3. As to Grounds of Appeal Nos. 5 and 6

A. Article 87(1) of the Industrial Accident Compensation Insurance Act (산업재해보상보험법, hereinafter “the Industrial Accident Insurance Act”) provides: “Where the Service has paid insurance benefits for an accident caused by the act of a third party, the Service shall be subrogated to the right to claim damages against the third party held by the person who received the benefits, within the limit of the amount of such benefits.” By its terms, this provision merely sets the limit of the right to claim damages that the Korea Workers’ Compensation and Welfare Service (hereinafter “the Service”) may subrogate, without specifically defining the scope of subrogation. Likewise, Article 87(2) of the same Act merely provides: “Where a beneficiary receives compensation for damages equivalent to insurance benefits from a third party for the same cause, the Service shall not pay insurance benefits under this Act within the limit of the amount converted from such compensation according to the method prescribed by Presidential Decree,” without specifically defining the scope of the amount for which the Service may withhold payment of insurance benefits. In particular, where the injured worker’s right to claim damages against the tortfeasor is limited due to comparative negligence or other causes, it is not clear, even under the above provisions, whether the insured employer’s liability for damages under the Civil Act (민법) and other laws is extinguished by the full amount of insurance benefits paid by the Service, and whether the Service may subrogate the injured worker’s right to claim damages for the full amount of insurance benefits, or withhold the corresponding insurance benefits.

The standard by which to calculate the scope of the tortfeasor’s liability for damages extinguished by the Service’s payment of insurance benefits under the above provisions, and the amount which the Service may subrogate or be relieved of future liability for within the limit of the insurance benefits paid, must be reasonably determined by the court, comprehensively considering the above provisions and other provisions of the Industrial Accident Insurance Act, the legislative purpose of the Industrial Accident Insurance Act, the legal nature and function of the industrial accident compensation insurance system, the nature of the right to receive insurance benefits, and the harmony with the legal order as a whole and considerations of equity.

Considering comprehensively the language and legislative intent of Article 87 of the Industrial Accident Insurance Act, the purpose and social security nature of the industrial accident compensation insurance system, and the balancing of interests among the injured worker (including bereaved family members and other beneficiaries of insurance benefits), the Service, and the tortfeasor, the scope within which the Service, having paid insurance benefits to an injured worker due to a tort committed by a third party, may subrogate the injured worker’s right to claim damages against the third party pursuant to Article 87(1) of the Industrial Accident Insurance Act is limited to the amount corresponding to the third party’s ratio of liability among the insurance benefits, subject to the limit of the third party’s amount of damages. Accordingly, the Service may not subrogate the amount corresponding to the injured worker’s ratio of negligence among the insurance benefits, and this amount must be regarded as ultimately borne by the Service for the benefit of the injured worker, who remains uncompensated for such loss even after the payment of insurance benefits. Under this approach, where an injured worker who has received insurance benefits under the Industrial Accident Insurance Act claims damages against a third party, and the injured worker’s own negligence has contributed to the occurrence of the damage, the amount of the injured worker’s claim for damages must be calculated by the “comparative negligence after deduction” method, whereby the insurance benefits are first deducted from the amount of damages of the same nature as the insurance benefits, and comparative negligence is then applied (see Supreme Court en banc Decision 2021Da241618, decided March 24, 2022).

B. The court below, on the premise that, due to the Plaintiffs’ incidental appeal, the portion of the first instance judgment in which the Plaintiffs lost also became subject to review by the court below, calculated the amount of passive damages as follows: pursuant to the “comparative negligence after deduction” method as stated in its reasoning, the court below deducted the total survivor benefits of KRW 187,295,340 received by the Plaintiffs from the Service from the amount equivalent to the Deceased’s lost income of KRW 938,487,302, and then limited the Defendant’s ratio of liability to 65%.

Examining this in light of the legal principles set forth above and the record, this determination by the court below does not, as argued in the grounds of appeal, violate the principle of party disposition or the principle of party presentation in a manner affecting the judgment.

4. Conclusion

Therefore, all appeals are dismissed, and the costs of the appeal are to be borne by the losing party. This Decision is rendered as set forth in the Order, with the unanimous consent of the participating Justices.

Justice Park Jung-hwa (Presiding Justice), Kim Seon-su, Noh Tae-ak (Justice in charge), Oh Kyung-mi

【참조조문】

산업재해보상보험법 제87조 제1항, 제2항

【참조판례】

대법원 2022. 3. 24. 선고 2021다241618 전원합의체 판결(공2022상, 753)

【주문】·【이유】 전문 3,077자 · 펼쳐 보기

【원고, 피상고인】 원고 1 외 1인 (소송대리인 법무법인 삼현 담당변호사 서중석 외 1인)

【피고, 상고인】 디비손해보험 주식회사 (소송대리인 변호사 허금탁 외 1인)

【원심판결】 서울중앙지법 2021. 6. 25. 선고 2021나885 판결

【주 문】

상고를 모두 기각한다. 상고비용은 피고가 부담한다.

【이 유】 상고이유(상고이유서 제출기간이 지난 다음 제출된 준비서면의 기재는 이를 보충하는 범위 내에서)를 판단한다.

1. 상고이유 제1, 2점에 대하여

원심은 그 판시와 같은 사정을 종합하여, 이 사건 사고 직전 해인 2017년을 기준으로 관할관청에 신고된 망 소외인(이하 ‘망인’이라 한다)의 근로소득 83,248,790원을 일실수입 산정의 기초로 하여 이를 12개월로 나눈 금액인 6,937,399원을 월평균 급여액으로 보되, 임금피크제를 적용하여 만 55세가 되는 다음 달부터 정년이 되는 만 60세까지의 월평균 급여액은 매년 5%씩 순차 감액하여 산정하고 그 후부터 만 65세까지는 고용노동부 발행의 고용형태별근무실태조사 보고서상 대졸정규직 근로자 수입 상당액인 월 4,014,000원의 소득을 얻을 수 있을 것으로 본 다음, 생계비를 공제한 망인의 일실수입 합계를 938,487,302원으로 산정하였다.

관련 법리와 기록에 비추어 살펴보면, 원심의 위와 같은 판단에 상고이유 주장과 같이 논리와 경험의 법칙을 위반하여 자유심증주의의 한계를 벗어나거나 필요한 심리를 다하지 아니한 채 일실수입 산정의 기초가 되는 소득의 범위 등에 관한 법리를 오해하여 판결에 영향을 미친 잘못이 없다.

2. 상고이유 제3, 4점에 대하여

원심은 그 판시와 같이, 임금피크제는 임금이 최고액에 달하는 것을 전제로 하는데 이 사건 사고 당시 망인의 나이는 만 35세 4개월에 불과하여 정년까지 상당한 기간이 남아 있어서 이 사건 사고 당시의 평균임금액에 임금피크제를 적용하여 이를 수정하면 망인의 평균임금액이 부당하게 감소되는 결과가 된다는 등의 사정을 들어 이 사건 사고 당시의 평균임금액을 기준으로 망인의 일실퇴직금을 산정함으로써, 일실퇴직금 산정에도 임금피크제를 적용하여야 한다는 피고의 주장을 받아들이지 않았다.

관련 법리와 기록에 비추어 살펴보면, 원심의 이러한 판단에 상고이유 주장과 같이 논리와 경험의 법칙을 위반하여 자유심증주의의 한계를 벗어나거나 필요한 심리를 다하지 아니한 채 일실퇴직금과 임금피크제에 관한 법리를 오해하는 등으로 판결에 영향을 미친 잘못이 없다.

3. 상고이유 제5, 6점에 대하여

가. 산업재해보상보험법(이하 ‘산재보험법’이라 한다) 제87조 제1항은 "공단은 제3자의 행위에 따른 재해로 보험급여를 지급한 경우에는 그 급여액의 한도 안에서 급여를 받은 사람의 제3자에 대한 손해배상청구권을 대위한다."라고 규정하여, 문언상 근로복지공단(이하 ‘공단’이라 한다)이 대위할 수 있는 손해배상청구권의 한도를 정하고 있을 뿐 구체적으로 대위할 수 있는 범위를 특정하고 있지 않다. 마찬가지로 같은 조 제2항도 "수급권자가 제3자로부터 동일한 사유로 보험급여에 상당하는 손해배상을 받으면 공단은 그 배상액을 대통령령으로 정하는 방법에 따라 환산한 금액의 한도 안에서 이 법에 따른 보험급여를 지급하지 아니한다."라고 정하고 있을 뿐 구체적으로 공단이 보험급여를 하지 않을 수 있는 금액의 범위가 특정되어 있지 않다. 특히 과실상계 등의 사유로 재해근로자의 가해자에 대한 손해배상청구권이 제한되는 경우에 공단의 보험급여 지급에 의하여 보험가입자의 민법 등에 따른 손해배상책임이 그 보험급여 전액만큼 소멸되는지 및 공단이 보험급여 전액에 대하여 재해근로자의 손해배상청구권을 대위하거나 그에 해당하는 보험급여를 하지 않을 수 있는지는 위 각 규정에 의하더라도 명확하지 않다.

위 각 규정에 따라 공단의 보험급여에 의하여 소멸하는 가해자의 손해배상책임의 범위나 공단의 보험급여 한도에서 공단이 대위하거나 향후 부담을 면하는 금액을 어떤 기준에 의해 산정할 것인지는 법원이 위 각 규정과 산재보험법의 다른 규정들의 내용 및 산재보험법의 입법 목적, 산업재해보상보험제도의 법적 성격과 기능, 보험급여 수급권의 성격, 법질서 전체와의 조화나 형평의 관념 등을 종합적으로 고려해서 합리적으로 결정하여야 한다.

산재보험법 제87조의 문언과 입법 취지, 산업재해보상보험제도의 목적과 사회보장적 성격, 재해근로자(유족 등 보험급여 수급자를 포함한다)와 공단 및 불법행위자 사이의 이익형량 등을 종합하여 보면, 공단이 제3자의 불법행위로 재해근로자에게 보험급여를 한 다음 산재보험법 제87조 제1항에 따라 재해근로자의 제3자에 대한 손해배상청구권을 대위할 수 있는 범위는 제3자의 손해배상액을 한도로 하여 보험급여 중 제3자의 책임비율에 해당하는 금액으로 제한된다. 따라서 보험급여 중 재해근로자의 과실비율에 해당하는 금액에 대해서는 공단이 재해근로자를 대위할 수 없으며 이는 보험급여 후에도 여전히 손해를 전보받지 못한 재해근로자를 위해 공단이 종국적으로 부담한다고 보아야 한다. 이와 같이 본다면 산재보험법에 따라 보험급여를 받은 재해근로자가 제3자를 상대로 손해배상을 청구할 때 그 손해 발생에 재해근로자의 과실이 경합된 경우에, 재해근로자의 손해배상청구액은 보험급여와 같은 성질의 손해액에서 먼저 보험급여를 공제한 다음 과실상계를 하는 ‘공제 후 과실상계’ 방식으로 산정하여야 한다(대법원 2022. 3. 24. 선고 2021다241618 전원합의체 판결 참조).

나. 원심은 원고들의 부대항소로 제1심판결 중 원고들 패소 부분도 원심의 심판대상이 되었음을 전제로 하여 소극적 손해액을 산정하면서 그 판시와 같이 ‘공제 후 과실상계’ 방식에 따라 망인의 일실수입 상당액 938,487,302원에서 원고들이 공단으로부터 지급받은 유족급여 합계액 187,295,340원을 공제한 다음 피고의 책임비율을 65%로 제한하였다.

위에서 본 법리와 기록에 비추어 살펴보면, 원심의 이러한 판단에 상고이유 주장과 같이 처분권주의나 변론주의를 위반하여 판결에 영향을 미친 잘못이 없다.

4. 결론

그러므로 상고를 모두 기각하고 상고비용은 패소자가 부담하도록 하여, 관여 대법관의 일치된 의견으로 주문과 같이 판결한다.

대법관 박정화(재판장) 김선수 노태악(주심) 오경미

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