사망보험계약에서 보험자의 면책사유에 관한 고찰 = The Review of Reasons for Insurer’s Indemnification on Insurance Contracts

다국어 초록 (Multilingual Abstract)

Even if an insurance accident specified in the insurance contract occurs during the insurance period, there is a reason why the insurer is not liable for insurance payments, which is called the reason for indemnification. Reasons for indemnification are divided into legal indemnification stipulated by the Commercial Act and contractual indemnification stipulated by the parties. As for the reasons for legal indemnification stipulated by the Commercial Act, artificial insurance accidents are typically stipulated in Article 659 of the Commercial Act.
The main problem with insurance accidents is that they artificially cause accidents to defraud insurance money, and this problem is not only contrary to the principle of good faith in insurance contracts in precedents, but if insurance money is paid, insurers should be exempted because there is a possibility that the insurance contract may be used for unfair purposes such as obtaining insurance money. In this context, if the insured intentionally harms him during a death insurance contract, it is regarded as a reason for indemnification, and if he harms himself while not being able to make free decisions due to mental illness, etc., it is regarded as an exception. However, as an exception to these reasons for indemnification, the judgment on the state of not being able to make free decisions due to mental illness is ambiguous. The law stipulates that the deceased should be judged comprehensively by considering the age and prosperity of the deceased, physical and mental conditions, the timing and progress of mental illness, the specific symptoms around the time of suicide, the surrounding situation surrounding the deceased and the behavior of the deceased at the time of suicide, the timing and place of the suicide, the motive, the circumstances and methods of suicide. But since there are various situations for each case, important implications can be drawn through case-by-case comparison and analysis if a case dealing with the same issue comes out at the same time.
The four cases examined in this paper stipulate that the insured intentionally harms himself under the provisions of the terms and conditions in the death insurance contract, the same issue described above, as the reason for indemnification. In the third and fourth cases, there are cases in which the insured has been treated for depression or attempted suicide if symptoms are severe before the insurance case, so medical objective evidence is sufficient to recognize it as a reason for exemption from the insurer's immunity. On the other hand, in the first and third cases, the insured had never received a medical diagnosis before the insurance case, had no suicide attempt, and was living a daily life at the time of suicide, so it was unreasonable to see them as unable to make free decisions. Nevertheless, all four cases were recognized as reasons for exemption from the insurer's insurance payment, and in the first and second cases, recognition as an occupational accident seems to be a major consideration. This interpretation can be seen as an excessive interpretation of the fact that it has been recognized as a business accident because there must be a significant causal relationship between work and the disaster, and the proof does not need to be medical or scientific.