재해사망특약상의 자살면책제한조항의 해석에 관하여

Abstract

As the insured’s intentional act, suicide constitutes a ground for exclusion in life insurance contracts. However, for policy reasons of protecting the bereaved family, insurer’s exclusion of the insured’s intentional act is limited when it comes to suicide beyond a certain point in time. Meanwhile, since an accident as covered loss under an accidental death policy is required to be accidental and external, a suicide does not constitute an accident to begin with, and thus, is not a covered loss eligible for accidental death benefit under the accidental death policy. Therefore, there is no need for the general terms of an accidental death policy to exclude suicide. Nor is it reasonable to provide for limitation of suicide exclusion. Nonetheless, most life insurers categorically provide for limitation of suicide exclusion in their accidental death policies. The issue is whether the insurer is liable to pay accidental death benefit for a suicide beyond the period specified for suicide exclusion. In a recent decision, the Supreme Court of Korea held the insurer liable for payment of accidental death benefit in such a case on the ground that a suicide beyond the two-year mark may, as an exception, be deemed to be defined as covered loss under the accidental death policy, based on the standard of an average customer’s understanding. However, it is important to review the range of issues raised by the above decision, as well as by those views for and against the payment of accidental death benefit, including: the reasonable intention of the policyholder and the insurer of an accidental death policy; the content of an average customer’s understanding in view of the principle of objective interpretation of the terms of an insurance policy; whether limiting suicide exclusion is to be deemed to create a new covered loss; the application to suicide exclusion limitation clause in accidental death policy of the principles of contra proferentem (interpretation against the drafter) and falsa demonstratio non nacet (a false description of an item in a legal document does not necessarily vitiate the document); and whether paying accidental death benefit for suicide is contrary to good morals and other social order (against public policy) under Article 103 of the Civil Act. Based on such a review, the more sensible stance would be to view that to construe a suicide beyond the specified period as a covered loss under the accidental death policy is unreasonable in view of the reasonable interpretation of the intention of the policyholder and the insurer, as well as being contrary to the inherent nature of an accidental death policy.