지적장애사실 불고지와 고지의무 위반 여부 — 부산지방법원 2018. 10. 24. 선고 2018나46292 판결에 대한 평석을 중심으로 —

Abstract

The most problematic area of ​​the theory surrounding the insurance system is the obligation(duty of disclosure). The policyholder shall notify the insurer of important matters when concluding the insurance contract. This is an institution related to the goodness of the insurance system. However, in order to judge whether or not to pay insurance premiums in case of misrepresentation of important matters, it is necessary to examine various devices surrounding the notice duty system. In case of breach of obligation, there are various devices for protecting policyholders. There is no disagreement about the fact that the insured did not notify the intellectual disability of insured in the case of Busan District Court. However, the place where the seawater stream begins is deep and the water is prohibited. There was a jersey in the vicinity where there were signs such as 'no swimming zone' and 'danger'. Whether there is a causal relationship with this is the key to solving this issue. Even in the case of a normal person, it is possible to enter dangerous areas even if there are warning phrases and obstructions. However, the Supreme Court is taking a position that there is a causal relationship if we can get a glimpse of causation. If we look at the issue in question with the Supreme Court case, there is no relation between the intellectual disability and the incident. Therefore, Supreme Court cases can lead to the conclusion that there is a causal relationship and that the insurer may not pay insurance benefits. However, strict interpretation of causal relationships does not necessarily mean that causal relationships exist in such cases. The Supreme Court's case can be interpreted as recognizing the causal system as having some problems in pursuing the goodness of insurance contracts. In the German case, the patient was immobilized, and the causal relationship was found to exist even if the insured person's physical damage occurred due to the negligence of the patient's surgery at a later date. Therefore, it is judged that there is a causal relationship if the causal relationship can be recognized to some extent . In this regard, the judgment of the Busan District Court on the matter that was subject to review in this article is reasonable. However, the Pusan ​​District Court concluded that "when the insurance contract is violated, it is proved that the occurrence of the insurance accident is not caused by the insolvency or disinformation of the policyholder. I can not cancel the insurance contract because of the notice. "This is not correct. In order for an insurer to refuse payment of a claim for breach of obligation, various requirements must be met. First, it must violate the notice obligation with intentional or grave error. There must be a causal relationship between the burning fact and the accident occurrence. Notice of breach of obligation shall be made from January 1, not later than 3 years after the contract date. The Supreme Court considers that there is causality if there is a slight glimpse of the causal relationship, taking into account the purpose of the obligation. In this way, the mechanism surrounding the obligation is very complex. It is important for insurance contractors to understand this in order to avoid the occurrence of disputes. In this regard, it is necessary to understand the meaning of the insurance system accurately and to implement insurance duties and other duties appropriately so as to expand insurance education so that accidents do not occur later.