Open Decision Ledger · Civil obligations & remedies
Insured benefits, contributory negligence and the rate on direct claims
Supreme Court, May 30, 2019, 2016Da205243 (judgment)
Case name: 보험금
Official text on the National Law Information Center
Question
Where a victim who received benefits under the Industrial Accident Compensation Insurance Act or the National Health Insurance Act claims damages from a third party, must the benefits be included in the loss before contributory negligence is applied, and what is the legal nature of the victim's direct claim under Article 724(2) of the Commercial Act and which default interest rate governs it?
Holding
Yes. The loss on which contributory negligence operates must include the insurance benefits, so the order is to reduce the ascertained loss by the victim's share of fault first and only then deduct the benefits, even where the victim already subtracted them when framing the claim. The direct claim under Article 724(2) of the Commercial Act is a damages claim of the victim against the insurer, arising because the insurer has concurrently assumed the insured's damages debt to the victim; it is not a variation of the insured's claim to the premium, so the 5% civil statutory rate, not the 6% commercial statutory rate, applies to its delayed interest.
Summary of the holding, verbatim
산업재해보상보험법 또는 국민건강보험법에 따라 보험급여를 받은 피해자가 제3자에 대하여 손해배상청구를 할 경우 손해발생에 피해자의 과실이 경합된 때에는 먼저 산정된 손해액에서 과실상계를 한 다음 거기에서 보험급여를 공제하여야 하는바, 피해자 스스로 보험급여를 공제하고 손해배상청구를 한 경우에도 과실상계의 대상이 되는 손해액에는 보험급여가 포함되어야 한다.
Unofficial English translation
Where a victim who has received insurance benefits under the Industrial Accident Compensation Insurance Act or the National Health Insurance Act brings a claim for damages against a third party, if the victim's negligence contributed to the occurrence of the damage, comparative negligence must first be applied to the amount of damages initially calculated, and the insurance benefits must then be deducted therefrom; accordingly, even where the victim has deducted the insurance benefits on his or her own and brought a claim for damages, the insurance benefits must be included in the amount of damages subject to comparative negligence.
Disposition
Reversed and remanded Stated in the decision
원심판결을 파기하고, 사건을 서울고등법원에 환송한다.
Unofficial English translation
The judgment of the court below is reversed, and the case is remanded to the Seoul High Court.
Form of the test
Elements stated Stated in the decision
상법 제724조 제2항에 의하여 피해자에게 인정되는 직접청구권의 법적 성질은 보험자가 피보험자의 피해자에 대한 손해배상채무를 병존적으로 인수한 것으로서 피해자가 보험자에 대하여 가지는 손해배상청구권이고, 피보험자의 보험자에 대한 보험금청구권의 변형 내지는 이에 준하는 권리가 아니므로
Unofficial English translation
The legal nature of the direct claim recognized in favor of the victim under Article 724 (2) of the Commercial Act is that it is a right to claim damages which the victim holds against the insurer, the insurer having concurrently assumed the insured's liability for damages owed to the victim, and it is not a transformed version of, or a right equivalent to, the insured's right to claim insurance proceeds against the insurer
Factors
- 손해발생에 피해자의 과실이 경합된 때에는
- 먼저 산정된 손해액에서 과실상계를 한 다음 거기에서 보험급여를 공제하여야 하는바
- 피해자 스스로 보험급여를 공제하고 손해배상청구를 한 경우에도 과실상계의 대상이 되는 손해액에는 보험급여가 포함되어야 한다
- 보험자가 피보험자의 피해자에 대한 손해배상채무를 병존적으로 인수한 것으로서
- 피보험자의 보험자에 대한 보험금청구권의 변형 내지는 이에 준하는 권리가 아니므로
Unofficial English translation
• if the victim's negligence contributed to the occurrence of the damage
• comparative negligence must first be applied to the amount of damages initially calculated, and the insurance benefits must then be deducted therefrom
• even where the victim has deducted the insurance benefits on his or her own and brought a claim for damages, the insurance benefits must be included in the amount of damages subject to comparative negligence
• the insurer has concurrently assumed the insured's liability for damages owed to the victim
• and is not a transformed version of, or a right equivalent to, the insured's right to claim insurance proceeds against the insurer
Relation to precedent
Follows earlier decisions Stated in the decision
대법원 2010. 7. 15. 선고 2010다2428, 2435 판결(공2010하, 1575)
Unofficial English translation
Supreme Court Decision 2010Da2428, 2435 decided July 15, 2010 (Gong 2010 Ha, 1575)
Decisions referred to
[1] 대법원 2010. 7. 15. 선고 2010다2428, 2435 판결(공2010하, 1575) / [2] 대법원 2019. 1. 17. 선고 2018다245702 판결(공2019상, 466)
Burden of proof
Not addressed Not in the decision
Open question and revisit condition
Where the victim claims directly against the insurer under Article 724(2) of the Commercial Act after the insurer has already paid the benefits, does the same order of contributory negligence first and deduction of benefits second still govern?
A later decision on whether contributory negligence is applied before deducting benefits in a direct claim against the insurer would require this entry to be read again. The remand judgment of the Seoul High Court will also show how the order of contributory negligence and benefit deduction was applied to the past treatment costs.
Cross-family AI independent reading & axis check
7 of 8 axes matched GPT-6 Astra (OpenAI, codex CLI) · 2026-10-25
A reader from another model family (GPT-6 Astra), given the official text but not the primary reading, agreed on 7 of the 8 axes; the readings differed on axis 8 (open question and revisit condition).
Axis 8 (Open question and revisit condition): Primary “Where the victim claims directly against the insurer under Article 724(2) of the Commercial Act after the insurer has already paid the benefits, does the same order of contributory negligence first and deduction of benefits second still govern?” vs Independent “How should the deduction be calculated when insurance benefits cover only some categories of the victim's losses?”
The primary asks whether the same order applies when the insurer has already paid and the victim claims directly, while the independent asks how deduction should work when benefits cover only some loss categories.
산업재해보상보험법 또는 국민건강보험법에 따라 보험급여를 받은 피해자가 제3자에 대하여 손해배상청구를 할 경우 손해발생에 피해자의 과실이 경합된 때에는 먼저 산정된 손해액에서 과실상계를 한 다음 거기에서 보험급여를 공제하여야 하는바, 피해자 스스로 보험급여를 공제하고 손해배상청구를 한 경우에도 과실상계의 대상이 되는 손해액에는 보험급여가 포함되어야 한다.Raw responses and comparison record: Protocol · Blind readings (JSONL) · Axis comparison (JSONL) · SHA-256 (JSON)
Lower-court contrast & scope of application
Lower-court reading vs. Supreme Court holding
Lower-court context: The Seoul High Court, in its judgment of 7 January 2016 (2015Na2032910), held that the defendant, as insurer under the insurance contract in this case, was obliged to pay the plaintiff damages under Article 724(2) of the Commercial Act. In calculating the past treatment costs within the positive loss, it deducted the health insurance benefits the plaintiff had already received under the National Health Insurance Act from those costs itself, and applied contributory negligence only to the treatment costs the plaintiff claimed. It ordered payment of delayed interest at 6%, the commercial statutory rate.
Supreme Court standard: The Supreme Court found no error on the first ground, holding that the court below had correctly found the defendant obliged to pay under Article 724(2) of the Commercial Act and had not misread the law of tort or breached the rules of evidence. It held the second ground well founded, because deducting the plaintiff's own benefit before applying contributory negligence misread the law on calculating the damages of a victim who received insurance benefits. It held the third ground well founded as well, because the direct claim is not a variation of the insured's claim to insurance proceeds, so ordering interest at the 6% commercial rate misread the law on the direct claim and on statutory interest. The whole judgment was reversed and remanded by agreement of the Justices concerned.
Distinguishing conditions
- A case in which the victim's own fault did not contribute to the loss, so that no apportionment by contributory negligence is made in the first place.
- A victim who received no benefits under the Industrial Accident Compensation Insurance Act or the National Health Insurance Act, since the rule governs the order of set-off between the two sums.
- A claim to the insured's own insurance proceeds against the insurer, which the Court expressly said is not what the victim's direct claim is a variation of.
Record verification notes
Identify which Act paid the benefits and whether the victim already subtracted them when framing the claim, since the correction turned on that subtraction. Then separate the past treatment costs, which the court below computed in the wrong order, from the finding that the defendant was an insurer under Article 724(2), which the Supreme Court left standing. Finally, check the accrual dates of the delayed interest, because this judgment applies the 5% civil statutory rate to delayed interest on the direct claim.
From the official text
Points at issue
[1] 산업재해보상보험법 또는 국민건강보험법에 따라 보험급여를 받은 피해자가 스스로 보험급여를 공제하여 제3자에게 손해배상청구를 한 경우, 과실상계의 대상이 되는 손해액에 보험급여가 포함되는지 여부(적극) [2] 상법 제724조 제2항에 따라 피해자에게 인정되는 직접청구권의 법적 성질(=손해배상청구권) 및 이에 대한 지연손해금에 관하여 적용되는 법정이율(=민사법정이율)
Unofficial English translation
[1] Whether the insurance benefits are included in the amount of damages subject to comparative negligence where a victim who has received insurance benefits under the Industrial Accident Compensation Insurance Act or the National Health Insurance Act deducts the insurance benefits on his or her own and brings a claim for damages against a third party (affirmative) [2] The legal nature of the direct claim recognized in favor of the victim under Article 724 (2) of the Commercial Act (= right to claim damages) and the statutory interest rate applicable to the default interest thereon (= statutory interest rate under civil law)
Summary of the holding
[1] 산업재해보상보험법 또는 국민건강보험법에 따라 보험급여를 받은 피해자가 제3자에 대하여 손해배상청구를 할 경우 손해발생에 피해자의 과실이 경합된 때에는 먼저 산정된 손해액에서 과실상계를 한 다음 거기에서 보험급여를 공제하여야 하는바, 피해자 스스로 보험급여를 공제하고 손해배상청구를 한 경우에도 과실상계의 대상이 되는 손해액에는 보험급여가 포함되어야 한다. [2] 상법 제724조 제2항에 의하여 피해자에게 인정되는 직접청구권의 법적 성질은 보험자가 피보험자의 피해자에 대한 손해배상채무를 병존적으로 인수한 것으로서 피해자가 보험자에 대하여 가지는 손해배상청구권이고, 피보험자의 보험자에 대한 보험금청구권의 변형 내지는 이에 준하는 권리가 아니므로, 이에 대한 지연손해금에 관하여는 연 6%의 상사법정이율이 아닌 연 5%의 민사법정이율이 적용된다.
Order
원심판결을 파기하고, 사건을 서울고등법원에 환송한다.
Unofficial English translation
The judgment of the court below is reversed, and the case is remanded to the Seoul High Court.
Provisions referred to
[1] 민법 제396조, 제750조, 제763조 [2] 상법 제724조 제2항, 민법 제379조
Read 2026-10-25 · Cross-read 2026-10-25. All quotes matched against the official text. The Chinese-character placeholders the court used for anonymised parties are given in their Korean readings, and parenthetical Chinese-character glosses are omitted.
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