Korean Insurance Law Association最新文献

{"title":"Review on the Korean Supreme Court Case on Legal Interest for Confirmation in a Lawsuit for Negative Confirmation Brought by an Insurance Company: Korean Supreme Court Case No. 2018Da257958･257965 rendered on 7 June 2021","authors":"Hyunjee Park","doi":"10.36248/kdps.2022.16.2.189","DOIUrl":"https://doi.org/10.36248/kdps.2022.16.2.189","url":null,"abstract":"In case where there is a dispute between an insurance company and an insured as to whether an insurance company should pay insurance proceeds and/or as to how much insurance proceeds should be, a lawsuit for negative confirmation, claiming for a judgment to declare that the insurance company should not be held liable to pay any insurance proceeds, is the only possible form of a lawsuit that an insurance company can bring preemptively before a court. A plaintiff who wishes to bring such negative confirmation/declaration claim should have legal interest for such confirmation as it is legal requirement for a confirmation claim, and the Korean court has generally accepted that an insurance company has the legal interest to bring a negative confirmation/declaration claim as long as there is a dispute between an insurance company and an insured regarding insurance coverage and/or insurance proceeds. \u0000However, recently, in the above mentioned case, the Korean Supreme Court (en banc) had in-depth discussion as to whether the negative confirmation/declaration claim brought by an insurance company should be restricted or not. Especially, three supreme court judges made a dissenting opinion holding that an insurance company must show special circumstances on order to bring a negative confirmation/declaration claim, especially considering the public nature of insurance, legal obligation of an insurance company to provide protection for an insured, the equity that is required between the parties to an insurance contract and the possible abuse of negative confirmation lawsuit by an insurance company. \u0000Although it may be necessary to prevent the abuse of a lawsuit by an insurance company in order to protect an insured, it is difficult to accept the dissenting opinion because the right to bring a lawsuit is constitutional right of an insurance company, and if the court restricts the negative confirmation claim made by an insurance company by requiring additional conditions for “legal interest for confirmation” without a specific provision in a legislation, it could be considered as infringement of such constitutional right. As rightfully pointed out by the supplementary opinion to the majority opinion in this Supreme Court case, the negative confirmation/declaration lawsuit brought by an insurance company could also be beneficial to an insured as it will lead to a swift resolution of the dispute. Moreover, the special circumstance that the dissenting opinion mentioned seems very vague and abstract. So, if the Court requires the special circumstances for the negative confirmation claim, it will be too burdensome to both parties as there will be another dispute over the existence of such special circumstances. \u0000Currently, there are ways to control and suppress abusive and/or excessive litigation by an insurance company - (i) internal control system such as litigation management committee established within an insurance company and (ii) external control system such","PeriodicalId":129340,"journal":{"name":"Korean Insurance Law Association","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134398055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Study on the exclusionary Clause of ‘Professional Climbing for club activities’ in Health-Accidental Insurance","authors":"D. Lim","doi":"10.36248/kdps.2022.16.2.269","DOIUrl":"https://doi.org/10.36248/kdps.2022.16.2.269","url":null,"abstract":"The standard terms and conditions of Personal accident and Sickness Insurance compensate for sudden, external and identifiable event that happens by chance, but \"professional climbing for the purpose of job, duty and club activity\" shall not be compensated unless additional contracts. \u0000An insured person, a member of the mountaineering club and an educational technology director of the Gwangju Metropolitan Federation of the Korea Alpine Federation, fell and died while climbing the 8,586m above sea level in Kanchenjunga. The Supreme Court cannot be regarded as professional climbing for the purpose of job or duties ① because it is not a professional climbing for the purpose of maintaining a living, such as the Brand Climbing Team or the Business Team, ② The parallel listing of \"the purpose of the club’s activities\" along with \"job and duty\" in the exclusionary provision, is based on the fact that the club’s activities are repeated for a certain period of time, such as job or duty. ③ In other words, in the case of overseas expedition climbing, several people form a team and it will take a considerable period of time from the preparation stage to the actual climbing stage, so it cannot be considered for the purpose of club activities just because several people prepared for a long time and did professional climbing together. ④ In addition, the Gwangju Mountaineering Union, which limited membership requirements to member organizations, was not allowed to join, and the Gwangju Mountaineering Union was not directly or indirectly involved in the expedition. ⑤ In the case of the Himalayan Kanchenjunga expedition, death benefit should be paid because it is not a \"professional climbing for the purpose of club activities\" stipulated in the exclusionary provision because people from different mountaineering clubs are only one-time. A professional mountaineer who has climbed alpine more than 8,000 meters four times in the past while interpreting the purpose of the club’s activities excessively reduced and recognized the insurer’s responsibility for paying a death benefit again during alpine climbing, making the exclusionary provision useless. Therefore, it is judged that the best way is to clearly define \"professional climbing for the purpose of club activities\", separate Alpine climbing, and enter into an insurance contract through additional subscription and acceptance procedures for \"Professional sports Applicable to the policy\" to meet the original purpose of exclusionary provision. It is expected that disputes related to professional climbing for the purpose of club activities will be minimized through the revision of the standard terms and conditions in the future.","PeriodicalId":129340,"journal":{"name":"Korean Insurance Law Association","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129067957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investment of insurers on general agencies: Legal issues review","authors":"Jae Wook Seo, Eun Hee Ko","doi":"10.36248/kdps.2022.16.2.299","DOIUrl":"https://doi.org/10.36248/kdps.2022.16.2.299","url":null,"abstract":"General agencies are gaining market share within insurance sales market, based on their advantage to compare and sell different kinds of insurance products. Size of individual general agency is getting bigger, as medium-to-large sized agencies attract more sales agents and gain market share. As these agencies exert greater influence in the sales market, insurers are trying to enhance their bargaining power by acquiring stakes of general agencies or establish agency themselves as a form of subsidiary. \u0000In case when insurers invest in such agencies by acquiring stakes, the insurers must abide by requirements of Insurance Business Act, and the Act on the Structural Improvement of the Financial Industry, and etc. Those include restrictions of insurers acquiring stake of other companies and obtaining an approval from the Financial Services Commission. In addition, when insurers hold a general agency as their subsidiaries, the insurers should comply with the various requirements set forth in the Insurance Business Act and its subordinate regulations. \u0000Also, general agencies must follow relevant regulations such as the Insurance Business Act and the Financial Consumer Protection Act as the agencies themselves are insurance solicitors and financial product distribution agents or brokers. \u0000Penalties and sanctions can be applied to the agencies in case of violation. Particularly, the Financial Consumer Protection Act imposes strong sanctions on violation of its sales regulation, to prevent financial consumer damages from miss- selling of financial products. The Act has also introduced stronger measures to enhance effectiveness for consumer remedies. \u0000Therefore, reviewing those regulations details and violation effects are important when determining size and risk of the insurers’ investment to such agencies. It is necessary to ensure sound management on general agencies and protect insurance consumers by regulating governance of general agencies, such as setting up internal control standards, and etc. \u0000Particularly, Regulation on Supervision of Insurance Business prohibits insurers from supporting rental fees and etc. to agencies as a business standard for general agencies. The issue can be problematic as insurers provide money through stake investment. That said, it is appropriate to exempt such action from prohibition, unless stated otherwise, as capital procurement through stake acquisition is an execution of investment and do not share the same legal character of lease or borrowings.","PeriodicalId":129340,"journal":{"name":"Korean Insurance Law Association","volume":"136 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121955494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Study on the Prohibition of Transfer and the Protection of Trade Secrets of The Insurance Workers","authors":"Goeun Seo","doi":"10.36248/kdps.2022.16.2.047","DOIUrl":"https://doi.org/10.36248/kdps.2022.16.2.047","url":null,"abstract":"As the 4th Industrial Revolution was applied to the entire industry, many changes occurred in the financial industry, including the insurance industry. These changes can be examined through ① insurance product development·improvement and risk management through big data analysis, ② rapid and accurate insurance rate calculation and underwriting of insurance contract using A·I, ③ the simplification of insurance conclusion, insurance premium payment, and insurance payment procedures using block chain technology, ④ effective marketing and efficient contract maintenance and management tasks through chatbot. The pace of change in the insurance industry is increasingly accelerating due to numerous practical changes in a short period of time and normative changes such as the revision of related laws of insurance industry. \u0000With the rapid change of the insurance industry, phenomena such as ① diversification of the people working in the insurance industry, ② activation of job change of the people engaged in the insurance industry, and ③ advancement of technology or information required or used in the insurance industry are occurring. If the people engaged in the insurance industry changes their jobs frequently, the possibility of leakage of information or technology related to the insurance industry or infringement of trade secrets may occur. Since this can cause fatal damage to the insurer, it will be necessary to prepare a plan to prevent the leakage of such information and technology and to protect trade secrets. \u0000In this paper, in order to protect the interests of insurers, the validity of the contract for prohibition of job transfer, which is a pre-emptive remedy, not an ex-post remedy according to the Act on the Prevention of Unfair Competition and Trade Secret Protection, the Monopoly Regulation and Fair Trade Act, etc. And we would like to examine the effectiveness of the contract for prohibition of job transfer and review its application to the people engaged in the insurance industry.","PeriodicalId":129340,"journal":{"name":"Korean Insurance Law Association","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127836030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Judgment Review on Liability for Cataract Surgery Costs in Medical Indemnity Insurance","authors":"H. J. Kim","doi":"10.36248/kdps.2022.16.2.141","DOIUrl":"https://doi.org/10.36248/kdps.2022.16.2.141","url":null,"abstract":"Cataract is a disease in which the lens becomes cloudy due to aging and causes loss of vision. It is treated with surgery to remove the cloudy lens and insert an artificial lens. There are single vision lenses and multifocal lenses as types of intraocular lenses, which are the treatment materials used at this time. Monofocal lenses have the disadvantage of requiring separate corrective glasses for near vision even after insertion, but they are inexpensive and require medical treatment under the National Health Insurance Act. On the other hand, multifocal lenses have the advantage of correcting both near and far vision, but they are expensive and do not qualify for medical care benefits under the National Health Insurance Act. \u0000In this case, while the state determines the price of the salary, the non-insurance price is set by the medical institution, so the medical institution has an incentive to make a profit by arbitrarily setting the cost of treatment for non-insured items. In particular, in the case of non-insured items covered by medical insurance for indemnity insurance, the patient can claim most of the medical expenses from the insurance company as insurance money. There may be cases in which overpayment or overtreatment may occur. \u0000In relation to cataract surgery, some eye clinics, mainly in the Gangnam area of Seoul, arbitrarily adjust the cost of examination or multifocal lenses, which are representative non-covered items, according to changes in the health insurance benefit system or medical insurance policy, without reasonable standards. It is confirmed that they are taking advantage of the business by misusing them. For example, in September 2020, when health insurance was applied to the examination fee, it was no longer possible to claim high medical expenses for the examination fee. Excessive indemnity payments are being made in the medical insurance for loss by processing hospitalization and issuing a confirmation of hospitalization, and the damage is being passed on to good medical consumers and insurance organizations. \u0000However, in the recent judgment of 2021 na 2013354 of the Seoul High Court on January 20, 2022, the scope of claims for medical insurance for medical loss for insured persons who underwent cataract surgery was limited to the amount of out-of-patient insurance, not hospitalization. Based on the Supreme Court’s general definition, it was emphasized that ‘the substance of hospitalization’ should be provided in addition to the standards of the Ministry of Health and Welfare notification. He also pointed out that the fact that the comprehensive fee-for-service system is applied in cataract surgery is completely different from judging whether or not the patients were actually ‘hospitalized’. \u0000As such, it can be said that the above judgment on the criteria for ‘hospitalization’ for cataract surgery is not limited to the clinic in this case, but is also applied to general ophthalmology clinics performing cataract surgery","PeriodicalId":129340,"journal":{"name":"Korean Insurance Law Association","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127088114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study on legislation of insurance company debt management with the introduction of the K-ICS","authors":"GW Ji","doi":"10.36248/kdps.2022.16.2.239","DOIUrl":"https://doi.org/10.36248/kdps.2022.16.2.239","url":null,"abstract":"Recently, there is a public opinion that the insurance industry needs to diversify its liability adjustment plans with the introduction of the new Solvency Margin system (K-ICS), which is a system to evaluate the Solvency standard of insurance companies according to IFRS17, which evaluates assets and liabilities at market value. A concern for the domestic insurance industry, which is about to introduce K-ICS, is that if a debt is measured on a market value basis under a low-interest rate trend, debt will increase. If the problem of mismatch between assets and liabilities becomes larger due to an increase in liabilities, the burden of redemption by insurance companies will increase and it is expected that capital management will become difficult. Therefore insurance companies emphasize supporting the need for insurance company debt management. \u0000The systems that have been informed in Korea as insurance liability adjustment measures that are attracting attention ahead of the introduction of the new Solvency Margin system include coinsurance, insurance buy-back, and run-off. Although coinsurance has already been introduced and enforced, it is not easy to utilize the system due to the limited utilization of the system such as coinsurance costs, and the effectiveness of the system has been questioned. Next, insurance buy-back that it is not familiar with is a system in which insurance companies pay policyholders a premium for high-interest insurance products sold in the past and eliminate existing insurance policies. From the standpoint of an insurance company, there is not much profit or loss, but the risk burden, which is an immediate issue for insurance companies, is high. It is a system that can contribute to the sustainability of insurance companies. Finally, run-off refers to the transfer of all or part of an insurance contract to another company and is used for the transfer of insurance business, business sale, risk mitigation, etc. of non-core business divisions of insurance companies. This paper considers that it is necessary to diversify insurance company debt management measures for the sound management of the insurance industry at present, when the new Solvency Margin system is about to be enforced. After examining possible legislative reviewing through a comparative study, this paper suggests the legal considerations to introducing insurance company debt management.","PeriodicalId":129340,"journal":{"name":"Korean Insurance Law Association","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134243843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Status and Prospect of Driver’s Insurance Policy: Focusing on the Criminal Responsibilit of Self-Driving Car Accidents","authors":"S. Lee, Young Jin Joung","doi":"10.36248/kdps.2022.16.1.233","DOIUrl":"https://doi.org/10.36248/kdps.2022.16.1.233","url":null,"abstract":"","PeriodicalId":129340,"journal":{"name":"Korean Insurance Law Association","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116280470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study on the prerequistiese for the passive duty of disclosure","authors":"Kyungbae Cho","doi":"10.36248/kdps.2022.16.1.003","DOIUrl":"https://doi.org/10.36248/kdps.2022.16.1.003","url":null,"abstract":"","PeriodicalId":129340,"journal":{"name":"Korean Insurance Law Association","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123025607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Act on the Protection of Financial Consumers and Protection of Policyholders","authors":"In-ho Park","doi":"10.36248/kdps.2022.16.1.041","DOIUrl":"https://doi.org/10.36248/kdps.2022.16.1.041","url":null,"abstract":"","PeriodicalId":129340,"journal":{"name":"Korean Insurance Law Association","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131637171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on the Deeming Clause for Unfair Replacement of Insurance Contracts","authors":"Young Hwa Paik","doi":"10.36248/kdps.2022.16.1.269","DOIUrl":"https://doi.org/10.36248/kdps.2022.16.1.269","url":null,"abstract":"","PeriodicalId":129340,"journal":{"name":"Korean Insurance Law Association","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133108229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}