보험사기 방지를 위한 수익자 적격성 기준의 제도화와 공공성 확보 방안: 전세보증보험을 중심으로

Amid the growing prevalence of Jeonse fraud in South Korea, the existing indemnity insurance system exposes critical structural flaws, most notably the lack of enforceable and consistent standards for determining beneficiary eligibility. These institutional shortcomings have allowed fraudulent actors to exploit interpretive ambiguities in policy and contract frameworks, often resulting in the exclusion of legitimate victims from compensation. This paper revisits the legal and operational foundations of beneficiary eligibility, using a comparative approach to examine Jeonse guarantee insurance alongside group and life insurance. Through a detailed analysis of domestic and international case law, statutory regulations, and administrative practices, the study uncovers systemic weaknesses—such as inconsistent eligibility criteria, severe information asymmetry, and insufficient oversight of guarantee institutions. These deficiencies not only exacerbate the risks of fraud but also erode public trust in the insurance system’s fundamental role of risk-sharing and social protection. The paper proposes a multi-pronged reform agenda, including: codifying eligibility criteria through legislative amendments; implementing standardized contract structures; mandating explanatory duties for guarantee institutions; introducing a conditional prepayment mechanism; and aligning these reforms with the Insurance Fraud Prevention Act. Collectively, these measures aim to promote institutional accountability, protect victims' rights, and reorient the insurance framework toward greater fairness and transparency. The findings underscore the need for legislative and administrative recalibration to ensure that indemnity insurance fulfills its intended public function.