대법원의 보험약관 해석 법리에 관한 비판적 검토

Over the past five years, the number of insurance lawsuits reached a record high of 5,366 cases in 2023, with this increase attributed to various factors such as disputes over insurance claim payments, contract cancellations, and issues related to service quality. In particular, issues related to insurance claim payments are the primary cause of the increase in insurance lawsuits. Generally, conflicts arise when insurance consumers and insurance companies interpret the terms of the policy conditions differently regarding the payment of insurance claims as stipulated in the policy. Insurance litigation resolves related issues through the interpretation of policy conditions by the Supreme Court and lower courts; however, a serious issue has emerged in the Supreme Court's legal reasoning regarding the interpretation of policy conditions. Examining cases involving the interpretation of provisions related to accident death benefits, suicide exemption clauses, and the classification of workplace-related cancer as covered cancer, the following issues arise: First, the interpretation of policy conditions is limited to either an objective interpretation as prescribed by the Act on the Regulation of Terms and Conditions or consideration of whether the interpretation aligns with the principle of avoiding adverse effects on the drafter. Second, even when applying the principle of objective interpretation, the legal reasoning regarding the criteria for determining the average customer's understanding is not consistent. Third, if the principle of private autonomy is broadly applied to the payment of accident life insurance benefits in cases of suicide, this could render the legislative intent of Article 659(1) and Article 732-2(1) of the Commercial Act meaningless and potentially lead to the inducement or encouragement of suicide, thereby constituting an act contrary to social order and violating the provisions of the Civil Act. To improve this situation, the Supreme Court's legal principles regarding the interpretation of policy conditions must be reestablished. In cases such as the long-term care insurance policy case and the claim for reimbursement of medical expenses under a health insurance policy with a discount for acquaintances, First, fair interpretation should be utilized to harmonize with the existing objective interpretation. Second, corrective interpretation and narrowing interpretation to maintain validity should be applied to fill any legal gaps that may arise from fair interpretation. In order to gradually reduce insurance lawsuits over insurance payments, the Supreme Court's legal doctrine on the interpretation of policy conditions should promptly establish objective and consistent standards based on the principles of interpretation of terms and conditions according to Article 5 of the Act on the Regulation of Terms and Conditions, and enhance legal stability to protect the interests of the entire insurance organization.