근로복지공단의 산재보험제도 개선에 관한 연구 : 구상권에 관한 대법원 판례분석을 중심으로

다국어 초록 (Multilingual Abstract)

Industrial Accidents Compensation Insurance(IACI), the first social insurance in the Republic of Korea, was introduced on 1 July, 1964 for the purpose of compensating occupational accidents of workers and played partial roles of other social insurances beyond its original function since the establishment of national pension(1988), health insurance(1977) and employment insurance(1995) was delayed. And dependence of other social insurances on IACI and IACI''s vicarious action still continue even after the establishment of other insurances. For example, health insurance passes burden of medical benefits for injured workers retiring from their companies over to IACI and national pension doesn''t pay 50% of its pension benefits to IACI beneficiaries receiving survivors'' or disabilities pension.

However, the finance of IACI counts entirely on premiums paid by employers, not by the government, and insurance benefits have drastically been increasing every year(28 hundred billion KRW(''04), 30 hundred billion(''05), 31 hundred billion(''06)). This situation is due to many problems of IACI. It is needed to innovate IACI especially for financial soundness in consideration of the fact that the level of IACI benefits surpass the standards of ILO and western developed nations. Financial problems of IACI are caused by the increasing trend of benefits patronized by politicians, lengthened periods of medical care, the accumulated pensioners, moral hazards of some beneficiaries, the tendency of lenient rulings by courts and so on.

Moreover, IACI faces a new problem ; the supreme court has recently given judicial decisions different from the previous decisions in relations to indemnity cases in which it is difficult to proceed actual lawsuits owing to its civil procedures and to retrieve the compensation money. At present, the indemnity money which hasn''t been yet retrieved amounts to 140 billion KRW(6,411 cases) and has an immense effect on the finance of IACI.

In the indemnity system of IACI, Korea Labor Welfare Corp.(KLWC) demands indemnity within the level of insurance benefits from the responsible third party in subrogation of injured workers while giving benefits to injured workers. KLWC prevents injured workers from receiving double compensation both by KLWC and by the responsible third party, at the same time it secures IACI''s finance soundly by means of calling the third party to account.

However, the supreme court gave the ruling that KLWC should give insurance benefits to injured workers even in case it can''t demand indemnity from the wrongdoer, differently from the previous rulings. Accordingly the new ruling put KLWC(the ministry of labor), which sticks to the existing administrative interpretation(the previous rulings) that injured workers lose the right of demanding insurance benefits in case KLWC can''t demand indemnity from the wrongdoer, in conflict with injured workers who want to secure lawful remedies in courts.

This study examined a better way of claiming indemnity for improving IACI and offered an alternative of an administrative system mirroring the principle of social insurances and public interests by analysing cases especially related to problems in a real working process as to the recent rulings of the supreme court which are likely to have a negative influence on IACI''s finance and instigate moral hazard. Improving ways are as follows.

First, overlapping benefits in social insurances of R.O.K may provide excessive security net to some beneficiaries or aren''t likely to give adequate compensation to other beneficiaries in some cases, for mutually-connected system among social insurances doesn''t exist. Therefore, it would be rational to introduce a way of coordinating social insurances'' benefits on the principle that medical care, benefits related to compensation and benefits after retirement are allocated to Health Insurance, IACI and National Pension respectively.

Second, KLWC(the ministry of labor) should strongly support the existing interpretation not only because the interpretation doesn''t have a bad effect on innocent workers but also because IACI has a financial instability and relatively high level of compensation. And it is needed to prevent unavoidable costs arising from necessary lawsuits of injured workers. Therefore, a rational provision should be made in related laws through collecting general opinion.

Third, in case sub-businesses of a single business is carried out separately from one another, KLWC shouldn''t pursue indemnity regardless of whether the related businesses are mandatorily-covered or not for IACI currently is applied entirely to businesses with 1 or more worker and some employers can apply for IACI''s benefits coverage. This finally makes IACI faithful to the principles of public interest and solidarity of social insurances.