CDSC found that an insurer must disburse disaster insurance benefits in case the insurer cannot clearly verify that an accident was intentionally caused

With regard to a case where A’s inheritor claimed disaster insurance benefits from S Life Insurance Company (hereinafter referred to as the “insurer”), the Consumer Dispute Settlement Commission (CDSC; Chairperson Shin Jong-won) of the Korea Consumer Agency (KCA) made a resolution that the insurer should pay the disaster insurance benefits because it failed to verify that the accident in question (suicide) was intentionally caused by the insured.

The insurer argued that it could not disburse the insurance benefits because A ignited charcoal briquettes for the purpose of committing suicide, and as a result, suffered from carbon monoxide poisoning, given that A had a history of mental health treatment, and words like “self-injury” and “suicide” were written in his medical records.

However, the CDSC took note of the fact that A received a comprehensive medical check-up 20 days before the accident, and exchanged text messages with his colleague, as usual, one day before the accident. In addition, the CDSC argued that the insurer should pay the insurance benefits on the grounds that it failed to clearly prove A’s intentional accident (suicide) because A’s suicide note was not found, police records said the burnt debris was found in the multipurpose room which was divided from the room where A was found unconscious, and it is hard to conclude the burnt debris was the remains of the burnt briquettes.

The CDSC decision reconfirmed the ruling* of the Supreme Court that “an insurer must bear a strict burden of proof to the extent that the suicide of an insured person must be proved beyond reasonable doubt.”

In addition, the decision by the CDSC is of great significance in that it has put the brakes on the practices of insurance companies for refusing payment of insurance benefits so far by vaguely arguing that the insured person intentionally has committed suicide.