Should insurance firms pay money for death from depression after a car accident? < Hospital < Article




The insurance industry has refuted a court ruling that underwriters should pay insurance money for suicide due to depression caused by a car accident.


In the “Insurance Act Review” published by the Korea Insurance Research Institute (KIRI) on Monday, underwriters said they must first examine whether depression amounts to injury before paying injury and death insurance money.


The industry argued that although the court had already defined depression as injury and made a legal judgment, the case should be judged based on the injury criteria defined by the insurance policy.


The claimant subscribed to the driver’s insurance of an insurance company, which included a special contract for traffic accident death, with his mother as the beneficiary. The mother had a car accident while driving on a rainy night in 2017. She suffered from post-traumatic stress disorder and depression after being trapped in the vehicle for a long time before being rescued. The mother eventually killed herself.


The contract stipulated that the underwriter pays insurance money of 100 million won ($77,000) if the subscriber dies “as a direct result of injuries due to a car accident.”


The claimant requested the company to pay traffic accident death insurance money. However, the company refused to pay the money, claiming that it could not think the mother died directly from the injury and that the underwriter could be exempted if subscribers killed themselves.


A lower court denied the obligation to pay the insurance money, judging that the mother’s death was not the direct result of injury due to the traffic accident. It did not inevitably result from depression or occur in a state of mental or physical loss.


However, the Supreme Court reversed and remanded the lower court’s ruling, judging it was mistaken by denying the causal relationship between the traffic accident and the mother’s death despite her doctor’s opinion that there was a causal relationship between the “traffic accident, depression, and the suicide.”


The revocation and remand trial ended on Nov. 25 with compulsory mediation.


The industry opinion paper said that the lower court and the Supreme Court had judged that the mother’s depression amounted to injury without separate judgment. However, the paper noted that one must first examine the concept of injury defined by the special contract on traffic injury and death.


“Injury usually means physical injury, and the term injury in the car insurance means a wound. Therefore, injury in this accident can mean physical injury and wound under the special contract on traffic injury and death,” said Hwang Hyeon-ah, a researcher at KIRI.


Pointing out that the ruling presupposes that depression is an injury according to the driver’s insurance traffic accident death special agreement without further argument, Hwang said it might cause concerns about confusion in the meaning of injuries compensated for by accident insurance, automobile insurance and driver’s insurance in the future.


“Before judging whether the mother committed suicide as a direct result of depression, they should have reviewed first whether depression constitutes injury under Article 1 of the Special Rules,” Hwang added.