The Supreme Court ruled that even if an insurer is at fault, such as by failing to properly explain a product, that does not make an insurance fraud act innocent.
The Supreme Court's Third Division (Presiding Justice Noh Kyung-pil) said on the 3rd that it overturned the appellate ruling that acquitted an insurance planner, a person surnamed Yang, who was indicted on charges of violating the Special Act on the Prevention of Insurance Fraud, and remanded the case to the Jeju District Court.
Yang was also indicted on charges of conspiring with another insurance planner, a person surnamed Kim, and a customer, a person surnamed Cho, to submit false documents for an insurance claim, allowing Cho to receive 27,484,845 won in insurance money. Yang and Kim were said to have agreed to receive a portion of the insurance payout from Cho.
Cho reportedly took out a children's injury insurance policy in the son's name in 2019. Cho's son was said to have suffered a fracture in an electric scooter accident in 2021. However, the policy Cho purchased does not pay insurance benefits for electric scooter accidents. Accordingly, Cho is accused of conspiring with Kim and Yang to submit false materials to the insurer stating "fell down and got hurt" and receiving the insurance payout.
The trial court found Yang guilty of insurance fraud and fined Yang 2 million won.
However, the appellate court acquitted Yang. The appellate panel said, "The insurer did not fulfill its duty to explain that 'electric scooter accidents are not covered for insurance payouts.'" It added, "Because this is a case in which an insurance payout should have been made, it is hard to see that Yang deceived the insurer."
The Supreme Court found the appellate ruling to be wrong. The court said, "The act of Yang and others obtaining an insurance payout with false materials goes beyond the scope that can be tolerated as a means of exercising rights under social norms and constitutes a deceptive act in the crime of fraud." It continued, "Even if the insurer bears an obligation to pay due to failure to fulfill its duty to explain, that does not change the conclusion."