Disputed permanent impairment: full claim of about ₩240 million awarded

Background

While driving his own car on an expressway, our client was in an accident in which the car struck a guardrail and then the median barrier. He suffered serious injuries to his knee and elsewhere and was hospitalized for several months. He claimed benefits from the insurer that had issued the auto policy on his vehicle, but the insurer disputed the scope of payment by challenging the assessment of his permanent disability.

The issue

Permanent disability is impairment that remains after treatment, and the payout depends heavily on the percentage of working capacity lost. The insurer argued that a torn knee ligament can be rated as a disability only after a test measuring how unstable the joint remains after treatment, and that an appraisal made without that test was unreliable. The issues were whether the disability could be recognized without that test and whether each item of loss was properly calculated.

Our approach

We argued for the disability on the client's behalf based on the court-ordered medical appraisal. The appraising physician gave the opinion that the existence of the ligament tear itself falls within the disability rating criteria, so an instability test was unnecessary. On that basis, we calculated and claimed each item separately, including future income lost due to the disability, lost earnings during hospitalization, and compensation for emotional distress.

The court's reasoning

The court applied Supreme Court precedent that an appraisal must be respected unless its method is clearly flawed, for example by contradicting common experience or lacking rationality. Considering also that the client had not undergone ligament reconstruction surgery, the court found no clear flaw in the method the physician applied and rejected the insurer's argument. It recognized permanent disability of the knee as well as permanent and temporary (time-limited) disabilities in other areas. The loss the court calculated on this basis exceeded the amount the client had claimed.

Outcome

The court ordered the insurer to pay the full amount claimed, about KRW 240 million, plus late-payment interest from the date of the accident. It also ordered the insurer to bear all litigation costs and made the judgment provisionally enforceable before it becomes final.

What this case means

Even when an insurer disputes how a disability was assessed, a court-ordered appraisal without clear flaws can be upheld. Recognition of disability turns on medical grounds such as the physician's opinion and the course of treatment, so careful preparation from the appraisal stage matters.

This is the outcome of an individual case and does not guarantee the same result in similar matters. Some facts have been generalized to protect the parties involved.