보험모집인 및 보험대리점의 보험계약법적 문제점과 개선방안

Abstract

보험상품은 다른 금융상품과 비교할 때 판매 방식에 차이가 존재할 뿐만 아니라 계약기간이 장기라는 점에서 보험계약자 등 보험소비자에게 미치는 영향이 크다. 보험계약자는 일반적으로 보험자 및 보험모집 종사자가 제시한 표준약관에 근거하여 보험계약을 체결하지만, 보험사고가 발생한 후 보험금을 받는 과정에서 계약 체결 당시에는 알 수 없었던 새로운 사실에 직면한다. 예를들어 교통사고를 당하거나 화재사고가 발생했다고 가정할 경우, 그 사고의 보상에 관련된 사람이 적게는 1～2명에서 수십 명에 이르게 되고 그 피해액수도 수억 원에 달할 수 있다. 이때, 피해액을 보험금으로 전보할 수 있는지가 보험모집인이나 보험대리점의 권한과 관련되어 있다는 중대한 법률문제를 깨닫게 되는 것이다. 정상적인 보험계약을 체결한 경우에는 보험사고로 발생한 피해액을 전보할 수 있으나 계약체결상의 문제가 있다면 보상은 어렵게 된다. 그러므로 보험계약자가 보험모집인이나 보험대리점을 통해 보험에 가입할 경우 어떻게 계약을 체결하였는지 그리고 이들과의 관계에서 어떤 행위를 하였는지가 매우 중요하다.

보험계약자는 일반적으로 고지의무의 존재를 인식하고, 성실하게 이행하여야 함을 보험모집자의 설명을 통해 알게 된다. 즉 다수의 보험계약자와 계약을 체결하는 보험자로서는 보험약관이라는 정형화된 계약의 내용을 만들고, 이에 대한 숙지 도가 높은 보험설계사 등 보험모집 종사자가 보험계약자 등에게 이를 설명하도록 하여 청약의 유인을 한다. 이러한 이유로 보험전문가와 계약을 체결하게 되는 보험계약자 보호를 위해 보험약관 설명의무 등이 중요하게 부각된다. 보험계약 체결 과정에서 실제 설명의무를 이행하는 보험설계사의 중요한 역할에도 불구하고 보험설계사는 계약체결 실적에 따라 수수료를 받으므로 보험계약의 체결을 위해 보험약관 등에 대한 설명을 부실하게 할 가능성이 존재한다. 이러한 상황에서는 보험계약자 등 보험소비자는 정보의 비대칭에서 벗어나기 어렵다. 또한, 보험자 입장에서도 대수의 법칙에 근거하여 최대한 많은 보험계약의 체결을 위해 노력하므로 모집 과정에서의 법적 문제점에 대해서 적극적 조사와 확인을 게을리하는 경향이 있다고 본다. 보험소비자의 경우에 전문적인 지식이 부족할 뿐만 아니라 보험설계사 등의 권유로 청약에 이르기 때문에 계약체결과정에서 이루어지는 법적 쟁점에 대해서 보험모집조직을 전적으로 신뢰할 가능성이 높다. 따라서 보험계약자는 보험계약체결과정에서는 인지하지 못했던 법적 쟁점을 보험사고 발생 이후 보험금을 청구하는 과정에서 뒤늦게 알게 된다. 이와 같은 보험의 불완전판매 문제가 최근들어 새로운 보험상품 즉 변액보험, 복합상품 등의 판매와 맞물려 더욱 부각되고 있다. 전체 금융업에서 발생하는 민원 중 보험이 차지하는 비중이 과반수에 이르고 있으며, 특히 보험모집과 관련된 문제로부터 야기되는 사항이 상당 부분을 차지하고 있다. 금융 당국은 이러한 문제를 해결하기 위해 감독강화, 제도 개선 및 법률 개정 등 다양한 방안을 검토하고 있다.

본 논문에서는 국내의 중요한 보험모집조직인 보험설계사와 보험대리점의 문제점을 분석하고, 합리적인 개선방안을 모색하였다. 먼저 2013년 2월 국회에 제출된 정부의 상법 보험편 개정안을 검토하고, 보험소비자 보호 차원에서 입법 개선 방안을 제안하였다. 보험설계사 역할의 중요성을 고려하여 이들에 대한 정의 및 권한을 보험대리점에 준하여 상법 보험편에 규정하는 방안을 검토하였다. 아울러 보험자에게 부여된 보험약관 설명의무 규정에 대한 입법 개선안을 제안하였다. 보험약관의 설명에 문제가 있음을 보험계약자 등이 인식하는 시기가 보험계약 체결 이후 상당 기간이 지난 후임에 주목하여 보험계약자가 1개월 이내에 보험계약의 취소권을 행사하는 것이 의미가 없음을 지적하였다. 이에 따라 취소권 행사 기간을 보험계약자가 그 사실을 안 날로부터 1개월 이내에 행사하도록 주장하고, 최근 보험선진국에서 논의되고 있는 정보제공의무 규정을 상법 보험편에 두는 방안을 제안하면서 보험계약자의 청약철회권을 포함하였다. 2013년 2월 현재 보험업법에 보험계약자 청약철회권 규정을 두는 입법안이 제안되었으나 보험소비자 보호와 보험계약법 체계상 상법 보험편에 두는 새로운 입법안을 제안하였다. 보험소비자 보호를 위한 입법 개선의 필요성을 인식하고, 실제 그러한 방향으로 논의되고 있음은 다행스러운 일이다. 우리나라의 경우 보험모집에 있어서 보험설계사의 역할이 중요함에도 이들의 법적 신분이 분명하지 않은 점이 문제시되어 왔다. 이에 보험소비자 보호 차원에서 보험설계사의 권한을 보험계약법에 명시적으로 규정할 것을 제안하였다. 또한, 보험계약자가 보험설계사와 보험자를 동일시하는 보험거래의 현실을 고려하여 보험설계사에게 근로자성을 인정하자는 논의가 있다. 그러나 이는 보험자와 보험설계사의 계약관계에 관한 문제이므로 일률적으로 근로자성 여부를 결정할 것이 아니라 보험설계사의 전문성 등 업무능력과 보험회사의 사정을 고려하여 이원화하는 방안을 모색하여야 할 것이다.

보험대리점의 경우에는 보험설계사보다 상대적으로 법적 문제가 적은 것으로 보인다. 그러나 최근 들어 독립법인대리점의 급성장으로 인해 보험설계사의 대량 이동이 이루어지고 있고, 이 때문에 보험모집질서가 문란해지고 있다. 높은 수수료를 지급하는 것을 조건으로 보험대리점은 보험설계사를 기존의 보험회사 또는 다른 보험대리점에서 스카우트하고 있으며, 보험계약 체결 실적에만 주목하여 사실상 부실한 보험계약이 체결되고 있다. 보험계약자 등이 보험모집 보조자의 모집행위로 인해 손실을 본 경우, 보험업법 제102조에 따라 보험회사가 이에 대한 책임을 부담하는 것이 현재의 법률 구조이다. 추후 보험회사는 부실 보험계약 또는 불법행위를 한 보험설계사에 대하여 구상 청구를 함으로써 보험설계사는 자신의 행위에 대해서 책임을 지게 된다. 그러나 독립법인대리점은 보험설계사를 피용인으로 활용하고 있음에도 이에 대한 책임을 지지 않는 문제가 제기된다.

본래 보험업법 제102조의 규정은 배상자력이 있는 보험회사에 그 책임을지우고 추후 구상하는 것으로서, 독립법인대리점의 경우에는 보험판매업자로서 스스로 책임을 질 수 있는 충분한 배상자력이 있으므로 직접 이들에게 책임을 물을 수 있도록 배상능력을 강화하는 방안이 검토되어야 할 것이다. 결국, 금융기관 보험대리점, 대통령령으로 정하는 법인보험대리점의 경우 통상의 보험대리점과는 차이가 있는 대형 판매회사로서 보험회사 등과 비교할 때, 최소한 대등한 배상자력을 갖는 것으로 본다. 이에 따라 보험업법 제102조에서 정하는 보험회사의 배상책임 대상에서 제외하고 직접 이들이 배상책임을 지도록하는 입법안의 제안이 가능하다. 그러나 문제는 보험대리점을 세분하여 다른 규정을 적용하는 것에 대한 기준이 모호할 뿐만 아니라 대리의 법리 및 법체계상으로도 타당하지 않다는 사실이다. 상기 내용의 법제화를 위해서는 신중한 검토가 전제되어야 하며 그 기준은 법리적 타당성, 법률의 체계성, 국제적 정합성 등이 고려되어야 할 것이다. 따라서 이들 독립법인대리점이 직접 책임을 지도록 하는 법규정을 두는 것은 현재 상황에서는 어렵다고 본다. 더 나아가 현행 보험업법에서 규정하고 모집을 위탁한 보험회사의 책임 규정은 보험계약 당사자 사이의 권리와 의무에 관한 사항이므로 보험계약법에 규정하는 것이 타당하다고 본다. 이에 보험계약법인 상법에 모집을 위탁한 보험회사의 책임 규정을 두는 방안을 제안하였다.

21C 금융시장에서 보험업의 지속적인 성장을 위해 필요한 것은 보험소비자 보호를 위한 보험모집 종사자의 인식 전환과 이를 뒷받침할 수 있는 입법 및 제도 개선이라고 본다. 보험 민원의 과도한 발생은 보험모집 과정에서의 문제가 주요 원인이며, 이러한 상황의 지속은 보험업의 성장에 부정적인 영향을 미칠 것이다. 따라서 금융 당국의 적극적인 개선 노력과 보조를 맞추어 보험회사, 보험모집 종사자 등의 인식 전환이 필요하다. 다만, 본 논문에서의 보험소비자는 대다수의 선의의 보험계약자를 의미하는 것이므로 사기적 보험계약이나 보험금 청구를 함으로써 보험시장을 어지럽히는 보험범죄자는 배제되어야 하며, 근절의 대상이 되어야 한다.| Insurance products not only have differences from other financial products in terms of sales approaches, but also exercise great influence on insurance consumers including the insured compared with other industries for their long-term contract periods. The insured generally make insurance contracts based on the standard terms provided by the insurer and insurance salesman. However, they would face a new set of facts not known at the time of making the contract in the process of collecting insurance money after an insurance accident in most cases. When the insurance contract was made normally, the amount of damage caused by an insurance accident can be supplemented. If there had been some problem with the contract, however, compensation will be difficult. Thus it is extremely important to consider whether the disclosure items were properly disclosed and the disclosure items were notified to the just individual with the right to receive disclosure at the time of insurance subscription.

It is the common case that the insured get to perceive the existence of duty of disclosure and understand that it should be sincerely carried out through the explanations of insurance salesmen. That is, the insurer makes a contract with a large group of the insured, thus making the insurance terms, the standardized content of contract, and having professionals of insurance solicitation such as insurance salesmen with good knowledge of them explain them to the insured to drive them toward subscription. It is only natural that the insurer possesses much more information on insurance contracts than the insured. It is those reasons that make the duty of explaining the insurance terms to the insured so important in order to protect the insured who make a contract with the insurance professional. Although insurance salesmen are supposed to play a critical role to carry out the duty of explanation in the process of making an insurance contract, there are some temptations for them to give poor explanations to make an insurance contract because they receive commissions according to the number of contracts they make. Under such a situation, it is difficult for insurance consumers including the insured to escape from information asymmetry. The insurers also have a tendency of being lazy with actively investigating and checking legal issues in the solicitation process since they try to make as many insurance contracts as possible according to the law of large numbers. Insurance consumers not only lack specialized knowledge, but also get to the stage of subscription by the recommendation of the insurance salesman, which means that they are highly likely to put utter trust in the insurance solicitation organization for the legal issues in the process of making a contract. The insured are late to learn the legal issues, which they failed to notice in the process of making an insurance contract, in the process of claiming for insurance money after an insurance accident. Such an issue of incomplete insurance sales has recently emerged to the surface further in combination with the sales of new insurance products such as variable insurance and hybrid products. As a matter of fact, insurance accounts for a majority of the entire civil petitions in the finance sector especially with a lot of appeals made regarding the problems with insurance solicitation.The financial authorities have sought after various measures including reinforced supervision, improved institutions, and revised acts in order to resolve those issues and problems.

This paper presents an analysis of problems with insurance salesmen and agents, the important insurance solicitation organizations in the nation, and an inquiry into rational improvement measures. The study first reviewed the bill of Insurance Act to be revised in 2013 in the realm of commercial law and proposed ways to improve the legislation to protect insurance consumers. Given the important roles of insurance salesmen, the study examined their definitions and rights in the context of Insurance Act of commercial law at the level of insurance agents. The study also tried to reflect the matters that had long been discussed including the right to receive premiums, the right to receive disclosure, and the proxy right for conclusion of a contract in the bill.

Also proposed in the study was an improvement to the bill with regard to the provision of duty to explain the insurance terms imposed on the insurer. Paying attention to the fact that the insured learn that there is some problem with the explanation of the insurance terms only a long time after the conclusion of an insurance contract, it was pointed that there is no meaning in the insured exercising the right to cancel the insurance contract within a month. The study thus proposed to eliminate the provision of cancellation right, include the provision of duty to provide information, which has recently been discussed in advanced insurance countries, in Insurance Act of commercial law, and introduce the subscription withdrawal right of the insured. It was also reviewed that there had been discussions about introducing the provision of subscription withdrawal right in Insurance Act of commercial law or in Insurance Business Act. Realistically speaking, there will be active discussions about introducing the provision of subscription withdrawal right in Insurance Business Act since a bill was put forward for it in 2013. The concerned acts should be revised in a way of further protecting the insured in line with the protection of insurance consumers.

It is good that they recognize a need to improve the concerned acts to protect insurance consumers and move their discussions toward the direction. In South Korea where insurance salesmen play an important role in insurance solicitation, the lack of their legal status has always been a problem. The study thus reviewed the problem, made their rights clear for the protection of insurance consumers, and discussed rational alternatives for contract relations between the insurer and insurance salesmen. Considering that the insured identify insurance salesmen as the insurer and that insurance salesmen play an important role in insurance solicitation, it will be appropriate to recognize their worker status of special type.

Insurance agents seem to have relatively fewer legal issues than insurance salesmen. In recent years,however, the rapid growth of independent corporation agents has caused a large-scale movement among insurance salesmen and resulted in a disorder in the order of insurance solicitation. Insurance agents scout insurance salesmen from their old insurance companies or other insurance agents on the condition of high commissions and make incomplete insurance contracts only by focusing on the number of insurance contracts. In case of incomplete insurance contracts, insurance salesmen have to pay to the insured. It is a problem that independent corporation agents take no responsibility whatsoever for incomplete insurance contracts even though they use insurance salesmen as employees for insurance contracts. Article 102 of Insurance Business Act holds an insurance company with the capacity for compensation accountable for an incomplete insurance contract and makes a claim for compensation later. Independent corporation agents do have enough capacity for accountability and compensation, which means that the concerned act should be improved in a way to hold them directly accountable for it. Based on that perception, the study proposed to stipulate a provision of holding independent corporation agents accountable the same as insurance companies and prevent insurance salesmen or employees of insurance agents from directly compensating for insurance consumers.

Insurance solicitation professionals should change their perceptions to protect insurance consumers and be accompanied by law and institution improvements to support them in order to ensure the ongoing growth of the insurance industry in the financial market of the 21st century.The excessive number of civil petitions regarding insurance is mainly attributed to the problems taking place in the process of insurance solicitation. Such a situation will have negative impacts on the growth of the insurance industry. The financial authorities thus need to help insurance companies and insurance solicitation professionals change their perceptions in line with their active efforts for improvement. Since insurance consumers here mostly refer to the insured with a good intention, insurance criminals that disturb the insurance market with fraudulent insurance contracts and insurance money claims must be excluded from the consideration and be the target of eradication.; Insurance products not only have differences from other financial products in terms of sales approaches, but also exercise great influence on insurance consumers including the insured compared with other industries for their long-term contract periods. The insured generally make insurance contracts based on the standard terms provided by the insurer and insurance salesman. However, they would face a new set of facts not known at the time of making the contract in the process of collecting insurance money after an insurance accident in most cases. When the insurance contract was made normally, the amount of damage caused by an insurance accident can be supplemented. If there had been some problem with the contract, however, compensation will be difficult. Thus it is extremely important to consider whether the disclosure items were properly disclosed and the disclosure items were notified to the just individual with the right to receive disclosure at the time of insurance subscription.

It is the common case that the insured get to perceive the existence of duty of disclosure and understand that it should be sincerely carried out through the explanations of insurance salesmen. That is, the insurer makes a contract with a large group of the insured, thus making the insurance terms, the standardized content of contract, and having professionals of insurance solicitation such as insurance salesmen with good knowledge of them explain them to the insured to drive them toward subscription. It is only natural that the insurer possesses much more information on insurance contracts than the insured. It is those reasons that make the duty of explaining the insurance terms to the insured so important in order to protect the insured who make a contract with the insurance professional. Although insurance salesmen are supposed to play a critical role to carry out the duty of explanation in the process of making an insurance contract, there are some temptations for them to give poor explanations to make an insurance contract because they receive commissions according to the number of contracts they make. Under such a situation, it is difficult for insurance consumers including the insured to escape from information asymmetry. The insurers also have a tendency of being lazy with actively investigating and checking legal issues in the solicitation process since they try to make as many insurance contracts as possible according to the law of large numbers. Insurance consumers not only lack specialized knowledge, but also get to the stage of subscription by the recommendation of the insurance salesman, which means that they are highly likely to put utter trust in the insurance solicitation organization for the legal issues in the process of making a contract. The insured are late to learn the legal issues, which they failed to notice in the process of making an insurance contract, in the process of claiming for insurance money after an insurance accident. Such an issue of incomplete insurance sales has recently emerged to the surface further in combination with the sales of new insurance products such as variable insurance and hybrid products. As a matter of fact, insurance accounts for a majority of the entire civil petitions in the finance sector especially with a lot of appeals made regarding the problems with insurance solicitation.The financial authorities have sought after various measures including reinforced supervision, improved institutions, and revised acts in order to resolve those issues and problems.

This paper presents an analysis of problems with insurance salesmen and agents, the important insurance solicitation organizations in the nation, and an inquiry into rational improvement measures. The study first reviewed the bill of Insurance Act to be revised in 2013 in the realm of commercial law and proposed ways to improve the legislation to protect insurance consumers. Given the important roles of insurance salesmen, the study examined their definitions and rights in the context of Insurance Act of commercial law at the level of insurance agents. The study also tried to reflect the matters that had long been discussed including the right to receive premiums, the right to receive disclosure, and the proxy right for conclusion of a contract in the bill.

Also proposed in the study was an improvement to the bill with regard to the provision of duty to explain the insurance terms imposed on the insurer. Paying attention to the fact that the insured learn that there is some problem with the explanation of the insurance terms only a long time after the conclusion of an insurance contract, it was pointed that there is no meaning in the insured exercising the right to cancel the insurance contract within a month. The study thus proposed to eliminate the provision of cancellation right, include the provision of duty to provide information, which has recently been discussed in advanced insurance countries, in Insurance Act of commercial law, and introduce the subscription withdrawal right of the insured. It was also reviewed that there had been discussions about introducing the provision of subscription withdrawal right in Insurance Act of commercial law or in Insurance Business Act. Realistically speaking, there will be active discussions about introducing the provision of subscription withdrawal right in Insurance Business Act since a bill was put forward for it in 2013. The concerned acts should be revised in a way of further protecting the insured in line with the protection of insurance consumers.

It is good that they recognize a need to improve the concerned acts to protect insurance consumers and move their discussions toward the direction. In South Korea where insurance salesmen play an important role in insurance solicitation, the lack of their legal status has always been a problem. The study thus reviewed the problem, made their rights clear for the protection of insurance consumers, and discussed rational alternatives for contract relations between the insurer and insurance salesmen. Considering that the insured identify insurance salesmen as the insurer and that insurance salesmen play an important role in insurance solicitation, it will be appropriate to recognize their worker status of special type.

Insurance agents seem to have relatively fewer legal issues than insurance salesmen. In recent years,however, the rapid growth of independent corporation agents has caused a large-scale movement among insurance salesmen and resulted in a disorder in the order of insurance solicitation. Insurance agents scout insurance salesmen from their old insurance companies or other insurance agents on the condition of high commissions and make incomplete insurance contracts only by focusing on the number of insurance contracts. In case of incomplete insurance contracts, insurance salesmen have to pay to the insured. It is a problem that independent corporation agents take no responsibility whatsoever for incomplete insurance contracts even though they use insurance salesmen as employees for insurance contracts. Article 102 of Insurance Business Act holds an insurance company with the capacity for compensation accountable for an incomplete insurance contract and makes a claim for compensation later. Independent corporation agents do have enough capacity for accountability and compensation, which means that the concerned act should be improved in a way to hold them directly accountable for it. Based on that perception, the study proposed to stipulate a provision of holding independent corporation agents accountable the same as insurance companies and prevent insurance salesmen or employees of insurance agents from directly compensating for insurance consumers.

Insurance solicitation professionals should change their perceptions to protect insurance consumers and be accompanied by law and institution improvements to support them in order to ensure the ongoing growth of the insurance industry in the financial market of the 21st century.The excessive number of civil petitions regarding insurance is mainly attributed to the problems taking place in the process of insurance solicitation. Such a situation will have negative impacts on the growth of the insurance industry. The financial authorities thus need to help insurance companies and insurance solicitation professionals change their perceptions in line with their active efforts for improvement. Since insurance consumers here mostly refer to the insured with a good intention, insurance criminals that disturb the insurance market with fraudulent insurance contracts and insurance money claims must be excluded from the consideration and be the target of eradication.