Changes and Challenges in the Concept of Industrial Accident Insurance in Korea

산업재해 인정 형태 변화와 보상체계 합리화 연구

The compensation system in industrial accident insurance is systemized with "either receiving all or no benefits at all" according to "admited or denied as an industrial accident". Therefore, they are centered on the decision as "industrial accident" or "non-industrial accident", but judging between the two is very complicated, and has inherent conflicting factors. In the early stage of industrialization, industrial accident compensation was based on the indemnity liability for employer's faults. In order to be compensated any damage, the injured worker should prove that the accident was not due to his or her faults. However it was very difficult for injured worker or his or her family to prove the employer's faults, so it was almost impossible to get compensation. Thereafter industrialization progress and improvement of workers' political status lead to conversion from principle of liability with employer's faults to principle of liability without employer's faults. In addition to that, coverage of industrial accident compensation was also expanded. This improvement strengthened the benefit payment principle of "All or Nothing". Even though the "All or Nothing" principle provokes tremendous criticism, the reason why it's difficult for industrialized countries to adopt partial compensation system, is that partial compensation system worsens the administrative hardship, therefore industrialized countries overcome the restrictions of the "All or Nothing" principle with making balance in provisions for any risk to some extent. However, in Korea because the general compensation system for covering medical cost and income loss from accidents, is not equipped, it could be possible to cause acute conflicts with regard to coverage of industrial accidents. Therefore it is required to improve the industrial accident insurance with the acceptance of the significance and logic of discriminated compensation, and create the integrated compensation system in the long run.

본 연구는 산재보험의 재해보상이 산재 여부에 따라 급여 수급을 전액받거나 혹은 전액 받지 못하는 체계로 인해 산재여부에 대한 판정의 복잡성과 갈등의 요소가 내재되어 있는 문제점의 개선에 초점을 두고 있다. 재해보상형태는 초기 원인주의에 입각한 사용자의 배상책임에 따라 배상 정도가 결정되었으나, 이후 무과실책임주의로의 전환과 재해인정범위의 확대 과정을 거치게 되었다. 이러한 발전은 재해인정에 있어서 All or Nothing 원칙 강화로 이어지게 된다. All or Nothing 원칙이 상당한 논란의 소지가 있음에도 부분인정제도를 도입하기 어려운 이유는 행정적 복잡성을 더욱 심화시키는 점에 있다. 따라서 선진국에서는 사회보장의 종합적 차원에서 보편적 보장을 통해 전체인정제도의 한계를 극복하고 있다. 하지만 한국의 경우 재해로 인한 비용발생이나 소득손실에 대해 종합적 보장체제가 이뤄져 있지 않아 산재인정과 관련된 논란이 심해질 우려가 있다. 따라서 보상차등화의 취지와 논리 수용을 통한 제도개선과 더불어 장기적으로는 종합적인 재해보상 체제 구축이 요구된다.