Supreme Court Rules "Corns and Calluses Are Skin Diseases Not Covered by Insurance"... Final Defeat for Policyholder After 379 Procedures

Claim Filed for 379 Cryotherapy Procedures to Remove Corns

Lower Courts Rule: "Corns Fall Under Exclusion Clause"

Supreme Court: "Misapplied Res Judicata, but Exclusion Decision Is Justified"

The Supreme Court has issued a final ruling that insurance companies are not obligated to pay surgical fees for cryotherapy procedures performed hundreds of times to remove corns or calluses, as these are considered "skin diseases" under the exclusion clause of the insurance terms.

Seoul Seocho-gu Supreme Court. Photo by Yonhap News

According to the legal community on June 7, the Supreme Court (Presiding Justice Oh Seokjun) recently affirmed a lower court ruling in favor of the insurer in a lawsuit filed by policyholder A against the insurer for insurance benefits, as well as in a countersuit by the insurer against A for the return of unjust enrichment.

In July 2016, A entered into an insurance contract that provided a surgical fee of 300,000 won per procedure in the event of surgery due to illness. Subsequently, from September 2016 to November 2020, A underwent cryotherapy 379 times at various hospitals to remove corns and calluses, and filed claims for insurance benefits.

The insurer initially paid approximately 34.93 million won for the first 114 procedures, but later refused further payments and filed a countersuit, citing contract invalidation and the exclusion of certain diseases. Previously, in 2017, the insurer had also filed a lawsuit to confirm the invalidity of the contract against A, but lost, and the 2020 ruling became final.

Both the first and second instance courts ruled in favor of the insurer, ordering A to return approximately 17.83 million won. The appellate court determined that the contract was invalid, considering that A continued to undergo repeated surgeries even after the previous judgment became final. Furthermore, even if the contract was valid, the court found that corns and calluses constituted skin diseases subject to the exclusion clause, meaning the insurer was not obligated to pay the benefits.

The Supreme Court also upheld the lower court's conclusion that the insurer was not required to pay the insurance benefits. However, it corrected the appellate court's view that the contract was invalid in this case, noting that the validity of the contract had already been conclusively determined in the previous lawsuit, and that the lower court had misunderstood the principle of res judicata (the binding effect of a final judgment).

Nevertheless, the Supreme Court did not overturn the outcome, recognizing that corns and calluses are subject to the exclusion clause. The panel stated, "The lower court's finding that 'corns and calluses' fall under the skin diseases specified in the exclusion clause of this case, and therefore that the insurer is not obligated to pay insurance benefits for cryotherapy, is appropriate," adding, "The earlier misunderstanding of the principle of res judicata has no impact on the outcome of the ruling," and dismissed the appeal.

This content was produced with the assistance of AI translation services.