Evaluation of Applications to the Insurance Arbitration Commission with the Claim of Increased Degree of Incapacity for Work Under the Rule “No Application Can Be Made to the Commission Regarding Disputes Referred to the Court” (Article 30/14 of the Insurance Law)
According to Article 30/14 of the Insurance Law (IL) No. 5684, applications cannot be made to the Insurance Arbitration Commission regarding disputes referred to courts or consumer arbitration committees. This provision of the Insurance Law can be linked to pendency and res judicata, among the negative litigation conditions regulated in the Code of Civil Procedure (CPC) No. 6100. However, the exact scope of the rule is not fully clear from its wording. In some of its decisions, the Court of Cassation has not limited the application of this rule to the pendency or res judicata. The practice of the Court of Cassation in this direction has also been observed in some of its decisions concerning the applications made to the Commission by a person whose action for damages based on incapacity against the insurer in the state court was concluded, claiming that the degree of incapacity for work has subsequently increased. The Court of Cassation, which considers it possible to file a new lawsuit for the compensation of damages linked to an increase in the degree of incapacity, has adopted the view in some of its recent decisions that no application can be made to the Insurance Arbitration Commission for this second lawsuit, citing Article 30/14 of the Insurance Law. This study evaluates the scope of the rule in Article 30/14 of the Insurance Law and the view of the Court of Cassation.
İş Göremezlik Oranının Arttığı İddiasıyla Sigorta Tahkim Komisyonuna Yapılan Başvuruların ‘‘Mahkemeye İntikal Etmiş Uyuşmazlıklarla İlgili Olarak Komisyona Başvuru Yapılamaz’’ Kuralı (SK m 30/14) Çerçevesinde Değerlendirilmesi
5684 sayılı Sigortacılık Kanunu (SK) m 30/14’e göre, mahkemeye veya tüketici hakem heyetine intikal etmiş uyuşmazlıklar ile ilgili olarak Sigorta Tahkim Komisyonuna başvuru yapılamaz. Sigortacılık Kanunu’nda öngörülen bu hükmün, 6100 sayılı Hukuk Muhakemeleri Kanunu’nda (HMK) düzenlenen olumsuz dava şartlarından derdestlik ve kesin hüküm ile ilişkilendirilmesi mümkündür. Ancak hükmün hangi hâllerde uygulama alanı bulacağı lafzından tam olarak anlaşılmamaktadır. Yargıtay bazı kararlarında bu hükmün uygulama alanını, mahkemede daha önce açılan aynı davanın hâlen derdest veya kesin hükme bağlanmış olması hâliyle sınırlandırmamıştır. Yüksek Mahkemenin bu doğrultudaki uygulamasına, iş göremezliğe bağlı zararının tazmini için sigortacıya karşı devlet mahkemesinde açtığı tazminat davası neticelenen kişinin, daha sonra iş göremezlik oranının arttığı iddiasıyla Sigorta Tahkim Komisyonuna yaptığı başvurulara ilişkin verdiği bazı kararlarında da rastlanılmaktadır. Artan iş göremezliğe bağlı olarak ortaya çıkan zararın tazmini için yeni bir dava açılmasını mümkün gören Yargıtay, yakın tarihli bazı kararlarında Sigortacılık Kanunu m 30/14 hükmünü gerekçe göstererek bu ikinci dava için Sigorta Tahkim Komisyonuna başvurulamayacağı görüşünü benimsemiştir. Bu çalışmada Sigortacılık Kanunu m 30/14’te öngörülen kuralın kapsamı ve Yargıtayın bu görüşünün isabetli olup olmadığı değerlendirilmektedir.
In cases where a person suffers partial or total permanent incapacity for work due to a tort or contractual breach, he/she may bring an action for compensation against the insurance company whose liability arises because of the damage due to this incapacity. For this purpose, the injured person can apply to the state court or the Insurance Arbitration Commission (for voluntary insurances, provided that the relevant insurer is a member of the insurance arbitration system; for compulsory insurances, membership is not required). The person who has exercised his/her right of choice in favour of filing a lawsuit in the state court may experience a progression in the effect of the damaging incident and a consequent increase in the degree of incapacity after the conclusion of the lawsuit.
At this point, the question arises as to whether the injured party, who had previously obtained a judgment from the state court concerning the same incident, still has the option to choose between state jurisdiction and the Insurance Arbitration Commission in respect of a new case based on the increase in incapacity. Because in Article 30/14 of the Insurance Law, it is accepted that no application can be made to the Commission regarding disputes submitted to the court. This study mainly aims to address this issue.
In this context, firstly, the issue of whether the negative effect of res judicata [Article 114/1 (i) of the CPC] arising as a result of the first lawsuit will constitute an obstacle to the examination of the second lawsuit to be filed with the claim that the degree of incapacity has increased is examined. It has been determined that the Court of Cassation has adopted the view that if there is an increase in the degree of disability of the injured person due to an evolving situation, a new lawsuit can be filed for compensation of the damage linked to this reason. In other words, the Court of Cassation accepts that there is a difference in terms of cause and subject matter of the case between the compensation case filed based on the evolving situation and the compensation case previously filed and concluded regarding the same damaging incident.
This study then examines the scope of the rule in Article 30/14 of the Insurance Law. It is possible to associate the aforementioned rule with pendency and res judicata, among the negative litigation conditions regulated in the CPC. However, in Article 30/14, instead of the concept of pendency or res judicata, a phrase unusual for our civil procedure law terminology and whose scope is uncertain (the dispute has been submitted to the court) has been used. This phrase raises doubts about the cases in which this rule will be applied.
Until the end of 2022, the Court of Cassation had interpreted the aforementioned rule in parallel with the pendency and res judicata. However, it has been determined that the Court of Cassation’s approach to the scope of application of the Insurance Law Article 30/14 has tended to change since late 2022 and has begun to interpret the field of application of the provision more broadly.
This tendency of the Court of Cassation was also determined in our subject of examination. Because until late 2022, the Court of Cassation considered it permissible to apply to the Commission for compensation of damages linked to an increased degree of incapacity due to an evolving situation. However, some more recent decisions have concluded that such applications should be rejected under Article 30/14 of the Insurance Law.
In our opinion, Article 30/14 of the Insurance Law, as a rule, can be applied in cases where a previously filed lawsuit with the same parties, cause and subject matter is still pending in the state court or where the negative effect of the res judicata exists. Accordingly, if it is accepted that the lawsuit filed for compensation for damages linked to the increased incapacity due to an evolving situation is different in terms of cause and subject matter from the first compensation lawsuit filed and decided by the state court, it should be possible to file a second lawsuit by applying to the Commission. In fact, in this situation, the dispute previously examined in the court differs from the dispute to be examined by the insurance arbitrators, and no prior dispute regarding compensation for damages linked to increased incapacity for work has been referred to the court. In addition, after it is deemed possible to file a new lawsuit for compensation for the damage linked to an increased degree of incapacity, there is no interest to be protected in not accepting that this case can be filed by applying to the Insurance Arbitration Commission.