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(영문) 부산지방법원 2020.04.23 2019나56968

보험금

Text

1. The defendant's appeal is dismissed.

2. The costs of appeal shall be borne by the Defendant.

Purport of claim and appeal

1..

Reasons

1. Facts of recognition;

A. On November 20, 1998, the Plaintiff concluded C insurance contracts with the Defendant, D insurance contracts on March 31, 2005, and E insurance contracts on July 27, 2005, respectively.

(hereinafter referred to as “each of the instant insurance contracts”. The Defendant paid 30,000 won per day (120 days limit) for each of the above insurance contracts to the Plaintiff when the Plaintiff continued to be hospitalized for at least four days due to disease in each of the above insurance contracts.

B. Of the terms and conditions of each of the instant insurance contracts, the contents pertaining to the instant case are as shown in the attached Form.

C. On March 22, 2017, the Plaintiff was diagnosed by the F Hospital located in Seo-gu, Busan (hereinafter “instant hospital”) with an engine expansion certificate and detailed unknown identification, etc., and was discharged after being hospitalized in the said hospital for 30 days from the same day until April 20, 2017.

On April 28, 2017, the Plaintiff re-exploited the instant hospital to undergo a diagnosis of detailed unknown consciousness, detailed organ blapation, organ expansion, etc., and discharged the hospital after being hospitalized for 32 days from the same day until May 29, 2017.

[Ground of recognition] Facts without dispute, Gap evidence 1 to 5, Eul evidence 1 to 3 (including each number; hereinafter the same shall apply) and the purport of the whole pleadings

2. The parties' assertion

A. The Defendant shall pay 5,580,000 won to the Plaintiff, equivalent to the total period of 62 days of the Plaintiff’s hospitalization according to each of the instant insurance contracts.

B. 34 days or 21 days out of the total period of hospitalization of the Plaintiff cannot be deemed as cases where the pertinent number of days of hospitalization under each insurance contract of this case was necessarily required to the Plaintiff, that is, the pertinent period of hospitalization. Therefore, there is no obligation to pay insurance to the Defendant for the pertinent period of hospitalization.

Therefore, the defendant is obligated to pay only the insurance money equivalent to KRW 2,520,00 (28 days of proper hospitalization) or KRW 3,690,000 (41 days of proper hospitalization) according to each insurance contract of this case to the plaintiff.

3. Determination

A. Relevant legal principles.