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(영문) 서울중앙지방법원 2012.06.28 2012가단11547

보험금

Text

1. The Plaintiff:

A. Defendant Samsung Life Insurance Co., Ltd.: 20 million won and its relation thereto from July 8, 201 to February 2, 2012.

Reasons

1. Facts of recognition;

A. Article 12 of the Terms and Conditions of the Defendant Samsung Life Insurance Co., Ltd. (hereinafter “Defendant Samsung Life Insurance”) to which the Plaintiff joined the contract on June 1, 1999 refers to a disease (i.e., classification No. 160-63, 165-I66) classified as brain stroke among the cerebrovascular diseases as specified in the attached Table 6 (Classification of Brain Diseases and Brain Diseases). ② The diagnosis confirmation of brain strokes is to be made by a person who holds a medical doctor’s license (excluding dentists) of a domestic hospital as defined in Article 3 of the Medical Service Act or an overseas medical institution (excluding dentists) recognized by the company as equal to the above, and this diagnosis should be made by computerized strokescopic examination, nuclear self-copic image method, cerebrovasopic copic copic stroke, cerebrneopic copic typhical typhical typhical m.

B. Article 15 of the terms and conditions of the Defendant Samsung Fab Life Insurance Co., Ltd. (hereinafter “Defendant Samsung Fabio”), which entered into the contract on November 15, 2004, include the same content as the Defendant Samsung Fab Life Insurance’s Non-Distribution Women’s Health Insurance Act during the stroke of the terms and conditions, and require the Plaintiff to pay KRW 10 million when the diagnosis is conducted with brain fabrus for more than one year after the date of the contract.

C. The Plaintiff complained of drums, etc., and was hospitalized at B Hospital from May 23, 2011 to June 20, 2011, and the doctor C diagnosed the Plaintiff with brain resistant M&C (I63.8).

Based on this diagnosis, the Plaintiff claimed the payment of insurance money to the Defendants, but the Defendants refused payment to the effect that it does not constitute an insured incident under the terms and conditions.

Grounds for recognition: