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

Purport of claim and appeal

1..

A. On October 2014, the Plaintiff entered into a “C” contract (hereinafter “instant insurance contract”) between the Defendant and the insured, the Plaintiff, the beneficiary, or statutory heir, the insurance premium of KRW 126,842, and the insurance period from October 20, 2014 to October 20, 2081.

The insurance contract of this case is included in the insurance amount of 400,000 won, the insurance amount of 16 large-scale disease surgery expenses, 500,000 won.

B. The main contents of the relevant special agreement among the instant insurance contracts are as follows.

2-24. 질병수술비 특별약관 제1조(“수술”의 정의와 장소) 이 특별약관에서 “수술”이라 함은 병원 또는 의원의 의사, 치과의사의 자격을 가진 자(이하 “의사”라 합니다)에 의하여 치료가 필요하다고 인정한 경우로써 의사의 관리 하에 치료를 직접적인 목적으로 기구를 사용하여 생체(生體)에 절단(切斷, 특정부위를 잘라 내는 것), 절제(切除, 특정부위를 잘라 없애는 것) 등의 조작(操作)을 가하는 것을 말합니다.

In addition, the new medical technology evaluation committee under the Ministry of Health and Welfare (in the case of the subsequent revision of the system, the institution that performs the same function as that of the committee) will include the latest operation method that recognizes the stability and treatment effect.

다만, 흡인(吸引, 주사기 등으로 빨아들이는 것), 천자(穿刺, 바늘 또는 관을 꽂아 체액ㆍ조직을 뽑아내거나 약물을 주입하는 것) 등의 조치 및 신경차단(神經遮斷, Nerve Block)은 제외합니다.

The operation referred to in paragraph (1) shall be performed at a domestic or foreign medical institution prescribed in Article 3 (2) of the Medical Service Act (medical institution) due to difficulties in medical treatment at home, etc.

Article 2 (Grounds for Payment of Insurance Money) Where the insured undergoes an operation for the direct purpose of treating a disease diagnosed and confirmed during the insurance period, the company shall purchase the insurance amount of the special terms and conditions per operation.