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(영문) 대법원 2011. 7. 28. 선고 2011다30147 판결

[손해배상(기)][미간행]

Main Issues

[1] The principle of interpretation of a standardized contract

[2] In a case where the issue is whether high-frequency agents Gap received for the treatment of Gap's maleculation constitutes "operation" under the terms and conditions of the insurance contract, the case holding that, in the insurance policy or the insurance policy, the operation subject to the payment of operating expenses does not limit it to the external treatment method to cut or cut off part of body by using medical equipment, and without limiting it to the external treatment method to cut or cut off part of body, it is hard to include it in the form of a high-frequency agents, which inserted it in the form of a male, generated by an intersection electricity in the area of high-frequency, and it is sufficiently possible to include it in a broad sense that high-frequency agents Gap received are alcohol under the terms and conditions of the insurance contract, and such interpretation theory also conforms to the principle of disadvantage of the author in the interpretation of the terms and conditions

[Reference Provisions]

[1] Article 5 of the Regulation of Standardized Contracts Act / [2] Article 5 of the Regulation of Standardized Contracts Act

Reference Cases

[1] Supreme Court Decision 2005Da35226 Decided October 28, 2005 (Gong2005Ha, 1862), Supreme Court Decision 2006Da72093 Decided February 22, 2007 (Gong2007Sang, 498)

Plaintiff-Appellant

Plaintiff

Defendant-Appellee

Kant Life Insurance Co.

Judgment of the lower court

Daejeon District Court Decision 2010Na17169 Decided February 24, 2011

Text

The judgment of the court below is reversed, and the case is remanded to Daejeon District Court Panel Division.

Reasons

The grounds of appeal are examined.

The contents of a standardized contract shall be objectively and uniformly interpreted on the basis of the average customer's understanding potential without considering the intent or specific circumstances of individual contract-holders. When the contents of a standardized contract are not clear or doubtful in terms of customer protection, the contents of a standardized contract shall be limited and interpreted favorably to the customer and unfavorably to the person who prepared the standardized contract (see Supreme Court Decisions 2005Da35226, Oct. 28, 2005; 2006Da72093, Feb. 22, 2007, etc.).

According to the reasoning of the first instance judgment cited by the judgment below, the court below acknowledged the facts as stated in its reasoning after compiling the adopted evidence, and determined that the operation generally refers to "the act of cutting off, cutting off, or manipulating the skin, sacrine, and other tissues using medical equipment and cutting off illness by using medical equipment," and that it cannot be viewed as an "the method of surgery to remove the flady by the string of the 1st through the electric current in the area of high-frequency, after inserting the string of the string, in the external string in the external string, and inserting the string through the electric current in the area of high-frequency," and it cannot be viewed as an "the method of surgery to remove the string by the string through the electric current."

However, such determination by the court below is difficult to accept for the following reasons.

According to the reasoning of the judgment below and the records, the insurance policy or the insurance clause of this case does not have any definition on the meaning of the surgery subject to the payment of the surgery expenses. Article 10 of the insurance policy and the insurance clause of this case provides that 7,500,000 won per surgery shall be paid when the surgery is performed for the direct purpose of treatment of the "12 diseases of the present" including "a disability". The plaintiff under the diagnosis of the upper ray of the disabled around 2009 and received the high frequency surgery from the large-scale hospital located in Yeongdeungpo-gu Seoul Metropolitan Government on February 13, 2009. On the other hand, the high frequency surgery is more likely to be performed by the defendant's high-frequency surgery than that of the defendant's high-frequency hospital, rather than that of the defendant's high-frequency hospital's high-frequency surgery, it is more likely that the defendant's high-frequency surgery will be performed for the removal of the upper tension surgery in the area of a specific diveter.

Examining the above facts in light of the legal principles as seen earlier, the insurance policy of the insurance contract of this case or the insurance terms and conditions do not limit the surgery subject to the payment of operating expenses to the external treatment method that cuts part of body by using medical equipment, and do not limit it to the external treatment method that reduces part of body, and the Plaintiff appears to have undergone high-frequency cliffic treatment by replacing the external treatment method for the direct purpose of the treatment of the Gap cliffic. Thus, it is sufficient to include high-frequency clifficing surgery, which reduces cliffics to the high-frequency cliffics through the electric current crossing in the high-frequency area, and thus, it is reasonable to view that the Plaintiff’s high-frequency clificing surgery, which the Plaintiff received, corresponds to the principle of interpretation of the terms and conditions of the insurance contract of this case, also corresponds to the disadvantage of the author.

Nevertheless, the court below erred by misapprehending the legal principles as to the interpretation of the insurance terms and conditions, which affected the conclusion of the judgment, on the contrary, that the high-frequency dives of this case did not fall under the scope of the insurance contract.

Therefore, without further proceeding to decide on the remaining grounds of appeal, the lower judgment is reversed, and the case is remanded to the lower court for further proceedings consistent with this Opinion. It is so decided as per Disposition by the assent of all participating Justices on the bench.

Justices Park Si-hwan (Presiding Justice)

심급 사건
-대전지방법원 2011.2.24.선고 2010나17169