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(영문) 서울중앙지방법원 2016.10.13 2014가단5331332

보험금

Text

1. The defendant,

A. As to Plaintiff A’s KRW 48 million and as to this,

B. As to Plaintiff B’s KRW 20 million and this,

Reasons

1. Basic facts

A. (1) On August 25, 1998, Plaintiff A entered into an insurance contract with the Defendant to pay KRW 50 million insurance money (including KRW 10 million in the special agreement for non-distribution cancer diagnosis) when the diagnosis of the insured and the beneficiary as “C,” and “in the case of diagnosis confirmation,” respectively, to pay KRW 10 million (including KRW 2 million in the special agreement for non-distribution cancer diagnosis), and to pay KRW 10 million in the case of surgery for cancer treatment, and KRW 2 million in the case of surgery for cancer treatment (hereinafter “instant insurance contract”).

(2) On March 3, 2001, Plaintiff B entered into a health insurance contract for the New Women’s Health Insurance Act (hereinafter “instant 2 insurance contract”) with the insured and the beneficiaries as Plaintiff B, with the effect that: (a) KRW 20 million of the insurance money when the diagnosis and determination is made as “ female specific cancer”; and (b) KRW 4 million of the insurance money when the diagnosis and determination is made as “ordinary cancer”; and (c) KRW 5 million of the insurance money when the surgery for female specific cancer treatment is performed; and (d) KRW 1 million of the insurance money when the surgery is performed for the treatment of the upper cancer cancer (hereinafter “instant 2 insurance contract”).

(b) Article 9 of the terms and conditions of the Insurance Agreement [the definitions and diagnosis confirmation of “Cance”] (1) The term “Cance” in this Agreement refers to diseases (as shown in attached Table 3 “Crance Life Classification”) classified as malicious life in the basic classification of the Korea Standard Disease Classification.

However, it is important to set aside the term of "Pregrant" or the term of office malgrant farant farant farant farant farant farite, which shows symptoms of diseases falling under C44 of the classification number C4 of the attached Table 3, shall be excluded from the above classification.

(3) The diagnosis and confirmation of cancer shall be conducted by a person with a professional doctor's license for autopsy pathology or clinical pathology, and this diagnosis shall be based on the current condition check of tissue or blood examination.

§ 10. (hereinafter omitted)