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(영문) 서울중앙지방법원 2020.09.25 2020나15958

보험금

Text

The plaintiff's appeal is dismissed.

Expenses for appeal shall be borne by the plaintiff.

Purport of claim and appeal

purport.

Reasons

1. Basic facts

A. (1) The Plaintiff’s ASEAN concluded an insurance contract on November 5, 1999, between the Defendant and the beneficiary, the insured and the beneficiary were the Plaintiff (round December 7, 2010, the beneficiary was changed to C through a change of name.

) In the event of hospitalization for more than 181 days due to modern 12 diseases, D insurance contracts under which the cost of healthy life and the cost of hospitalization, etc. are paid in the event of hospitalization for more than 3 days (hereinafter “instant insurance contract”).

(2) According to the instant insurance contract, the Plaintiff is entitled to receive the following insurance proceeds in proportion to the number of days of hospitalization when the Plaintiff is hospitalized due to modern 12 diseases.

Healthy Living Costs: 17 million won per day (120 days per day) where hospitalization is conducted for more than 3 days due to modern 12 diseases: A special agreement for treatment of a specific disease for a woman of 50,000 won per day (120 days per day) where hospitalization is conducted for more than 3 days: A special agreement for hospitalization for more than 3 days per day (120 days per day) more than 3 days for hospitalization: 10,000 won per day (120 days per day) exceeding 3 days for hospitalization benefits.

B. From August 13, 2016 to February 14, 2017, the Plaintiff’s Plaintiff’s hospitalized treatment refers to the instant case’s hospitalized treatment at the Evalescent Hospital for 186 days, due to illness, high blood pressure, etc.

(C) On August 31, 2018, the beneficiary C of the instant insurance contract transferred the insurance claim to the Plaintiff under the instant hospital treatment, and notified the Defendant of the transfer of the said claim on September 3, 2018. D. The Plaintiff’s claim for the insurance claim was made on February 14, 2017, following the Plaintiff’s uratology 12 diseases in modern times, and women’s specific disease, the Plaintiff filed a claim against the Defendant for totaling KRW 26,380,00 ( KRW 17 million for healthy life expenses, KRW 5,850,00 for hospitalization expenses, KRW 2,360,00 for admission benefits under the instant insurance contract, and KRW 1,170,00 for special agreement for admission of a woman-specific disease, KRW 1,170,000 for admission.

2. On June 7, 2017, the defendant decided that the appropriate period of hospitalization was two weeks according to the medical consultation response, and paid only KRW 1970,00 to the plaintiff, and the plaintiff did not accept it.