부당이득반환등
1. The plaintiff's appeal is dismissed.
2. The costs of appeal shall be borne by the Plaintiff.
Purport of claim and appeal
1...
1. Facts of recognition;
A. The Plaintiff, the policy holder, and the insured, designated the Defendant as the Defendant, and concluded an insurance contract under which the Defendant received medical expenses within a certain scope when the Defendant was hospitalized in a hospital, etc. due to a disease during the insurance period (the product name agreement insurance, the securities number B, and the insurance period from October 8, 2007 to October 8, 2048).
B. On January 20, 201, the Defendant received, at C’s Council members, a procedure to remove a baton’s batom’s batom using the matom’s matom (hereinafter “matom’s matom procedure”).
C. On January 20, 201, the Defendant claimed insurance proceeds from January 20, 201 to 18:32 of the same day to the Plaintiff on the ground that he/she had been hospitalized in the hospital. On January 31, 2011, the Defendant received KRW 1.4 million insurance proceeds from the Plaintiff.
[Ground of recognition] Facts without dispute, Gap evidence 1 to 3, 5 evidence, Eul evidence 1 to 3, the purport of the whole pleadings
2. Determination as to the cause of action
A. The plaintiff's assertion that there was no need to receive hospitalized treatment after the Mamomom surgery, and the defendant obtained insurance money from the plaintiff by obtaining a false diagnosis as if he had received hospitalized treatment, even though there was no fact that he actually received hospitalized treatment. Thus, the defendant is obligated to pay the insurance money of 1.4 million won and damages for delay to
B. Determination means that, in a case where continuous observation by a medical personnel is necessary with respect to the side effects or incidental effects of the drugs which are very low resistance to, or are administered by, the disease of the patient, the treatment is being performed while staying in the hospital due to the need for continuous administration of drugs and foods, etc., where the patient’s pains are in a situation where the patient’s condition is unable to cope with, or where the patient’s risk of infection exists, etc.