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(영문) 서울남부지방법원 2019.11.28 2018가단242295

손해배상(기)

Text

1. The Defendant’s KRW 37,813,450 and the amount of the revised claim indicated in the attached Table “amount of the corrected claim” among the Plaintiff’s money.

Reasons

1. Facts of recognition;

A. On November 27, 1997 (Securities Number D), and November 19, 198 (Securities Number F), and June 30, 2001 (Securities Number H) between the Plaintiff and the company that engages in the insurance business prescribed by the Insurance Business Act as its business purpose, the Defendant concluded each contract, and each of the above insurance contracts included a special agreement under which hospital benefits are paid if the insured is hospitalized for a certain period of time.

B. The Defendant received insurance money from the Plaintiff on each date indicated in the “date of the first claim amount” column in the annexed Table in the “Date of the Payment of the First Claim Amount” column in the annexed Table by means of long-term hospitalization of the Defendant himself/herself or the Defendant’s children who are the insured, as long as necessary, by using the fact that the time zone was easily hospitalized at the patient upon the patient’s request without any objective grounds for symptoms, pretending to be false or minor symptoms, and making a long-term hospitalization of the insurance company as a serious symptoms.

C. As above, the Defendant was indicted for fraud on the charge of receiving insurance money (the victim of the crime subject to the above indictment includes not only the Plaintiff, but also other insurance companies) on August 11, 2016, and was sentenced to one year of imprisonment at the first instance court (Seoul District Court 2013Da4644) on December 11, 2016, and was sentenced to eight months of imprisonment at the appellate court (Seoul District Court 2016No2894) on December 1, 2016, and the judgment at the above appellate court became final and conclusive around that time.

On the other hand, when calculating the amount of pure damage, excluding the amount of lawful insurance payment due to the adequate number of hospitalization days, the amount of the amended claim is as indicated in the “amount of the amended claim” column in the attached Table, and the sum is KRW 37,813,450 as indicated in the pertinent “limit” column.

【Ground of recognition】 The fact that there has been no dispute, each entry of Gap's 1 through 5 (including virtual number), and the purport of whole pleadings

2. Determination as to the cause of action

A. The above facts of recognition are examined.

참조조문