Attached Form

1 In relation to the accidents described in the 1 List, it shall be listed in the attached Table 2.

A. On December 29, 2005, the Plaintiff concluded each of the insurance contracts listed in Attachment 2 List 1 with the Defendant, and the insurance contracts listed in Paragraph 2 of the same List as of July 23, 199, and Paragraph 3 of the same List (hereinafter “each of the instant insurance contracts”).

B. On February 17, 2012, the Plaintiff was hospitalized in B Hospital based on Nos. 3 and 4 verteblurism and vertebrate flurism, and on February 24, 2012, the Plaintiff received an climination and evacation during the extreme period (hereinafter “instant 1 surgery”), and was discharged from B Hospital after being hospitalized for 53 days from B Hospital until April 9, 2012.

C. On April 3, 2012, the Defendant was hospitalized in B Hospital, and around 15:35, the same accident as indicated in attached Table 1 (hereinafter “instant accident”). D.

On April 16, 2012, the Defendant visited B Hospital out of the 3,4 inverte vertebrates and spine instabilitys with “the evaculation 3, 4 inverteculations.” As a result of the inspection, the Defendant was diagnosed by the 3th evaculations, etc. (hereinafter “the instant injury”). After being hospitalized for 55 days from April 23, 2012 to June 16, 2012, the Defendant was hospitalized for 3,641,331 won (the personal charges) as medical expenses.

【Ground of recognition】 The fact that there has been no dispute, Gap’s Nos. 1, 2, 4, 5 (including Serial number), Eul’s Nos. 4, 5, and 9-2, and the purport of the whole pleadings

2. Determination as to the occurrence of insurance money payment obligation

A. The plaintiff asserts that the plaintiff did not have a causal relationship between the defendant's injury of this case and the accident of this case, and therefore, the plaintiff does not have an obligation to pay the injury medical expenses, the expenses of hospitalization of injury, the expenses of hospitalization of injury, the expenses of long-term hospitalization of injury

Even if the causal relationship is recognized, the Defendant received diagnosis of the instant injury, on July 2012, the nautical nautical nautical nautical nautical nautical nautical nautical nautical nautical nautical Purpose of the Horse University of the Korea Forest University, since the Defendant received diagnosis of the instant injury and received diagnosis of the 3, 4, and 5 historical nautical Purpose