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(영문) 서울중앙지방법원 2020.07.07 2018가단5256576

부당이득금

Text

1. The instant lawsuit shall be dismissed.

2. The costs of lawsuit shall be borne by the Plaintiff.

Reasons

1. Facts of recognition;

A. The status of the parties and the content of the insurance clause of this case 1) The Plaintiff is the insured as indicated in the attached list (hereinafter “the insured of this case”).

(2) The insured each of the lost medical expenses insurance (hereinafter “instant insurance”)

(1) The Defendant is an insurance company which has entered into a contract, and the Defendant is the D Hospital located in Jeonbuk-gun C (hereinafter referred to as “Defendant Hospital”).

(2) The insurance terms and conditions of the instant insurance provide that “the cost of hospitalization, hospitalization, surgery, etc. to be borne by the insured in the event of being hospitalized in a hospital due to a certain injury or disease shall be paid, and such cost means “the cost of the principal’s burden and the cost of the non-benefit” among the health care benefit prescribed in the National Health Insurance Act.

B. The Defendant hospital’s medical treatment for the instant insured and the Plaintiff’s insurance payment 1) The Defendant hospital for the instant insured (hereinafter “the instant medical treatment”) provides the “Non-Scram Signals Signals (Scram Signals)” for the instant insured.

(1) The insured provided medical treatment to the Defendant, and the Defendant paid medical expenses, such as hospitalization expenses, to the Defendant regarding the instant medical treatment, and the Plaintiff claimed insurance money in accordance with the instant insurance (hereinafter “the instant insurance money”).

2) The Plaintiff paid the instant insurance money to the insured through the account under the name of the third party, which was designated at the time of claiming insurance money, such as the policyholder’s name, not the account under the name of the insured. However, in light of the intent of the parties, it is reasonable to view that the instant insurance money was paid to the insured through such account even in cases where the instant insurance money was paid to other accounts than the insured account under the name of the

2) As to the Defendant hospital’s treatment, the Plaintiff’s treatment as to the instant case.