Gangnam-gu Seoul 00 Do- - 0000 buildings

- Dog- Building floor level 0000 Dogsan-gu at the place of service prior to the place of service - 0000

State Compensation Team

A representative director ○○, Kim Gi-gu

Attorney Lee In-bok, Counsel for the defendant-appellant

Ilsan City 00,000 00

A. It is confirmed that the insurance contract entered in Appendix 1, which was concluded between the Plaintiff and the Defendant, was terminated as of March 25, 201.

B. The plaintiff's remaining claims are dismissed.

2. The total cost of the lawsuit shall be borne individually by each party.

A. Conclusion of the instant insurance contract

1) On May 20, 2008, the Defendant entered into a contract under the attached Table 1 stating that the Plaintiff shall pay a certain amount of insurance premium in the event that the insured is treated for a certain injury or disease according to the terms and conditions set forth in the terms and conditions between the Plaintiff and himself as the insured, and that the Plaintiff shall pay a certain amount of insurance premium (hereinafter “instant insurance contract”).

2) However, the written offer of the insurance contract of this case contains the same content as the terms and conditions of the insurance contract of this case, "if the insurance contract of this case is not or falsely notified about the question, it may be rejected, and in particular, if the content constitutes an important matter, it may be terminated by the effective clause of the breach of the duty to notify the contract before the contract of this case regardless of the intention of the policyholder or the insured."

(b) Occurrence of insurance accidents and claim for insurance proceeds;

The defendant shall be 00 hospitals from December 13, 2010 to January 4, 2011, 201, the right-hand opening of the field of back to the right-hand opening.

The Plaintiff was hospitalized to receive treatment and claimed for payment of the insurance money based on the instant insurance contract. However, on March 25, 201, the Plaintiff refused to claim the payment on the ground of the Defendant’s breach of duty of disclosure and notified the Defendant that the instant insurance contract was terminated.

[Grounds for Recognition] Uncontentious Facts, the contents stated in Gap evidence 1 to 3, and 6, the purport of the whole pleadings

2. The parties' assertion

A. The plaintiff's assertion

The plaintiff asserted that the insurance contract of this case was lawfully terminated by the plaintiff's explanation on the ground of the violation of duty of disclosure under Article 651 of the Commercial Act, without notifying the plaintiff of this fact even if the defendant received several medical treatment prior to the conclusion of the insurance contract of this case due to bluri Nog, etc., and that the insurance contract of this case was lawfully terminated by the plaintiff's explanation on the ground of the violation of duty of disclosure under Article 651 of the Commercial Act

B. The defendant's assertion

The defendant argues that the insurance contract of this case shall be maintained since it cannot be said that the defendant violated the duty of disclosure because it did not intentionally or by gross negligence fulfill the duty of disclosure set forth in the insurance contract of this case, but there is no proximate causal relation between the defendant's failure to disclose the medical treatment and the occurrence of the insurance accident of this case, and that the content of the duty of disclosure as argued by the plaintiff cannot be considered as an important matter to determine whether to conclude the insurance contract of this case. Therefore, the plaintiff should pay the defendant insurance money based on the insurance accident of this case.

3. Determination

A. Whether disclosure obligation is violated

"Important matters" under Article 651 of the Commercial Act, which is a standard for the insurer to determine whether to enter into an insurance contract or the content of an insurance contract, such as the addition of an insurance premium or special exemption clause, by measuring the occurrence of an insurance accident and the extension rate of one liability to the insurer at the time of the insurance contract. If the insurer becomes aware of such fact, it refers to the matters that would be thought that the insurer would not enter into the contract, or would not enter into the contract at least the same time. What constitutes fact-finding, the fact-finding, the type of insurance of which must be different, must be objectively observed and judged in light of the insurance period, but the insurer asks in writing.

A matter is presumed to constitute an important matter in an insurance contract (Article 651-2 of the Commercial Act), and a written subscription may also be included in an insurance subscription. Thus, if an insurance subscription contains the intent to seek an answer in favor of a certain matter, the matter is presumed to be an "important matter" under Article 651 of the Commercial Act (see Supreme Court Decision 2003Da18494, Jun. 11, 2004, etc.).

Furthermore, in order to establish a violation of the duty of disclosure in an insurance contract, it must be intentionally or by gross negligence against the duty of disclosure. Here, it refers to the failure to give notice, or the failure to give notice in bad faith, knowing the fact that the subject matter of notification is the subject matter of notification, or constitutes an important matter to be notified. Although the fact that the gross negligence was to be notified was known, it refers to the failure to know that the fact was an important fact that the decision of importance of the fact is erroneous or that the fact should be notified due to the present negligence (see Supreme Court Decision 96Da27971 delivered on December 23, 196, etc.).

In addition to the purport of the arguments in evidence Nos. 2 and 7 back to the case, the defendant was subject to the diagnosis of 'compactitis, satchitis, satchitis, and satisfying satchosis' within 00, 42 times from March 4, 2005 to December 24, 2005, and 9 times from May 2, 2006 to July 13, 2006, the defendant received in-depth medical treatment, satisfy, etc., from 00 days to 0 days from 0 days from 0 days from 0 days from 0 days from 10 days from 10 days from 206 to 10 days from 10 days from 10 days from 200 days from 20 days from 20 days from 20 days from 20 days from 3 days from 20 days from 20 days from 20 days from 3 or more from 3 days from 3 days from the examination.

According to the facts found above, whether the defendant was diagnosed and treated with spawnitis and spathy, etc. is subject to duty of disclosure by measuring the occurrence of insurance accidents and the commencement rate of liability arising therefrom, which is an insurer, and making a standard for determining whether to enter into an insurance contract or the content of the insurance contract in this case, such as the addition of insurance premium or special exemption clause, and questioning the plaintiff in writing. However, although the defendant had received diagnosis and treatment due to spawnitis, etc. within the past five years, he stated that there was no such fact in the subscription form of the insurance contract in this case, the defendant violated duty of disclosure by failing to inform the plaintiff of the fact intentionally or by gross negligence (the contents stated in the subscription form of the insurance contract of this case, and the defendant violated duty of disclosure by failing to notify the plaintiff of the fact that the contract of this case had to be entered into of the insurance contract

Considering the frequency of medical treatment, the time interval between the conclusion of the instant insurance contract and the time of medical treatment, etc., it is reasonable to deem that the Defendant, at the time of entering into the instant insurance contract, knew of the fact that the Defendant received medical treatment as above, and did not inform the Plaintiff of the fact that it fell under important matters when entering into the instant insurance contract, or without knowledge by gross negligence).

B. Whether the insurance contract of this case was terminated and whether the insurance contract of this case was duty of payment

1) In the event that a policyholder or the insured has failed to notify material facts intentionally or by gross negligence at the time of an insurance contract, or has made a false notification, the insurer may be exempted from liability to pay the insured amount by terminating the examination contract even after the occurrence of the insurance accident, regardless of the existence of the occurrence of the insurance accident, notwithstanding the fact that the insurance accident was in violation of the duty of disclosure does not affect the occurrence of the insurance accident, i.e., when the fact that the insurance accident was in violation of the duty of disclosure was proved not to affect the occurrence of the insurance accident, the insurer cannot be exempted from liability to pay the insured amount even if the insurance contract was terminated (see, e.g., Articles 651 and 655 of the Commercial Act; Articles 201Da25353, Jul. 22, 2010).

2) First, we examine whether the instant insurance contract has been terminated or not.

As seen earlier, the Defendant’s failure to notify the Plaintiff of the fact that he had received at least seven days of medical treatment within five years when entering into the instant insurance contract. On March 25, 201, the Plaintiff sent to the Defendant a guide stating that the instant insurance contract is terminated on the ground of the Defendant’s breach of duty of disclosure as above, and the history of the Plaintiff’s office, which was served on the Defendant around that time, did not conflict between the parties or by the content stated in the evidence No. 6.

Therefore, the instant insurance contract was lawfully terminated on March 25, 201, and as much as the Defendant is administering it, there is a benefit to seek confirmation.

3) Next, we examine the Plaintiff as to whether the Plaintiff is obligated to pay the insurance proceeds for the instant insurance accident.

앞서 든 증거들과 ♥ 공 단 익산지사장 및 00 원장에 대한 각 사실

In other words, the insurance of this case, which is recognized by adding to the whole purport of the pleading as a result of the inquiry

In the accident, the diagnosis against the defendant is "the right field spawn," which had been treated prior to the conclusion of the insurance contract of this case, and other spawn, which had been accompanied by spawnosis, and other spawnosis, spawnosis, almatitis and Alredrosis, almatitis, Alredrosis, etc., all different parts and symptoms of the treatment, and the defendant's appeal against the above parts and spawnosis as the part of the insurance accident of this case, after August 20, 2010, after the conclusion of the insurance contract of this case. In light of the fact that the defendant did not have received all medical treatment at a medical institution for the right field of spawn for five years prior to the conclusion of the insurance contract of this case, it cannot be deemed that there was a substantial causal link between the insurance accident of this case, etc. without the notification of the defendant and the insurance accident of this case.

Therefore, as seen earlier, even if the instant insurance contract was terminated by the Defendant’s breach of duty of disclosure, as long as there is no causation between the instant insurance accident and the Defendant’s breach of duty of disclosure as seen above, the Plaintiff is liable to pay the Defendant the insurance money due to the instant insurance accident pursuant to the proviso of Article 655 of the Commercial Act.

4. Conclusion

Therefore, the part of the plaintiff's claim that confirmed the non-existence of the insurance claim due to the insurance accident of this case is dismissed as it is without merit, and the claim that seeks confirmation that the insurance contract of this case is terminated is accepted as it is reasonable. Since the judgment of the court of first instance is unfair with some different conclusions, the plaintiff's appeal is partially accepted and the judgment of the court of first instance is modified as above, it is so decided as per Disposition.

Judges Park Il-soo

Judges Manyang-si