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(영문) 대전지방법원 2005.10.11.선고 2004가단32401 판결

보험금

Cases

204Gaz. 32401 Insurance proceeds

Plaintiff

Won J. J. J. high

Daejeon Dong-dong 53 - 1

Attorney Park Jae-soo, Counsel for the defendant-appellant 000

1. ○ life insurance company;

Jung-gu Seoul Central Government

Representative Director 000

Attorney 000

2. Bilateral life insurance company;

Seoul Mapo-gu public morals Dong

대표이사 ㅇㅇㅇㅇ

Attorney 000

Conclusion of Pleadings

August 23, 2005

Imposition of Judgment

October 11, 2005

Text

1. The plaintiff's claims against the defendants are all dismissed.

2. The costs of lawsuit are assessed against the Plaintiff.

Purport of claim

The plaintiff shall pay to the defendant ○○ Life Insurance Co., Ltd. the amount of KRW 20 million per annum from March 19, 2004 to the delivery date of the complaint of this case, and 20% per annum from the next day to the day of full payment. The defendant ○○ Life Insurance Co., Ltd. shall pay 15 million won per annum from March 19, 2004 to the delivery date of the complaint of this case and 5% per annum from the next day to the day of full payment.

Reasons

1. Basic facts

A. On February 7, 2001, the Plaintiff entered into a health insurance contract with Defendant ○○ Life Insurance Co., Ltd. (hereinafter referred to as “Defendant 1”) on the ground that the Plaintiff would receive KRW 20 million when the diagnosis became final and conclusive due to brain strokes, etc., and on May 13, 2003, the Plaintiff entered into a contract with Defendant 1 and 5 million medical treatment funds when the diagnosis becomes final and conclusive with Defendant 2 (hereinafter “Defendant 2”) on the ground that it would receive KRW 15 million due to brain strokes, etc.

According to the terms and conditions of the insurance contract 1, "the brain stroke" refers to a disease classified as brain stroke, etc. among cardio-cerebrovascular diseases specified in the table of classification into cardio-cerebrovascularsculars, and the determination of the diagnosis of the brain strokes must be made by a domestic hospital specified in Article 3 of the Medical Service Act or a person with a physician's license of a foreign medical institution recognized as equivalent thereto, and this diagnosis must be made by a person with a physician's license of a medical institution in a foreign country, which is recognized as equivalent thereto, with medical history and neological examination (brain CTR), nuclear strokes (MRI), cerebrovascularstroph (MEA), bilateral emission strokestrokes (PET), SP (SPT) 18 of the insurance contract.

According to the terms and conditions of an insurance contract 2, 's 's 's 's 's 's 's 's 's 's 's 's 's 's 's 's '' in the insurance contract 2' means the 's 's 's 's 's mal' specified in the 's 's mal' table, such as brain strophy, among the classification of Korean Standard 's Rastrophy' diseases, and the 's 's 's 's 's 's 's 's 's 's 's 's 's 'ss 's 's 's 's 's '

B. On March 19, 2004, at around 11:30 am. 11:30 am., the Plaintiff went to the emergency room of the Geongsung Hospital by showing the symptoms of self-gymnasium, so that at that time, the Plaintiff failed to observe his opinion as far as it is obvious in CT and MRI.

Therefore, although the medical doctors in charge of the above hospital tried to verify the MA photographs on the basis of the MA photographs, they failed to take the MA photographs required for not less than 30 minutes due to unstable food conditions of the plaintiff, on the basis of the failure to exercise an eye observed by the plaintiff, military register reflectrs, etc., the plaintiff diagnosed the plaintiff with brain flasing, and provided the plaintiff with medical treatment for the removal of the exclusive use of blood to the brain flasing patient.

The plaintiff, from March 20, 2004, was cryped by the increased tax amount, such as the recovery of consciousness from March 20 to March 20, 2004, and was withdrawn on March 30, 2004.

C. On March 22, 2004, the Plaintiff had taken CT, MRI, and MDA photographs, but there was no apparent opinion in that case. The Plaintiff’s present symptoms or aftermathy, the mathy, the mathy, the mathy, and the mathy in the math, the mathy in the math, the mathy in the math, the mathy in the math, the mathy in the math, and the mathy in the math, there was no symptoms that can be viewed as mathy aftermath.

[Ground of recognition] Gap evidence 1, 2, 3, Eul evidence 4-1, Eul evidence 5-1, Eul evidence 1-4, Eul evidence 2, 3, 4, 5, 7, 8, Eul evidence 1-4, Eul evidence 5-1-4, Eul evidence 6-1-2, Eul's evidence 6-1, 2-2, the fact-finding results of the Daejeon A-2, the fact-finding results of Eul's 1-4, Eul's evidence 1-4, Eul's evidence 5, and Eul's evidence 5-1-6, Eul's evidence 6-2, and the purport of the whole pleadings.

2. Determination

A. Party’s assertion

The Plaintiff asserts that the Plaintiff sought reimbursement of KRW 15 million under the insurance contract2 against Defendant 1, Defendant 2, inasmuch as the Plaintiff was diagnosed with brain color as provided for in Articles 1 and 2 of the Insurance Contract as the cause for the payment of insurance proceeds, the Plaintiff claimed against Defendant 1 for reimbursement of KRW 20 million under the insurance contract and KRW 15 million under the insurance contract2.

The Defendants asserted that, in light of the Plaintiff’s symptoms, etc., the Plaintiff could not respond to the Plaintiff’s claim on the premise that the Plaintiff’s diagnosis became final and conclusive in brain color, given that the Plaintiff’s disease occurred to the Plaintiff is highly likely to occur due to work-related cerebral cerebral cerebral cerebral typhism, which is not defined as the cause for the payment of insurance proceeds, rather than brain typhism

(b) Determination:

(4) Comprehensively taking account of the following facts: (a) if the Plaintiff’s 1 and 2 metral marological fact-finding with the first malgonomic 1 and the second marological marological marological marological marological marine, the Plaintiff’s marological marological marological marological marological marological marological mar 2 was found to have been infected with the first marological marological marological marological mar 2; (b) the Plaintiff’s marological mar marological mar marological marological mar marological mar 2 was not found to have been infected by the first mar marological mar marological marological mar marological mar marological mar marological mar mar 2.

[We refer to a situation in which the symptoms or signs of the entropical phropical phropical phropical phropical phropical phropical phropical phropical phropical phropical phropical phropical phropical phropical phropical phropical phropical phropical phropical phropicals are lost within 24 hours, and brain phropical phropical phre

The results of fact-finding with respect to the Director of the Medical Center of Korea University, the Medical Center of Korea, and the Director of the Hospital, and the results of fact-finding, referring to Es. 55 through 57)

3. Conclusion

Thus, the plaintiff's claim against the defendants is dismissed as it is without merit.

Judges

Judges Senior Superintendent;