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(영문) 대전지방법원 2017.04.20 2016가단210075

보험금

Text

1. The plaintiff's claim is dismissed.

2. The costs of litigation shall be borne by the plaintiff.

Reasons

Basic Facts

On March 30, 2009, the Plaintiff and the Defendant, as the Defendant indicated in the separate sheet, concluded a zero-year-old health insurance (hereinafter referred to as “second-year-old insurance contract”) with the Defendant, respectively, on December 31, 2013, and on December 31, 2013, as follows.

On March 30, 2009, - March 30, 2082. (1) Basic Contract (general injury injury 50 million won) : < Amended by Presidential Decree No. 2427, Dec. 31, 2013; Presidential Decree No. 2590, Dec. 31, 2013; Presidential Decree No. 2590, Dec. 31, 2013; Presidential Decree No. 25077, Dec. 31, 2080; Presidential Decree No. 2509, Dec. 31, 2080>

Article 14 (Compensation for Loss) (1) A company shall compensate for the loss sustained by the insured due to a sudden and incidental accident that may occur during the insurance period, in accordance with the terms and conditions, if the insured sustains bodily injury due to such an accident.

Article 15 (Compensation for Non-Compensation) (1) The Company shall not compensate for any loss arising from any of the following causes:

7. A pregnancy, childbirth (including kings), miscarriage or surgery, or other medical treatment for the insured. However, in the case of injury borne by the company, compensation shall be made for the injury.

The main terms and conditions of the second insurance contract related to the insurance accident of this case are as follows.

Article 19 (Types and Grounds for Payment of Insurance Money) If the insured has a disability payment rate of at least 50% specified in the Disability Classification Table due to an injury (referring to an injury sustained by a person due to a sudden and remote accident that occurred during the insurance period) during the insurance period, the company is bound to pay the purchase amount of insurance to the beneficiary (if the beneficiary is not designated as the beneficiary of insurance, the insured) only once for the first one.

Article 21 (Grounds for Non-Payment of Insurance Proceeds) (1) Any of the following companies shall be applicable: