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(영문) 서울중앙지방법원 2016.06.10 2015나50070

보험금

Text

1.The judgment of the first instance shall be modified as follows:

The defendant shall pay to the plaintiff KRW 58,000,000 and the defendant shall pay to the plaintiff on March 2014.

Reasons

1. Basic facts

A. (1) On December 31, 2003, the Plaintiff entered into the instant insurance contract with the Defendant with the following terms and conditions (hereinafter “instant insurance contract”). The maturity date: The Plaintiff’s cancer diagnosis benefit (one time for hospitalization): 60 million won when the diagnosis becomes final and conclusive with the Plaintiff’s cancer (excluding other skin cancer): Other cancer other than the skin cancer (one day for more than three days, and 120 days): KRW 100,000 when the Plaintiff was hospitalized with the Defendant for more than four consecutive days: 5 million won when the instant insurance contract (hereinafter “instant insurance contract”) is partially included in the terms and conditions of the instant insurance contract (hereinafter “instant insurance contract”).

(A) Article 14 (Definition and Diagnosis Confirmation of Cancer)(1) of this Agreement refers to a disease (see attached Table 2, e.g., Table 2) classified as malicious life in the 4th Standard Disease Classification.

(이하 생략) ③ 암의 진단확정은 해부병리 또는 임상병리의 전문의사 자격증을 가진 자에 의하여 내려져야 하며, 이 진단은 조직(fixed tissue)검사, 미세침흡인검사(fine needle aspiration biopsy) 또는 혈액(hemic system)검사에 대한 현미경 소견을 기초로 하여야 합니다.

However, if it is not possible to conduct the above pathological diagnosis, the clinical diagnosis of cancer is admitted as evidence of cancer.

In such cases, I shall have a documented record or evidence proving that the insured has been under diagnosis or treatment as cancer.

(Attachment 2) The following diseases are included in the Korean Standard Disease Classification Classification (Statistics No. 2002-1, January 1, 2003, 2003) as listed in Article 14 of the Terms and Conditions of the Maternal Life Classification Table.

After the fifth amendment, the following diseases in the Korean Standard Disease Classification: