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(영문) 대법원 2016.06.28 2016다3034

보험금

Text

The judgment of the court below is reversed, and the case is remanded to the Seoul Central District Court Panel Division.

Reasons

The grounds of appeal are examined.

1. The term “emergency accident”, which is the requirement of the insurance accident under the instant insurance clause, means that the cause of injury or death means all the occurrence caused by external factors, not due to the physical defect of the insured, i.e., the disease or physical physical injury, etc., and the causal link between the external nature of the accident and the result of injury or death, has the burden of proof against the claimant for insurance.

(2) On July 10, 2014, the lower court: (a) cited the first instance judgment; and (b) determined that the deceased’s death was caused by an unexpected event during the operation and by an accident resulting from a post-explosion; and (c) based on the following circumstances, determined that the deceased’s death was caused by an unexpected event during the operation and resulting from a post-explosion.

① The medical team of the instant case additionally implemented an open-to-under-under-the-counter brain resistant surgery when performing a back-to-under-the-under-face wing surgery to the deceased, and thus, additionally implemented an open-to-under-the-under-face divers and diversary surgery.

(2) The Deceased was unable to find his consciousness continuously after the reciting reciting.

③ The Deceased was hospitalized for a long time with non-explosion brain, and thereafter, a series of long-term complosion occurred, resulting in the death of the deceased with a multi-plosion organ.

3. However, the lower court’s determination is difficult to accept for the following reasons.

According to the reasoning of the first instance judgment cited by the lower court and the record, the following circumstances are revealed.

① As stated by the lower court, it is difficult to readily conclude that the wing recognism, which is the treatment of the deceased’s wing regrhesion, is an accident caused by high blood pressure or is related to cerebral blood, and thus, it is difficult to readily conclude that the non-cerebral cerebral tyrosis itself generated to the deceased as an external accident

(2) The brain-resistant blood transfusion of the deceased was caused by the physical physical factors of the deceased, such as the scarcity of cerebrovascular wall caused by aging.