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(영문) 서울고등법원 2020.06.10 2019나2035849

보험에관한 소송

Text

1. The defendant's appeal is dismissed.

2. The costs of appeal shall be borne by the Defendant.

Purport of claim and appeal

1..

Reasons

1. The reasoning of the judgment of the court of first instance as to this case is as follows, except for the argument that the defendant emphasized again or added again by the court of first instance as to this case, and thus, it is consistent with the reasoning of the judgment of the court of first instance (excluding the judgment on the primary cause of claim) and the main text of Article 420 of the Civil Procedure Act.

2. As the Defendant’s additional or supplementary judgment was hospitalized for the purpose of relaxation and treatment of heavy pain, it is not excessive hospitalization, but it is difficult to trust the result of the request for appraisal of medical records to the AE Association of the first instance court, and thus, it is improper for the Plaintiff’s request.

However, in full view of all the following circumstances, it is reasonable to view that the Defendant hospitalized and received the insurance money from the Plaintiff even if the need for hospital treatment is not necessary, in full view of the descriptions of the evidence Nos. 3 through 6 and 8 and the result of the court of first instance’s entrustment of appraisal of medical records to the AE council of the court of first instance.

The defendant's above assertion is without merit. A.

The appraiser’s appraisal result should be respected unless the appraisal method violates the rule of experience or lacks rationality (see, e.g., Supreme Court Decision 2006Da67602, 67602, 67619, Jul. 9, 2009). The evidence submitted by the Defendant to this court alone is insufficient to recognize that the AE Council’s appraisal result is considerably erroneous, such as contrary to the rule of experience or unreasonable, and there is no other evidence to acknowledge it otherwise.

B. During the period of hospitalization recognized as excessive hospitalization as a result of the above appraisal, the defendant most of the defendant received the preservation treatment such as pharmacologic and physical therapy, and such preservation treatment seems to be sufficiently possible by the outpatient treatment.

At the time, there is no serious proof that the plaintiff needs to be hospitalized in the medical record.

(c) hospital for hospital treatment between 285 days, recognized as excessive hospitalization.