보험에 관한 소송
1. The plaintiff's appeal is dismissed.
2. The costs of appeal shall be borne by the Plaintiff.
The purport of the claim and appeal is the purport of the appeal.
1. The reasoning for the court’s explanation of this case is as follows: (a) the citing the judgment of the court of first instance shall correct the 3rd of the judgment of the court of first instance into the 16th insurance contract; and (b) the Plaintiff’s assertion of unjust enrichment which the Plaintiff added in the first instance trial to the 3rd of the judgment of the court of first instance is identical to the ground for the judgment of the court of first instance, and thus, it shall be
2. Additional determination
A. Even though the Plaintiff’s assertion that the insurance contract of this case was not null and void, the Defendant received the sum of KRW 30,438,245, including the daily amount of hospitalization, etc. from the Plaintiff by receiving unnecessary hospitalized treatment for 323 days, even though there is no need to actually be hospitalized. As such, the Defendant should return the insurance amount received from the Plaintiff as unjust enrichment.
B. The fact that the Defendant received 323 days of hospitalized treatment between December 2, 2010 and January 28, 2016, and received KRW 30,438,245 in total from the Plaintiff based on the instant insurance contract, as seen earlier.
However, in full view of the purport of the argument in the above evidence, the following circumstances, i.e., ① hospitalized treatment for the defendant, based on the doctor’s medical judgment, which is an expert, should be respected unless there are special circumstances, ② the defendant complained of false symptoms to the doctor in order to receive insurance money, or neglected
There is no evidence to view that there was no false or exaggerated diagnosis of the symptoms that the physician diagnosed the defendant to receive insurance money, and ③ the necessity of hospitalization may vary depending on the patient’s health condition at the time of hospitalization and it is not uniformly determined depending on the type of disease. ④ As seen earlier, most of the hospitalization treatments are on the ground of objective diagnosis or symptoms, not mere subjective appeal of the defendant.