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(영문) 서울북부지방법원 2016.05.04 2014가합8183

보험금

Text

1. All of the plaintiff's claims are dismissed.

2. The costs of lawsuit shall be borne by the Plaintiff.

Reasons

1. Basic facts

A. On July 25, 2006, the Plaintiff entered into a long-term damage insurance contract (hereinafter “instant insurance contract”) with the Defendant, between the Plaintiff, the monthly payment premium of KRW 159,300, the payment period of KRW 20, the insurance period of KRW 20, the insurance period of July 25, 2006 to July 25, 2035.

B. The main parts of the terms of the instant insurance contract relating to the instant case are as follows.

Article 17 (Insurance Money for Social Disability) (2) of the General Terms and Conditions: In case the insured was injured by an accident as prescribed in Article 14 (Compensation for Damages) and the injury was cured, and the company has, as a direct result, lost part of the body within two years from the date of the accident, or has permanently lost its function, and the remaining disability (hereinafter referred to as "general disability") whose payment rate as prescribed in the Disability Classification Table is less than 80%, remains, the company shall pay to the beneficiary an amount calculated by multiplying the insurance amount entered in the insurance policy (in case of the insurance contract of this case, 10 million won) by the payment rate as prescribed in the Disability Classification Table.

(4) If the rate of the payment of the residual disability insurance proceeds referred to in paragraphs (1) through (3) does not become final and conclusive after 180 days from the date of the accident, the rate of the payment of the residual disability shall be determined as the rate of the payment of the residual disability in a condition deemed fixed based on the diagnosis of intention on the date 1

Provided, That where the state of disability becomes worse during the period in which the disability is to be guaranteed thereafter, the rate of payment of disability after disability shall be determined on the basis of the aggravated state of disability, and where the timing for the determination of disability in the disability classification table is determined separately, it shall be at

(6) If two or more subsequent disabilities are caused by the same accident, it shall be paid by adding up the rate of payment of the subsequent disability.

Provided, That the criteria for determining each physical parts of the disability classification table shall be separately prescribed.