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(영문) 서울고등법원 2017.12.07 2015나2047509

보험금

Text

1. Upon a request for a change in exchange at the trial, the Plaintiff’s Schedule 1 against the Defendant is written.

Reasons

1. Basic facts

A. On February 20, 2008, the Defendant (BB) entered into an insurance contract between the Plaintiff and the Defendant with respect to the insurance money calculated by multiplying the amount subscribed (10 million won) to the Defendant as a general injury insurance money in the event of a disability with less than 80% due to a general injury by the payment rate determined by the Plaintiff, and when a disability with less than 50% to 80% due to a general injury occurs, the Plaintiff entered into an insurance contract in the attached Table 2 stating that each subscription amount shall be paid once a year under the pretext of general injury income loss compensation in the event of a disability with less than 50% as a general injury.

(hereinafter “instant insurance contract”). The main contents are as follows:

Article 14 (Compensation for Damages) ① When the insured sustains bodily injury (excluding physical assistance equipment, such as clothes, artificial arms, bills, and clothing) due to an accident that has been rapidly down and anticipated during the insurance period (hereinafter “accident”), the Plaintiff is bound to compensate for the damage resulting from the injury (hereinafter “damage”) in accordance with this Clause.

Article 15 (Compensation for Non-Compensation) (1) The Plaintiff shall not compensate for any loss arising from the following causes:

5. An insured's disease;

7. The pregnancy, childbirth (including king), miscarriage or surgery, and other medical treatment of the insured, but compensation for injury borne by the Plaintiff is rare.

Article 17 (Insurance Money for Social Disability) (2) General Disability Insurance Money: In cases where the insured has suffered from the injury as prescribed in Article 14 (Compensation for Damages) and has lost part of the body within two years from the date of the accident as a direct result, or has lost its function permanently (hereinafter referred to as "ex post facto disability") and the payment rate prescribed in each subparagraph of the Disability Classification Table remains less than 80% (hereinafter referred to as "general ex post facto disability"), the amount calculated by multiplying the payment rate prescribed in each subparagraph of the Disability Classification Table by the insurance amount of the ordinary terms and conditions.