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(영문) 부산지방법원 2018.12.20 2018나3653

보험금

Text

1. The plaintiff's appeal is dismissed.

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

Purport of claim and appeal

1...

Reasons

1. Basic facts

A. On November 27, 2003, the Plaintiff concluded a “C” contract with the Defendant (hereinafter “instant insurance contract”) with the following terms and conditions, and paid the insurance premium.

- The contractor and the insured - The plaintiff - the policyholder and the insured : 16,000 won when the insured continues to be hospitalized for not less than four days due to a disease or a disaster during the insurance period (the maximum of three days per day but not less than three days per day, and 120 days per day): The amount of adult disease hospitalization: 64,000 won when the insured continues to be hospitalized for not less than four days for the purpose of treating the fourth-party disease by the day immediately preceding the day when he/she falls under the age of 80 (the maximum of three days per day

B. The terms and conditions of the instant insurance contract stipulate the grounds for the payment of insurance proceeds as follows.

(hereinafter referred to as the "Terms and Conditions Provisions of this case"). Article 23 (Types and Grounds for Payment of Insurance Money) The Company shall pay the insurance money agreed to the beneficiary when any of the following events occurs to the insured during the insurance period of this contract:

2. Where the insured has been hospitalized for at least four consecutive days for the purpose of directly treating a disease or a disaster during the insurance period: The amount of hospitalization benefits for a disease or a disaster;

3. Where the insured has been hospitalized for not less than four consecutive days for the purpose of directly treating the fourth-class disease, the fifth-class disease, or the specific disease during the first insurance period (80 years old): The amount of adult hospitalization benefits (additional payment for the amount of hospitalization for a disease);

C. On August 10, 2013, the Plaintiff was diagnosed with brain death at a D Hospital and received hospitalized treatment from August 10, 2013 to August 7, 2015. The Plaintiff received KRW 32,960,000 insurance proceeds in total from the Defendant’s surgery allowances, 4 large-scale hospital hospitalization allowances, and 32,960,000,000.

In other words, the Plaintiff was hospitalized for 52 days at the E hospital from January 11, 2016 to March 2, 2016 due to cerebral e-mail; from March 2, 2016 to April 30, 2016; and from the E hospital from April 30, 2016 to June 14, 2016 to the E hospital, the Plaintiff was hospitalized for 52 days. < Amended by Act No. 13937, Jan. 2, 2016>