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(영문) 대구지방법원 2020.07.08 2019나317565

보험금

Text

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.

Reasons

1. Basic facts - The Plaintiff joined the “C” operated by the Defendant around January 2017.

- Of the terms and conditions of the above insurance, the part concerning cancer diagnosis costs is as follows:

- Around June 2018, the Plaintiff was diagnosed to have the possibility of liver cancer as a result of the D Hospital’s health examination (the result of the ultra-frequency test). Around July 2018, the Plaintiff was hospitalized in E Hospital for five days and was diagnosed as liver cancer as a result of the close examination.

- Upon filing a claim with the Defendant for reimbursement of cancer costs, the Defendant notified the Plaintiff that the said insurance contract will be terminated on the ground that the Plaintiff violated the obligation to notify the contract before signing the contract, on September 2018.

[Ground of recognition] Facts without dispute, Gap2 through 5 evidence, Eul evidence 3-1, 2, the purport of the whole pleadings

2. The assertion and judgment

A. The Plaintiff asserts that the Defendant should pay the cancer diagnosis cost of KRW 20 million.

B. The statutory provisions on the termination of an insurance contract on the ground of breach of duty of disclosure and the general terms and conditions of the insurance are as follows:

If the policyholder or the insured fails to notify material facts intentionally or by gross negligence at the time of the insurance contract under Article 651 (Termination of Contract due to Breach of Duty of Disclosure) of the Commercial Act, or has made a false notification, the insurer may terminate the contract within one month after becoming aware of such fact, or within three years after the conclusion of the contract

However, this provision shall not apply if the insurer knew of, or was negligent in, the fact at the time of the contract.

Even after an insured event under Article 65 occurs, if the insurer terminates the contract under Articles 650, 651, 652 and 653, it shall not be liable for paying the insurance proceeds and may claim the return of the insurance proceeds already paid.

However, if it is proved that the facts or risks violating the duty of disclosure are significantly changed or increased have not affected the occurrence of an insured incident, the insurance money shall be paid.

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