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(영문) 서울중앙지방법원 2015.08.21 2014가단87999
채무부존재확인
Text

1. An insured event committed by the Defendant (Counterclaim Plaintiff) due to the B/C hospitalization in the B/C hospital from November 4, 2013 to March 10, 2014.

Reasons

A principal lawsuit and a counterclaim shall be deemed simultaneously.

1. Basic facts

A. On August 26, 2011, the Plaintiff and the Defendant concluded an insurance contract indicated in the attached Form (hereinafter “instant insurance contract”) containing a special agreement on the guarantee of daily admission into pressure (amount of KRW 100,000).

B. The main contents of the instant insurance contract’s policy are as follows.

(1) The company under Article 2 (Types and Grounds for Payment of Insurance Money) shall, when the insured, as stated in the insurance policy (a certificate of insurance coverage) during the insurance period of this Special Terms and Conditions, is diagnosed and confirmed as cancer after the date of commencement of coverage (the starting date of liability) stipulated in Article 1 (2) or has received medical treatment under Article 5 after the starting date of coverage (the starting date of liability) provided for in Article 1 (1), pay the following amounts to the beneficiary as cancer daily admission when he/she has been diagnosed and confirmed as office cancer, other skin cancer, boundaryal pattern, or virtual cancer after the starting date of coverage (including oriental medical hospital or oriental medical clinic) and has been diagnosed and confirmed as office cancer, and for the direct purpose of the treatment (including transfer of hospital or clinic, etc., even if he/she has been hospitalized at least twice for the direct purpose of treating the same cancer, office cancer, other skin cancer, boundaryal pattern, or sensitive cancer: hereinafter the same shall apply) and received medical treatment from the beneficiary:

Article 3 (Detailed Provisions on Payment of Insurance Money): Article 3 (1) of the Insurance Amount per day exceeding 3 days and exceeding 100% of the total amount of insurance coverage per day for more than 3 days and more than 3 days in the event of continuous hospitalization for more than 4 days: 20% (2) of the total amount of insurance coverage per day exceeding 3 days in the event of continuous hospitalization for more than 3 days: The number of days of payment per cancer per time of hospitalization shall be limited to 120 days per hospitalization.

(3) Article 5 (Definition and Place of Hospitalization): Hospitalization in this Special Terms and Conditions shall be based on the doctor, dentist and herb doctor's license (hereinafter referred to as " doctor") of a hospital or a National Assembly member.

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