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(영문) 서울고등법원 2016.07.19 2015나2037380
보험금
Text

1. The plaintiff (Counterclaim defendant)'s appeal is dismissed.

2. The costs of appeal shall be borne by the Plaintiff (Counterclaim Defendant).

purport, purport, and.

Reasons

The main lawsuit and counterclaim are also examined.

1. Basic facts

A. The conclusion of the instant insurance contract and the content of the instant special agreement 1) between the Plaintiff on August 31, 2006 and the Defendant on August 31, 2006, the insurer is the Defendant in the case of the Plaintiff, the insured and the beneficiary, the Defendant in the case of the insurance type, the consortium integrated insurance, and the insurance period from August 31, 2006 to August 31, 2041 (hereinafter “instant insurance contract”).

(2) The instant insurance contract’s security includes “the diagnostic expenses for cerebrovascular diseases,” and the insurance period of the instant insurance accident is five years from August 31, 201, which is the first day of the collateral, to August 31, 2016, which is the first day of the collateral, and the insurance amount is KRW 40,000,00.

3) The part related to the instant case among the terms and conditions of the instant insurance contract for diagnosis expenses for cerebrovascular diseases (hereinafter “instant special terms and conditions”).

1. The amount of damages to be compensated as follows: (1) The insured stated in the insurance policy (insurance policy) shall be the insurance period of this special terms and conditions (hereinafter referred to as the "insurance period") stated in the insurance policy (insurance policy):

2) The term “cerebrovascular disease” refers to a disease infected or suffering from a cerebrovascular disease from the time when the company’s guarantee began under this contract; 2. The definition and diagnosis determination of the cerebrovascular disease refers to a disease classified as a cerebrovascular disease (see attached Table 5) of the 4th Korean Standard cerebrscular disease Classification; 2. The diagnosis determination of the cerebrscular disease must be made by a person with a certificate of qualification for a domestic hospital under Article 3 of the Medical Service Act or an overseas medical institution (excluding dentists) recognized by the company as equivalent thereto, and this diagnosis must be made by a person with a certificate of qualification for a medical doctor (excluding dentists) of a domestic hospital under Article 3 of the Medical Service Act or an overseas medical institution recognized as equivalent thereto.

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