2010 Ghana 28432 Insurance proceeds

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Gwangju Nam-gu OOdong 00 Mando - Dong-ho

444444. Stock company (the trade name before the change: Don stock company)

Seoul Jongno-gu O000

Maximum representative director Doz.

Law Firm Gwangjin-gu, Attorney Lee Jong-chul et al.

November 3, 2010

November 19, 2010

1. The defendant shall pay to the plaintiff 13,341,376 won with 5% interest per annum from May 17, 2010 to November 19, 2010, and 20% interest per annum from the next day to the day of full payment.

2. The costs of the lawsuit are assessed against the defendant.

3. Paragraph 1 can be provisionally executed.

The order is as set forth in the text.

1. Facts of recognition;

가. 원고는 2005. 3. 17. 피고와 사이에 아래와 같은 내용의 "무배당슈퍼암크리닉 보험 " 계약(계약번호 ◈♡♡♡♡♡♡♡♡♡♡♡♡, 이하 '이 사건이보 ) 체결하였다.

(a) Policyholders and the insured: the Plaintiff;

(2) Insurance period: from March 17, 2005 to March 17, 2036

(3) Details of guarantee

○ Admission Cost: Payment of KRW 100,000 per day of hospitalization when the insured was diagnosed as the first cancer after the date of commencing the responsibility for cancer security during the insurance period and continued to be hospitalized for at least four consecutive days for the direct purpose of treating such cancer (the maximum limit of 120 days per one time of hospitalization).

○ Hospital's benefits: Payment of KRW 10,000 per day of hospitalization (the maximum of 120 days per initial admission) for the purpose of direct treatment for four days or more after the insured reduces from illness or disaster during the insurance period of the special agreement for non-paid hospitalization (the maximum of 120 days per initial admission)

○ Hospital Benefits: Payment of KRW 10,000 per day of hospitalization when the insured continues to be hospitalized for at least four days for the purpose of direct treatment due to ' disease' during the insurance period of the special agreement for hospitalization without a dividend-free disease (the maximum of 120 days per one time of hospitalization).

나. 또한 원고는 2005. 3. 3. 피고와 사이에 아래와 같은 내용의 "무배당뉴씨이이플러 스종신보험" 계약(계약번호♡♡♡♡♡♡♡♡♡♡♡♡♡, 이하 '이 사건 ' 랜

was concluded.

(a) Policyholders and the insured: the Plaintiff;

(2) Insurance period: from March 3, 2005 to life (main contract), March 3, 2005 to March 3, 2005 (special agreement)

(3) Details of guarantee

○ Cancer benefits: Payment of KRW 50,000 per day of hospitalization when the insured was hospitalized for at least four days for the purpose of directly treating the cancer after the date of commencing the responsibility during the insurance period (the maximum of 120 days per one time of hospitalization).

○ Hospital's benefits: Payment of KRW 20,000 per day of hospitalization (the maximum of 120 days per initial admission) for the purpose of direct treatment for four days or more after the insured reduces from illness or disaster during the insurance period of the special agreement for non-paid hospitalization.

○ Hospital Benefits: Payment of KRW 20,000 per day of hospitalization when the insured continues to be hospitalized for at least four days for the purpose of direct treatment due to ‘disease' during the insurance period of the special agreement for hospitalization without a dividend disease (the maximum of 120 days per time of hospitalization).

다. 원고는 2009. 11. 19 . ♤☆☆☆병원에서 위암( 위 악성신생물) 진단을 받고, 2009. 12. 23. 위 병원에 입원하여 다음날인 24. 위절제술을 시행받은 다음, 같은 달 31.까지 9일간 입원치료를 받았으며, 이후 2009. 12. 31.부터 2010. 4. 26.까지 117일간 전남 담양군 00에 소재한 □△△△△병원과 병원에서 입원치료를 받았다.

D. Under the instant cancer insurance contract, the Defendant paid to the Plaintiff the sum of KRW 5,504,195 per day from December 23, 2009 to January 20, 2010 each of the hospitalization allowances (20,000 per day) for the entire hospitalization period (20,000 per day) and KRW 6,354,429,00 per day from December 23, 2009 to January 20. However, based on the instant life insurance contract, the Defendant refused the payment of the hospitalization allowances for the entire hospitalization period (40,00 won per day) and the total hospitalization allowances (50,00 won per day) for the purpose of direct hospitalization and treatment of cancer after January 21, 2010.

[Ground of Recognition] Facts without dispute, Gap evidence 1-1, Gap evidence 2-3, Gap evidence 4-1-5, Gap evidence 7-1, 2-8, Gap evidence 1-1, 2-2, Eul evidence 11-2, Eul evidence 2-1, 2-2, Eul evidence 2-1, 2-2, and the purport of whole pleadings

2. The plaintiff's assertion and judgment

A. The plaintiff's assertion

원고는 ♤☆☆☆병원에서 위절제술을 받은 후 항암치료를 직접 목적으로 □△△△△ 병원과 병원에서 입원치료를 받았으므로, 피고는 이 사건 암보험계약에 따른 120일 한도의 암입원비 중 미지급보험금과 이 사건 종신보험계약에 따른 120일 한도의 암입원급여금 중 미지급보험금을 추가로 지급하여야 한다.

B. Determination

"Direct purpose of the treatment of cancer" as stipulated in each insurance contract of this case refers to the case of hospitalization for the purpose of suppressing the propagation of life, such as operation to remove the species, radiation treatment, antibiotic drugs treatment, etc., or for the purpose of preventing a recurrence, and it is difficult to view that the treatment of crypary or merged treatment resulting from such treatment is included in the case of treatment for the purpose of treating the cryp or the recovery of health.

그러므로 원고가 □△△△△병원과 병원에서 입원한 기간이 암의 치 료를 직접적인 목적으로 한 것인지에 관하여 살피건대, 갑 제6, 12호증의 각 기재와 이 법원의 □△△△△병원장과 ☆☆☆병원장에 대한 각 사실조회결과에 변론 전체의 취지를 종합하여 보면, 원고는 2009. 12. 24. ♤☆☆☆병원에서 위절제술을 시행받은 이후 항암치료를 받다가 병실 사정으로 인하여 주치의가 전원을 권유하자 위 병원에서 퇴원하여 그날부터 □△△△△병원과 병원에 입원하게 된 사실, 항암요 법을 시행하게 되면 암세포뿐만 아니라 정상세포까지 손상을 입게 되어 면역력 약화, 간기능 이상, 요로감염 등의 증상이 나타나게 되는데, 원고는 □△△△△병원에서 3주 간격으로 암세포의 괴사 및 증식억제와 재발방지를 위하여 경구용 항암치료제인 S-1을 투여받은 다음, 그 사이에 약화된 면역력과 간기능의 향상을 위하여 ♥◈◇◈◇병 원에서 3주 간격으로 3회의 한방치료를 시행받은 사실이 인정되는바, 위와 같이 동일 한 내용의 항종양치료가 일정기간 지속되는 경우에는 비록 그 기간에 직접적인 수술, 방사선치료, 약물치료가 아니라 종양치료로 인한 후유증을 치료하고 건강을 회복하기 위한 입원기간이 포함되어 있다 하더라도 그것이 계속되는 항종양치료에 필수불가결한 것이라면 이 사건 각 보험계약의 보장내용인 '암의 치료를 직접 목적으로 하는' 입원에 해당한다고 봄이 상당하므로, 피고는 원고에게 2010. 1. 21. 이후의 입원기간에 대하여 도 위 각 보험계약에 따른 암입원비를 지급할 의무가 있다(피고는 원고가 □△△△△ 병원에 입원한 2010. 1. 20.까지의 암입원비와 암입원급여금을 지급하기도 하였다).

C. Sub-decision

Therefore, the Defendant is obligated to pay to the Plaintiff KRW 8,895,805,805, and KRW 120,000, which calculated by deducting KRW 5,504,195, which was already paid from the total of KRW 120,00,00 based on the cancer insurance contract (i.e., KRW 120,000 x 120 days) and the total of KRW 10,800,000 based on the life insurance contract of this case, and the total of KRW 6,354,429, which was already paid from the total of KRW 13,341,376, and the total of KRW 120,00,000, which was deducted from the total of KRW 14,45,571, and the total of KRW 1341,376, and damages for delay from the day following the date on which the complaint of this case was served to May 17, 2010.

3. Conclusion

Therefore, the plaintiff's claim of this case is justified and it is so decided as per Disposition.

Kim Jin-hwan