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(영문) 광주지방법원 2017.04.14 2015가단503075
부당이득금
Text

1. The Defendant’s KRW 45,146,91 as well as the Plaintiff’s KRW 5% per annum from March 19, 2015 to February 23, 2017.

Reasons

1. Basic facts

A. On July 21, 2009, the Plaintiff, an insurer running various non-life insurance business, entered into a contract with the Defendant and the Defendant, the insured on July 21, 2009 through July 21, 2056; the insurance period of 20 years from July 21, 2009 to July 21, 205; the insurance premium payment period of 20 years; expenses for hospitalization from a disease (at least one day); KRW 100 million from expenses for hospitalization from a disease; and KRW 30,000 from expenses for hospitalization from a disease (hereinafter “instant insurance contract”); and the details of the relevant special agreement are as follows:

Article 2 (Compensation for Damages) of the Special Clause of Security (1) of this Special Clause provides that where the insured is hospitalized in a hospital or clinic (including an oriental medical hospital or oriental medical clinic) due to a disease during the insurance period of this Special Clause, the company shall pay to the beneficiary (the insured if the beneficiary is not designated as a beneficiary) the daily amount stated in the insurance policy (insurance policy) for one day of hospitalization within the maximum of 180 days from the first date of hospitalization.

(2) In the case of paragraph (1), if the insured is hospitalized twice or more during the insurance period for direct purpose of the same disease, it shall be deemed hospitalized continuously, and shall be paid expenses for hospitalization by adding the number of days of hospitalization to

However, if 180 days have elapsed from the date of the discharge of the last hospitalization, and the hospitalization is deemed to be a new hospitalization.

Notwithstanding the provisions of Article 1(6) and (2) of the Special Terms and Conditions on the Guarantee of Medical Expenses for Hospitalization, the limit of compensation for expenses for hospitalization of a disease due to the same disease or one disease (the disease that is important in medical science shall be deemed the same disease, and even if the disease is treated at least twice due to the same disease, this shall be deemed one disease) shall be limited to 365 days from the date the diagnosis is

However, even if hospitalization is caused by the same disease, the hospitalization that was commenced after the lapse of 180 days from the date of the discharge of the last hospitalization for which the medical expenses for hospitalization were paid is considered to be a new outbreak and thus rarely compensated.

B. The defendant's details of hospitalized treatment and the defendant's payment.

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