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(영문) 광주지방법원 순천지원 2017.01.06 2015가단73313
보험금
Text

1. As to the diagnosis of the Defendant (Counterclaim Plaintiff) on December 15, 2014, the attached Form attached thereto is related to the diagnosis of the cerebral cerebral typhism in which the Defendant (Counterclaim Plaintiff) was diagnosed.

Reasons

A principal lawsuit and counterclaim shall also be deemed a principal lawsuit and counterclaim.

1. Basic facts

A. On September 15, 2009, the Defendant’s child B entered into an insurance contract with the Defendant as the insured and beneficiary (hereinafter “instant insurance contract”).

B. The instant insurance contract guarantees the diagnosis cost of KRW 30,000,000 among brains as one of the selective contracts. The relevant special terms and conditions are as follows.

Article 1 (Compensation for Loss) When the insured specified in the Insurance Policy (hereinafter referred to as the "Special Terms and Conditions") has been diagnosed as the " Brain" during the insurance period of this Special Terms and Conditions for the Guarantee of Brain Medical Expenses (hereinafter referred to as the "Special Terms and Conditions"), our company (hereinafter referred to as the "company") shall compensate for it in accordance with this Special Terms and Conditions.

Article 2 (Definition and Diagnosis Confirmation of Brain) In this Special Terms and Conditions, the term " brain stroke" means the blood stroke, brain cerebral stroke, and other non-cerebral erostroke, cerebral erostroke, which do not cause cerebral erostrophism, and the pulmonary erostroke and stroke, which are not caused by cerebral erostroke, as specified in attached Table 8 (Classification of Contagious Mestrokes) of the 5th Korean Standard Medical Disease Classification.

The diagnosis and confirmation of the Brain shall be conducted by a person with a physician's license (excluding dentists) of a domestic hospital prescribed in Article 3 (Medical Institution) of the Medical Service Act or a foreign medical institution recognized by the company as equivalent thereto, and this diagnosis shall be based on medical records, celein CT sect, self-made image method (MRI), cerebral typology and electronic emission ionograph (PET), celethic ionograph (PET), e-mail-emitting ionograph (SPECT), celethic typology examination, etc.

[Attachment 8] The disease classified as a stroke which is stipulated in the terms and conditions of the strokeum disease classification table shall be the first revised Korean Standard Industrial Classification Agency No. 2007-4, Jan. 1, 2008.

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