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(영문) 서울중앙지방법원 2016.10.06 2016나23433
보험금
Text

1. The part against the plaintiff corresponding to the money ordered to be paid under the judgment of the court of first instance shall be revoked.

2...

Reasons

1. Basic facts

A. On April 27, 2001, the Plaintiff entered into an insurance policy with the Defendant, which is the Plaintiff (hereinafter “instant insurance contract”), with the amount of KRW 30 million, and the insurance period from April 27, 2001 to April 27, 2038.

B. The main contents of the terms and conditions applicable to the instant special agreement are as follows.

Article 10 (Definition and Place of Hospitalization and Operation) (2) In this special agreement, the term "operation" means to perform the acts listed in the attached Table 4 (Operation Classification) under the control of a doctor at a domestic hospital or clinic as provided in Article 3(2) of the Medical Service Act or at a foreign medical institution recognized as equivalent to it, in case where it is deemed that medical treatment is required by a doctor due to disease or disaster.

Article 11 (Types and Grounds for Payment of Insurance Money) ① The Company shall pay to the insured under this Special Agreement the insurance money or allowances agreed upon to the beneficiary (hereinafter referred to as “beneficiary”) if any of the following events occurs:

(A) When he/she undergoes an operation directly for the purpose of treating a disability caused by a disease or a disaster that occurred during the insurance period of the special agreement (see attached Table 1, e.g., “the Standard Table for Payment of Insurance Money”): Provided, That where he/she undergoes at least two surgery at the same time, he/she shall be granted an operation allowance only for one kind of e.g., the highest benefit during the operation.

The plaintiff's insurance coverage amount of KRW 10,000,000 based on a special contract purchase price of KRW 30,000,000,000. The operation benefits amount shall be the kind 1 of class 60,2 of class 1, 120,000 won of class 3 of class 1, and 180,000 won of class 3 of class 1 of class 3 of class 1 of class. The treatment of disability caused by a disease or disaster during the insurance period.

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