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(영문) 서울고등법원 2015.10.23 2015나2000135
채무부존재확인
Text

1. The defendant's appeal is dismissed.

2. The costs of appeal shall be borne by the Defendant.

Purport of claim and appeal

1..

Reasons

1. Facts of recognition;

A. On March 29, 2000, the Plaintiff entered into an insurance contract with the Defendant for “pro rata Health Insurance” (securities number E; hereinafter “instant insurance”).

In relation to the payment of insurance money for cancer per day, if the insured is diagnosed and confirmed as cancer after the starting date of liability and is hospitalized for at least four consecutive days for the direct purpose of the treatment, the insurer shall pay 100,000 won per day for more than three days, and the terms and conditions of the contract.

6. The maximum of 120 days per time of hospitalization under Article 4 (1) of the Special Terms and Conditions on Security for Cancer Hospitalization.

6. Article 4(2) of the Special Terms and Conditions for the Security of Cancer Hospital. (B) The Defendant was diagnosed with the malkin finite, the right of which during the insurance period of the instant insurance contract, and was hospitalized on December 17, 2012 for 16 days for the purpose of partially controlling and anti-raid treatment at the Korea National University Cancer Hospital (hereinafter referred to as “Korea National University Cancer Hospital”). Furthermore, the Defendant was hospitalized for 16 days.

(C) The Plaintiff was hospitalized in the hospital and received medical treatment. (c) The Plaintiff paid the Defendant insurance amount of KRW 1.3 million per day of hospitalization (=100,000 won X (16 days - 3 days per day) in accordance with the terms and conditions of the insurance, and the Defendant rejected payment on the ground that the Defendant’s claim for the daily amount of hospitalization for hospitalized treatment in the hospital B, etc. was not for the direct purpose of treating cancer. [Grounds for recognition] There is no dispute over the fact that the Plaintiff did not have any direct purpose of treating cancer, the evidence Nos. 1 through 3 (including a serial number, the fact-finding on the hospital B and D council members, and the purport

2. In determining the terms and conditions of the instant insurance, “inpatient for the direct purpose of cancer treatment” that provides for the requirements for the claim for payment of insurance money for cancer per day, is intended for the treatment to defend the significant symptoms of military register directly resulting from cancer itself or from the growth of cancer.

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