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(영문) 서울중앙지방법원 2015.04.28 2013나62659
보험금
Text

1. The defendant succeeding intervenor's appeal against the plaintiffs is dismissed.

2. The costs of appeal shall be borne by the defendant successor.

Reasons

1. Conclusion of insurance contracts and terms and conditions;

A. D around March 31, 2008, between the Defendant and the insured, the term of the Plaintiff A and the insurance period from March 31, 2008 to March 31, 2028, 2028, and D concluded an insurance contract for the Defendant’s (i.e., the insured’s payment of diagnosis allowances of KRW 10 million when the diagnosis becomes final and conclusive due to brain stroke; and (ii) the Plaintiff B entered into an insurance contract for the Plaintiff B and the insurance period from March 16, 2009 to March 16, 2056 with the Defendant for the insurance premium of KRW 5 million (hereinafter “the insurance contract”).

B. Article 2(1) and attached Table 5 of the Special Terms and Conditions applicable to the special agreement on diagnosis benefits during the above strokes (in the case of Plaintiff B, attached Table 10) are as follows.

Article 2 (Definition and Diagnosis Confirmation of Brain) (1) The term "stroke" in this contract means the cerebral cerebral cerebral stroke, cerebral cerebral stroke, and other non-strokeic strokeic stroke, non-cerebral stroke, cerebral stroke, cerebral stroke, and the pulmonary stroke, which are classified into pulmonary stroke or stroke (attached Table 5 or 10).

(2) The diagnosis and confirmation of brain shall be conducted by a hospital, a clinic, or a person with a medical specialist's license recognized by the company as equivalent to the hospital prescribed in Article 3 (2) of the Medical Service Act, and such diagnosis shall be conducted based on the brain electronic computer system, the photographing floor (MRI), the nuclear calcan (MRI), the cerebrovascan (PET), the double-electronic emitting layers (PET), the calcan (SPECT), the calcan-emitting calcan, etc.

【The fourth amendment is made to the disease classified as brain stroke specified in the classification table among the 10th strokes.

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