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(영문) 광주지방법원 2019.02.13 2016가단529838
부당이득금반환
Text

1. All of the plaintiff's claims are dismissed.

2. The costs of lawsuit shall be borne by the Plaintiff.

Reasons

1. Facts of recognition;

A. On October 14, 2005, the Plaintiff Company concluded the F Insurance Contract with the deceased (the “First Insurance Contract”) as the deceased on October 14, 2005, and on August 4, 2006, G Insurance (the “Second Insurance Contract”) as of August 4, 2006.

("this case insurance"). (b) When referring to the above insurance, hereinafter "the insurance of this case".

On December 21, 2006, the deceased died on June 12, 2018 while receiving a diagnosis of cerebral cerebral Organisms and CIDP (Maternal Madal Madal Madal Madal Madal Madal Madal Madal Madal Madal Madal Madal Madal Madal Madal Madal Madal Madal ma

C. From January 10, 2012 to October 14, 2016, Plaintiff Company paid 268,802,451 won (i.e., medical expenses (= KRW 42,360,000 per 20 per 20,000 per 20,000 per 20,000 per 20,000 per 201,000 per 201,000 per 201,000 per 201,451) with respect to the Defendant’s hospitalized treatment under the instant insurance contract for the instant period of compensation (hereinafter “instant period of compensation”).

Article 1 (Compensation for Loss) (1) of the Special Terms and Conditions for Security of the Allowances for Disease Hospitalization (at least a day). If the insured is hospitalized in a hospital or a member due to a disease during the insurance period of this Special Terms and Conditions entered in the insurance policy, the company may pay to the beneficiary the purchase amount of insurance under this Special Terms and Conditions for 180 days, which is entered in the insurance policy per day of hospitalization, within the maximum of 180 days

(3) In cases under paragraph (1), where the insured has been hospitalized twice or more during the period of insurance for the direct purpose of treating the same disease, the number of days of hospitalization shall be considered as continuous hospitalization and added up.

However, hospitalization, even for the same disease, starting after the lapse of 180 days from the date of the final discharge from which the disease hospitalization benefit was paid, shall be deemed to be a new hospitalization.

Article 1 (Compensation for Loss) (1) of the Special Terms and Conditions for Guarantee of Disease, Hospitalization Medical Expenses (Compensation for Loss)

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