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(영문) 서울중앙지방법원 2015.01.28 2014나31577
보험금
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

Basic Facts

On August 16, 2006, the Plaintiff entered into an insurance contract with the Defendant with the following content:

(hereinafter referred to as the “instant insurance contract.” The main contents of the non-paid AI Multi-Life Insurance Clause (hereinafter referred to as the “instant insurance contract”) incorporated into the insurance contract of this case in 25 years of insurance period of KRW 43,330 per month for Defendant insurance policyholders, the insured, and the beneficiary of the instant insurance contract are as follows.

Article 14 (Kinds and Grounds for Payment of Insurance Money) The Company shall pay the insurance money agreed upon to the person who receives the insurance money (beneficiary) when any of the following events occurs to a person subject to insurance (insured).

(See attached Table 1’s “Standards for Payment of Insurance Money”).

1. When a disease specified in attached Table 3 (hereinafter referred to as "disease") occurs during the insurance period and the hospital or clinic continues to be hospitalized for at least four consecutive days (if the company recognizes it by moving to a hospital or clinic, it shall be deemed that the hospital or clinic was hospitalized continuously) for the direct purpose of treating the disease: Expenses for hospitalization of a disease;

2. When a disease as prescribed in attached Table 4 of the Major Disease Classification Table (hereinafter referred to as the "Major Disease Classification Table") occurs during the insurance period, and is hospitalized for not less than four consecutive days for the direct purpose of its treatment: The definitions of terms by adding the expenses for the hospitalization of a major disease;

4. "Hospitalization" means admission to a hospital or a clinic which requires treatment by a doctor and which makes it difficult for him to treat at his own home, etc., and always leads him to the care under the control of a doctor;

When a person is hospitalized for at least four days due to a disease during the period of coverage of expenses for hospitalization, the payment ground for the payment of insurance money in attached Table 1 shall be 20,000 won per day exceeding three days.

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