Text
1. Attached Form No. 1 concerning the plaintiff's symptoms of cerebrovascular that occurred to the defendant around February 28, 2015 against the defendant.
Reasons
On December 11, 2013, the Plaintiff entered into an insurance contract with the Defendant as shown in the attached Form (hereinafter “instant insurance contract”) (hereinafter “instant insurance contract”), and the said insurance contract includes the following special terms and conditions as a result of disease-sustaining disability (at least 80%, monthly payment type).
In the event that a disability payment rate is at least 80% due to a disease of a high-level disability that is paid once as a kind of insurance amount, the insured amount under this special agreement (the monthly payment shall be confirmed and paid every month from the date of occurrence of the cause for payment of the age limit for payment) was paid monthly and around February 28, 2015. The Defendant received rehabilitation treatment at C convalescent hospital on July 20, 2015 after being hospitalized in the hospital B due to the above symptoms.
On September 18, 2015, the Defendant received a diagnosis that the instant symptoms amount to 70% of the residual disability payment rate indicated in the ADS assessment table, and claimed insurance proceeds from the Plaintiff. On October 8, 2015, the Plaintiff paid KRW 1 million insurance proceeds to the Defendant, the insured, on the ground that the instant symptoms constitute at least 50% of the disease, around October 8, 2015.
The Defendant’s symptoms do not amount to 80% of the residual disability payment rate indicated in the above evaluation table. Therefore, the Plaintiff is not obliged to pay the Defendant insurance money under the special terms and conditions of the insurance contract for the illness, disability (at least 80%, and monthly payment).
Nevertheless, on October 12, 2015, the Defendant additionally claimed KRW 120 million from the insurance money according to the special terms and conditions of guarantee for the injury inflicted after illness (at least 80%, monthly payment type) to the Plaintiff. As such, the Plaintiff has the interest to seek confirmation of the absence of the obligation to pay the insurance money.
Since the defendant did not submit a written reply within 30 days from the date on which he was served with the complaint, it shall be deemed to have led to the confession of the facts constituting the cause of the claim in accordance with the main sentence of Article 257(1) of the Civil Procedure Act.