1. As to the accident described in the attached Form 1, it is listed in the attached Form 2 as to the Defendant (Counterclaim Defendant) of the Plaintiff (Counterclaim Defendant).

1. Basic facts

A. The conclusion of the insurance contract and the terms and conditions (1) the Plaintiff entered into three insurance contracts, around July 2009, with the insured as Defendant A, C (former name D and Defendant A’s children), including Defendant A and Defendant C (former name D and Defendant A’s children), as shown in the attached Table 2, including Non-dividend Sheet Insurance Co., Ltd. (hereinafter “the Insured A”); and around August 2007, non-dividend Shelle Group Insurance (S704) (hereinafter “the Insured 2 insurance”); and around January 2010, the Plaintiff entered into three insurance contracts, such as non-dividend Sheet Insurance Co., Ltd. (insured C and hereinafter “instant 3 insurance”).

(2) According to the above insurance contract, the insurance contract of this case guarantees the payment of the daily amount of hospitalization (30,000 won per day of hospitalization for less than 180 days from the date of the accident), the daily amount of hospitalization per disease (210,000 won per day of hospitalization for less than 31 days), the cost of long-term hospitalization for bodily injury or disease (30,000 won per day of hospitalization for more than 31 days), the cost of hospitalization for bodily injury or disease (the actual cost of hospitalization for not more than 50,000 won). The insurance contract of this case guarantees the payment of the daily amount of hospitalization for bodily injury (the daily amount of not less than 1,00,000 won per day of hospitalization for 180 days from the date of the accident) under special terms and conditions. The insurance contract of this case guarantees the payment of the daily amount of hospitalization for bodily injury or disease (the daily amount of not more than 310,000 won per day of hospitalization for 30 days).

(3) On the other hand, the major general terms and conditions of insurance Nos. 1, 2, and 3 of the instant case are as shown in attached Table 3.

C. (1) Defendant A is hospitalized at G Hospital located in Dongdaemun-gu Seoul Metropolitan Government for 50 days from December 17, 2012 to February 4, 2013, under the clinical presumption of injury medical expenses and damage insurance claims by the Defendants (1) under the name of light base, 3-4-5-6-7 (2), hydronuclear escape symptoms, 4-5 (4-5), etc.