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(영문) 서울중앙지방법원 2016.08.17 2015나69159
보험금
Text

1. The judgment of the court of first instance is modified as follows according to the plaintiffs' acceptance of lawsuit and the addition of the plaintiffs' claims.

Reasons

1. Facts of recognition;

A. On January 23, 2014, A entered into an insurance contract with the Defendant, on or before the relevant day prior to the date two years have elapsed since the date of the insurance contract, the Defendant entered into a non-dividend de facto cancer insurance contract (hereinafter “instant insurance contract”) which includes the payment of KRW 5,00,000 of the cancer treatment insurance money (hereinafter “instant insurance contract”).

B. Article 25 (Obligation to Notify before the conclusion of the contract) of the Regulation of the Terms and Conditions does not necessarily inform the fact that the contractor or the insured (the insured) is aware of the matters asked in the application form (including the time of health examination in the case of the diagnosis contract) at the time of subscription (hereinafter “the obligation to notify before the contract,” and the same as “the obligation to notify” in the

However, in the diagnosis contract, the health examination may be substituted by the data that can determine the health conditions, such as a copy of the health certificate executed by the workplace or individual at the general hospital and the hospital pursuant to the provisions of Article 3 (Medical Institution) of the Medical Service Act.

Article 26 (Effect of Violation of Obligations to Notify before Contract) (1) Where a contractor or an insured person (person subject to insurance) falsely notifies him/her of important matters by intention or gross negligence, notwithstanding Article 25 (Notice prior to Contract), the company may terminate the contract or restrict the guarantee by a method separately determined by the company.

Article 34 (Payment of Insurance Money, etc.) (1) When a company receives the documents prescribed in Article 33, it shall issue a receipt, and shall pay the insurance money or the refund for termination within three business days from the date it receives the documents.

However, in the case of insurance money, if it is necessary to investigate or confirm the grounds for payment, it shall be paid within 10 business days after receipt.

C. (1) A was diagnosed by the cross-section test, which was received from E on October 17, 2014, and was received at the Seoul Asan Hospital on October 29, 2014.

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