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(영문) 서울중앙지방법원 2020.01.16 2018가단5133802
채권자대위 청구의 소
Text

1. The lawsuit of subrogation by obligee among the lawsuit of this case shall be dismissed.

2. The plaintiff's remaining claims are dismissed.

3...

Reasons

1. Basic facts

A. On November 2008, the Plaintiff entered into an indemnity medical insurance contract that covers the medical expenses for hospitalization with the insured as E, and on November 2015, between F and F, the Plaintiff entered into an indemnity medical insurance contract that covers the medical expenses for hospitalization with the insured as G (each of the above insurance contracts is referred to as “each of the instant insurance contracts,” and the insured E and G (hereinafter “each of the instant insured”).

Meanwhile, the Defendant is a medical corporation that opened and operated a H Hospital.

B. The special terms and conditions applicable to each of the instant insurance contracts provide as follows:

Article 1 (Compensation for Loss) of the International Terms and Conditions of Insurance Contract in the Name of the Insured E-insured G Insurance Contract provides that the company shall compensate the beneficiary for the following expenses incurred in providing medical treatment when hospitalized in a hospital or clinic due to disease during the insurance period of this Special Terms and Conditions:

1. The medical examination fees: Medical examination fees, the standard sick room (referring to the standard sick room applied by the relevant hospital or clinic to patients insured by national health insurance), the fees for patient management, food expenses, etc.;

2. Expenses for hospitalization: Examination fees, radiation fees, medication and prescription fees, the main feed, private-research therapy fees, mental therapy fees, treatment fees, materials expenses, glurries, designated medical treatment fees, etc.

3. Expenses for surgery: Expenses for surgery, anesthesia, costs for materials for surgery, etc.;

4. Sick difference: The difference between the difference between the actual user's sick room and the standard sick room shall be covered by the total amount of the expenses under paragraph (1) 1, 2, and 3 (referring to the portion borne by the principal and the portion of the non-benefit among the health care benefit prescribed by the National Health Insurance Act) to be borne by the insured under the National Health Insurance Act, and 50% of the expenses under paragraph (1) 4 within the limit of the subscription amount stated in the insurance policy.

However, when the insured is not subject to national health insurance (including cases where the insured has not undergone health care benefit procedures prescribed in national health insurance), the hospitalization medical expenses.

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