1. As to the accident described in the attached Form 2, the plaintiff against the defendant based on the insurance contract mentioned in the attached Form 1.

1. The insured based on facts: C, the beneficiary: The defendant [general terms and conditions] 3 at the time of death (main duties of the company), 16. (Types and Grounds for Payment of Insurance Money) The company shall exclude the insured (persons subject to insurance) from the body of the insured (such as artificial organs, artificial arms, artificial arms, bills, artificial arms, etc.) due to a sudden and incidental accident that occurs during the insurance period, but shall replace their functions due to a physical transplantation, such as artificial organs or parts;

(C) If the rate of disability payment prescribed in the Disability Classification Schedule is equivalent to 3 per cent-100 per cent, the amount calculated by multiplying the rate of payment prescribed in the Disability Classification Schedule by the amount of insurance coverage of the ordinary terms and conditions shall be paid as insurance proceeds of injury (3 per cent or 100 per cent).

18. (Grounds for Not Paying Insurance Proceeds) (1) A company shall not prevent insurance proceeds when any of the following events occurs to cause the payment of insurance proceeds:

1. Intentional intent of the insured: Provided, That where the insured has impaired himself/herself in a state that he/she cannot make a free decision due to mental disorder, etc., he/she shall pay insurance proceeds;

Amount of insurance coverage for injury: 100,000,000

1. Terms and conditions of injury or death;

1. (Types and Grounds for Payment of Insurance Money) A company shall, during the period of insurance under this Special Terms and Conditions, inflict an injury on the insured person listed in an insurance policy (excluding physical assistance equipment, such as trees, artificial organs, artificial arms, artificial arms, artificial arms, etc., which has occurred during the period of insurance, but which includes cases where the function of the insured person is replaced by a physical transplant, such as artificial organs or parts;

(a)In the event of death as a direct result of the injury, the amount of insurance covered by this Special Terms and Conditions shall be paid as the amount of injury death insurance;

C The following contents are as between the Plaintiff on July 30, 2012.