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(영문) 부산지방법원 2016.10.28 2016가단309585
보험금
Text

1. The plaintiff's claim is entirely dismissed.

2. The costs of lawsuit shall be borne by the Plaintiff.

Reasons

1. Factual basis

A. On October 15, 2001, the Plaintiff: (a) on October 15, 2001, the insured Party B and the beneficiary were designated as the Plaintiff; and (b) concluded a new Vietnam insurance contract with the Defendant (hereinafter “instant insurance contract”); and (c) the content of the guarantee under the special agreement to which the said insurance contract was entered into is as follows:

(1) Life-disease's benefits: Payment of 10,000 won per day from the date the insured is hospitalized for at least four consecutive days (within the limit of 120 days per time of hospitalization) for the direct purpose of the treatment due to a disease or a disaster. (2) Major personality-disease's disease care expenses are diagnosed and confirmed as a major personality-related disease specified in the terms and conditions after the date of commencing the responsibility for the insured, and are continuously hospitalized for at least 31 days from the date the insured has been hospitalized for at least 31 days to the date of 120 days, 4,000,000 won for the period from 121 to 180 days, and 10,000 won for at least 181 days.

B. The terms and conditions applicable to the instant insurance contract (hereinafter “instant terms and conditions”) relating to the instant claim are as follows.

Article 9 (Definition and Place of Hospitalization) In this special agreement, the term "hospitalize" means that a person who is qualified as a doctor, dentist or herb doctor is in need of medical treatment due to a disease or disaster as determined by the Regulations on Classification of Disease and Disaster, and it is difficult to provide medical treatment at his own home, etc. so that he is in charge of the treatment under the control of a doctor by attending a domestic hospital or a member of a foreign medical institution as determined by Article 3 (2) of the Medical Service Act or

C. B, on December 19, 2009, was suffering from cerebral typhism and received treatment. However, on December 23, 2014, he/she complained of the right fingers and surrounding areas, and was born to the Yangsan Busan Metropolitan Hospital.

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