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(영문) 대구지방법원 포항지원 2017.01.24 2015가단305182
보험금
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. Facts of recognition;

A. On June 4, 2001, the Plaintiff entered into an insurance contract with the Defendant for “Life Insurance Class II” (hereinafter “instant insurance contract”) and included a special agreement for the guarantee of a specific disease. The main contents of the said special agreement for the guarantee of a specific disease are as follows.

Article 9 of the Terms and Conditions of the Special Agreement on the Guarantee of Specific Diseases with no Dividend Afluor Specific Diseases (1) The definitions and diagnosis of the specific diseases in this Special Agreement, and the term "the second and nine diseases" means the following diseases in the final classification of the third and subsequent Korean Standard Industrial Diseases:

2. The term "second-class disease" means a disease classified as urology, heart disease, high blood pressure, cerebrovascular disease, transboundary disease, chronic smoking disease, thystrophalopic disease, thystrophal disorder, Athalopic disorder, and thysphalopic disease (attached Table 3 referred to as " Nine-class disease classification table").

(2) The diagnosis and confirmation of the second and nine diseases shall be based on a written diagnosis submitted to a hospital or clinic in the Republic of Korea, or to a person who holds the qualification of doctor of a foreign medical institution recognized by the company as equivalent thereto (hereinafter referred to as "doctor").

Article 11 (Types and Grounds for Payment of Insurance Money) If any of the following events occurs to the insured during the insurance period, the company shall pay the insurance money agreed upon to the beneficiary (see attached Table 1, e.g., attached hereto):

3. When the insured has been diagnosed and confirmed as a nine-class disease during the insurance period, and undergoes an operation directly for the purpose of treating the nine-class disease: The name of the standard insurance payment table of the operating benefit (attached Table 1): The amount to be paid when the insured undergoes an operation for a direct purpose of treating the nine-class disease during the insurance period (Article 11 subparagraph 3 of the Terms and Conditions): Three million won (one time of the operation) and the amount to be paid: the disease classified as a nine-class disease under Article 9 of the Terms and Conditions of the 9th Disease Classification Table.

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