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(영문) 대전지방법원 2016.04.28 2015나103515
보험금
Text

1.The judgment of the first instance shall be modified as follows:

On December 9, 2013, the Defendant-Counterclaim Plaintiff (C77)’s transfer of the Aprypam (C77).

Reasons

The principal lawsuit and counterclaim shall be judged together.

Basic Facts

On March 30, 2011, the Defendant entered into the instant insurance contract (hereinafter referred to as the “instant insurance contract”) with the Plaintiff, Han Plus Integrated Insurance Policy 1004 (Securities Number : B).

At the time of entering into the instant insurance contract, the Defendant subscribed to a special agreement on cancer checkup expenses and cancer surgery expenses, and the main contents of the special agreement are as follows.

[Guarantee Details] - Cancer : 50,000,00 won - Cancer surgery expenses: 2,000,000 won [Special Terms and Conditions for Cancer ] Article 2 (Definition and Confirmation of "Canceance", "other skin cancer", and "Aythrance cancer"] of this Agreement refers to diseases (refer to attached Table 2) classified into malicious (Athram) in the Korean Standard Disease Classification.

However, it does not include the disease corresponding to No. C44 (Other Adex 2), the disease corresponding to the malicious life of No. C73 (Adex 2), or the former cancer, which is prescribed by the Classification Code C4 (Adex 2), the disease corresponding to the malicious life of No. C73 (Adex 2).

In this contract, the term “other skin cancer” means the c44(C.A.) of the classification numbers in attached Table 2(C.)(C.A.) of the table 2(C.A.) from among the c. in paragraph 1.

In this contract, the term “Ampirance cancer” means a disease falling under the classification number C73 (Ampirance of Ampirium) of attached Table 2 (C73 (Ampirance of Ampirium) from among “Ampirum” as stipulated in paragraph (1).

“암”, “기타피부암” 또는 “갑상샘암”의 진단확정은 해부병리 또는 임상병리의 전문의사 자격증을 가진 자에 의하여 내려져야 하며, 이 진단은 조직(fixed tissue)검사, 미세바늘흡인검사(fine needle aspiration biopsy) 또는 혈액(hemic system)검사에 대한 현미경소견을 기초로 하여야 합니다.

However, the above diagnosis is not possible.

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