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(영문) 서울북부지방법원 2016.01.07 2015가단103354
보험금
Text

1. The Plaintiff’s obligation to pay insurance money for diagnosis expenses for brain cerebrovascular diseases to the Defendant based on the insurance contract indicated in the attached list.

Reasons

1. Facts of recognition;

A. On November 26, 2004, the Plaintiff concluded an insurance contract with the Defendant as the insured and the beneficiary of brain cerebrovascular disease diagnosis expenses (hereinafter “instant insurance contract”).

B. From July 23, 2014 to August 12, 2014, the Defendant was hospitalized in B Hospital due to druma, brus, etc., and was diagnosed by the doctor C of the above hospital as “cerebral cerebral cerebral cerebral cerebral cerebral cerebral cerebral cerebral cerebral cerebral cerebral cerebral cerebral cerebral cerebral cerebral Spa, and with detailed unknown cerebral cerebral cerebr.”

C. Among the terms and conditions of the instant insurance contract, the main contents of the terms and conditions are as follows.

1. (Compensation for Loss) If the insured described in the insurance policy has been diagnosed and confirmed as the first cerebrovascular disease during the insurance period of this Special Terms and Conditions stated in the insurance policy (hereinafter “insurance period”), the company shall be bound to compensate for such disease in accordance with this Policy.

2. (Definition and Determination of Diagnosis of cerebrovascular Diseases) The term “cerebrscular diseases” means diseases classified as cerebrscular diseases (attached Table 5) of the third Korean Standard Classification of Patients (referring to the table of classification of cerebrscular diseases).

The diagnosis and confirmation of brain cerebrovascular diseases shall be conducted by a person with a physician's license (excluding dentists) of a domestic hospital prescribed in Article 3 of the Medical Service Act or a foreign medical institution outside the country recognized by the company as equivalent thereto, and this diagnosis shall be based on medical history, negonomic shotning (MRI), nuclear self-defluence (MRI), cerebrovascular refluence (PET), double-electronic emitting emeric emeric emeric emeric emeric emeric emeric emeric emeric emeric emeric emeric emeric emeric emul

[Attachment 5] The following diseases are included in the Korean Standard Industrial Disease Classification (Enforcement Date of the Statistics Korea Notice No. 2002-1, January 3, 2003), which is classified as the Hemovascular diseases under the terms and conditions of the Classification Table of Brain Diseases:

[Reasons for Recognition] Unsatisfy, Gap 1, 2, and Eul 2.

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