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(영문) 서울중앙지방법원 2017.10.18 2016가단5177181
부당이득금
Text

1. The Defendant’s KRW 14,211,176 as well as the Plaintiff’s annual rate from November 21, 2014 to October 18, 2017, and the following.

Reasons

Basic Facts

On January 14, 1999, the defendant entered into an insurance contract with the plaintiff and the insured and the beneficiary with the defendant entering into an insurance contract with the insurance products of "the best female health insurance class 2" with the content that the defendant receives the prescribed amount of insurance proceeds when the defendant is hospitalized into a specific disease.

(hereinafter “instant insurance contract.” According to the terms and conditions of the instant insurance contract, the term “the instant insurance contract” provides that when the insured has been hospitalized for at least four consecutive days for the purpose of directly treating 9 chronic diseases, cancer or thym cancer during the insurance period, 40,000 won per day exceeding 3 days and 20,000 won per day when he/she continued to be hospitalized for at least four consecutive days for the purpose of directly treating female specific diseases, 2 million won per day exceeding 3 days, and 4 million won when he/she continued to be hospitalized for at least 31 days for the purpose of directly treating the said disease.

In addition, the terms and conditions of the special agreement for hospitalization of the insurance contract of this case stipulate that KRW 10,000,000 shall be paid per day of hospitalization exceeding 3 days when he/she has been hospitalized for more than 4 days due to a specific disease or disaster, which is the amount equivalent to KRW 1/1,000 per day of hospitalization.

The Defendant received insurance proceeds of KRW 28,422,352 in total up to 18 times until November 20, 2014, on the ground that the Defendant was hospitalized for 22 days from August 2, 201 to August 23, 2011, including the receipt of KRW 1,100,000 on September 15, 201.

The Defendant was convicted of receiving insurance money of KRW 43,131,315 from the Plaintiff by being hospitalized for a long time in the hospital, even though it is a minor disease without the necessity of hospitalization, and was investigated on August 27, 2015, and was subject to a disposition of suspension of indictment on the ground that it was not a criminal record, and there was no violation of the law.

[Reasons for Recognition] There is no dispute, Gap evidence 1 to 7 (including the serial number) respectively.

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