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(영문) 광주지방법원 2019.11.08 2019나54664
보험금
Text

1. The plaintiff's appeal is dismissed.

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

The purport of the claim and appeal is the purport of the appeal.

Reasons

(b) the facts of the basis;

A. On March 31, 2003, the Plaintiff concluded the following insurance contract with the Defendant and the insured as the Plaintiff.

(hereinafter “instant insurance contract”). Insurance types: C Securities number: D contract period: from March 31, 2003 to March 31, 2030: the policyholder and the insured on March 31, 2030: The major security of the Plaintiff is as follows:

The amount of guarantee of the name of performance guaranteed by the early treatment fund shall be KRW 10 million when the insured is diagnosed and confirmed due to the first brain stroke or acute strophical strophy (limited to each time only once) when he/she is accompanied by a large-amount treatment expenses insured who is hospitalized for the direct purpose of treatment during the insurance period * 2.5 million won (the first operation once) of cerebrovascular disease or heart disease (the first operation).

B. As a result of brain MRI, the Plaintiff’s view on “the chronic scoppy transfusion on both sides” was observed; on October 17, 2017 at the Jeonnam University Hospital, the Plaintiff was administered with two astronomical and scopic scopic scopic scopic scopic scopic scopic scopic scopics on November 13 of the same year; and on December 29 of the same year, the Plaintiff was finally diagnosed “the scopic scopic scopic scopic scopic scopic scopic s

C. The terms and conditions applicable to the instant insurance contract (hereinafter “instant insurance contract terms and conditions”) include the following:

Part III Insurance Money Payment (Main Obligations of Company), Article 15 (Definition and Confirmation of Diagnosis of Brain Diseases and Amstropha), 15 (Definition and Confirmation of Diagnosis of Brain Diseases) (1) The term "cerebrovascular diseases" in this contract refers to the diseases specified in the attached Table 6 (Classification of Brain Diseases) in the basic classification of the Korean Standard Classification of Brain Diseases, and the term "cerebrstroke" means the diseases classified as brain cerebrstropha in the following categories (I60-I63, I65, I66), which do not cause severe cerebrstropha, such as cardiostropha, cerebrstropha, cerebrstropha, and other non-cerebrstropha, which are non-cerebrstropha, and do not cause serious cerebrstropha, and the diseases classified as pulmonary cerebrstropha (I60-I63, I65, and I66).

(2) The diagnosis and confirmation of cerebrovascular diseases shall be a hospital or clinic referred to in Article 3 (2) of the Medical Service Act.

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