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1. On August 7, 2007, after the Defendant went through water at the seaside of Jeju-do and left the snow, foreign substances were found to be snow.
Reasons
1. Basic facts
A. On November 15, 2002, the Defendant’s mother B concluded an attached insurance contract with the Plaintiff and the insured as the Defendant, the insurance period from November 15, 2002 to November 15, 2054.
나. 피고는 2007. 8. 20.경 원고에게 “07년 8월초경 제주도 집 방문한 차에 홀로 바다가에서 수영을 하던 중 양안에 미상의 물체가 들어가 수면에서 나와 눈을 비볐으나 뿌옇고 앞이 보이지 않아 자택에 귀가하여 1~2일 가량 요양하였고 호전 없어 제주대병원 내원하여 검사상 양안 0.1 / 0.15의 상태로 시각장애 5급1호에 해당하는 장해진단”(갑 7호증)을 받은 것을 보험사고로 보험금 청구를 하였다.
C. Provisions pertaining to the terms and conditions are as follows.
[Ordinary Terms and Conditions] Article 12 (Compensation for Damages) If the insured suffers bodily injury due to a sudden and incidental accident during the insurance period, the insured shall be compensated for the damage resulting from the injury in accordance with the Terms and Conditions.
Article 15 (Ex Post Facto Disability Insurance Money) General disability insurance proceeds: Where the insured was injured by an accident prescribed in Article 12, and the physical part of the body has been lost within one year from the date of the accident, or where the function thereof has been permanently lost or the payment rate prescribed in the subparagraphs of attached Table 1 is less than 80% because the insured has been lost as a result of the accident, the company shall pay to the beneficiary an amount calculated by multiplying the payment rate prescribed in each subparagraph of attached Table 1 by the insurance amount.
[Attachment 1] The kinds of subsequent disability in the table of the rate of payment of the latter disability
1. 1) When the 100% 60% 60% 34% 26% (special terms and conditions) of the company is either deceased or disabled during the insurance period due to a disease that occurred during the insurance period by the insured, and 2) one eye mix 3) one eye mix 0.02 or less (4) one eye mix 0.06.06.