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(영문) 서울남부지방법원 2016.11.17 2015가단200672
보험금
Text

1. The Defendant against the Plaintiff on April 20, 209, pursuant to the insurance contract that was concluded on April 20, 2009 as the Guarantee Insurance for Undividends 0904.

Reasons

1. Basic facts

A. On April 20, 2009, Nonparty B entered into an insurance contract with the insured as the Defendant, and Nonparty B entered into an insurance contract without dividends, APlus Guarantee Insurance 0904 (hereinafter “instant insurance contract”) including the guarantee that the insured suffers from illness or injury. The following terms and conditions of the instant insurance contract include the following (hereinafter “instant special terms and conditions”).

(1) In the 5th Korean Standard Industrial Classification, companies of Article 2 (3) of the 5th Standard Industrial Classification (III) shall not compensate for damages caused by dental diseases, such as dental symptoms, dental diseases, and dental diseases.

【See Attached Table 3 [Attachment 3] (hereinafter “Special Terms and Conditions 1 of this case”) (2) The Company of Article 2(4) of the General Terms and Conditions 3 of the 2nd Guarantee of Maternity Medical Expenses (III) shall not be covered by compensating for expenses incurred in sanitary management, sex surgery expenses for the unborn, and outpatient treatment expenses.

(hereinafter “Special Terms and Conditions No. 2”) (3) The company (Plaintiff) under the Special Terms and Conditions No. 2(2)4 shall compensate for damages arising from dental diseases, etc.

(hereinafter “Special Terms and Conditions of this case 3”) 【Attachment 3】

4. Dental diseases (K00-K08) such as dental surgery, dental surgery, dental surgery, and dental disease, and not less than the k07 dental surface (including irregular ties);

B. On January 10, 2012, the Defendant: (a) was diagnosed by “Apology (K071); and (b) Emphan (K071); and (c) was diagnosed by “Apology (K074); and (d) Emphan (K074).”

On July 31, 2014, the Defendant received treatment, such as receiving tegymnasium and tegymnasium in the tegymnasium and tegnasium in the tegnasium, and paid KRW 16.2 million in total for medical expenses and treatment expenses.

[Grounds for recognition] Gap 1 to 10 evidence respectively.

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