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(영문) 서울남부지방법원 2018.04.05 2017나59831
보험금
Text

1. The plaintiff's appeal is dismissed.

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

Purport of claim and appeal

The first instance court.

Reasons

1. Basic facts

A. On July 2, 1996, the Plaintiff concluded a pension insurance contract with the Defendant as the insured and beneficiary (hereinafter “instant insurance contract”).

The insurance contract of this case contains special terms and conditions as follows.

0. 80,000 won shall be paid once a month for one year each time when hospitalization has been continued for at least 31 days due to a disaster (income security benefits). When hospitalization has been continued for at least four consecutive days (at least three days per day) due to a disease or disaster (at least 15,000 won per day). (Hospitalization benefits)

B. The terms and conditions relating to the instant case are as follows:

(1) In this special agreement, the term "hospitalize" means, by a person holding a license of a doctor, dentist or herb doctor, a person who is deemed to require medical treatment due to a disease or disaster as specified in the Table 2 (Ad Hoc of Disease and Disaster Classification), he refers to the domestic hospital or clinic (excluding herb clinic) under Article 33(2) of the Medical Service Act or a foreign medical institution recognized by the company and who is equivalent thereto or recognized by the company, to concentrate on medical treatment under the control of the doctor.

(2) The Company shall pay to the insured the agreed insurance money when any of the following events occurs during the insurance period of the special agreement:

When the insured has been hospitalized for at least 31 consecutive days for the direct purpose of the treatment due to the occurrence of a disaster (in case of hospitalization by moving to a hospital or clinic, if the company recognizes this, it shall be deemed hospitalized continuously if it is recognized: hereinafter the same shall apply): Payment of income security benefits (Article 4(1)2 of the Clause of the Special Agreement on Disaster Security) (3) of the company shall continue to be hospitalized in case where the insured has been hospitalized by moving to a hospital or clinic for at least four consecutive days for the direct purpose of the treatment due to the occurrence of a " disease or accident" during the insurance period of the special agreement,

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