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(영문) 수원지방법원 2016.06.02 2014가단513243
보험에관한 소송
Text

1. The Defendant’s KRW 1,861,961 as well as the Plaintiff’s annual rate from June 4, 2014 to June 2, 2016, and the following.

Reasons

1. Basic facts

A. On February 6, 2006, the Defendant concluded the instant insurance contract with the Plaintiff. Of the content of the guarantee, the contents relating to hospitalization are as follows.

Special agreement of hospitalization: 20,000 won per day exceeding 3 days and 20,000 won per 4 days when a person is hospitalized for at least four days due to a disease or accident (120 days): Adult disease: 100,000 won per day exceeding 3 days when he/she is hospitalized for at least four days due to a serious disease: 30,000 won per day exceeding 3 days when he/she is hospitalized for at least four days due to an adult life disease (120 days limit).

B. B received hospitalized treatment at each hospital over 14 occasions as shown in attached Table 1 (hereinafter “instant hospitalized treatment”), and the Defendant claimed insurance payment to the Plaintiff, and the Plaintiff paid the insurance money indicated in the column for payment of the above Table 1.

C. B was prosecuted for committing a crime that obtained insurance money from an insurance company including the Plaintiff, by means of hospitalization or excessive hospitalization, even though it is not necessary after having subscribed to various insurance policies including the instant insurance contract, and that the details of hospitalization B (hereinafter “the details of hospitalization related to criminal trial”) were included in the criminal facts as shown in [Attachment 1] No. 1, 3 through 8, and 12.

In the above trial on January 29, 2015, the details of hospitalization indicated in Table 1 Nos. 1 Nos. 3 and 12 are recognized as the necessity of hospitalization, and the period as indicated in the table Nos. 1 and 12 can be seen as the appropriate period of hospitalization, but the verdict of innocence was rendered on the ground that it cannot be found as unnecessary long-term hospitalization without any reasonable doubt. As for the details of hospitalization indicated in Table 1 Nos. 1, 4, and 8, the court found the Defendant guilty on the ground that the Defendant, who is the victim, by deceiving him/her, by means of hospitalization or by means of long-term hospitalization with the appropriate period of hospitalization

(e) the above judgment;

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