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(영문) 광주지방법원 2020.10.08 2020나50330
공제금
Text

The judgment of the first instance shall be revoked.

The plaintiff's claim is dismissed.

All costs of the lawsuit shall be borne by the plaintiff.

purport, purport, and.

Reasons

1. Basic facts

A. On August 21, 2003, C, the spouse of the Plaintiff, entered into a mutual aid agreement with the Defendant, who is a mutual aid business entity, with the Insured on August 21, 2003, setting the beneficiary as the Plaintiff on August 21, 203, and as the beneficiary upon hospitalization and disability (hereinafter “instant mutual aid agreement”).

B. Of the terms and conditions of the instant mutual aid agreement (hereinafter “instant terms and conditions”), the parts relating to the instant case are as follows.

D Article 14 of the General Mutual-Aid Terms and Conditions "Definition of Hospitalization" refers to "Hospitalization" in this contract to a domestic hospital or an overseas medical institution (hereinafter referred to as "medical institution") recognized by a doctor, dentist, or a person qualified as an oriental medical doctor (hereinafter referred to as "doctor") as specified in the attached Table 2 in the Schedule of Disease and Disaster Classification (hereinafter referred to as " Disease and Disaster") and to concentrate on medical treatment under the control of a doctor, as it is deemed necessary for medical treatment due to difficulty in medical treatment at home, etc.

Article 15 (Definition and Confirmation of 7 Large-Term Diseases) (1) The term “seven-Term Diseases” in this Agreement means the diseases specified in attached Table 5 “The 7 Large-Term Diseases Classification” in the 4th Standard Disease Disease Classification.

(2) The diagnosis and confirmation of a seven major diseases must be made by a person with a medical doctor's license (excluding dentists) of a medical institution, in whole or in part of medical opinions, cellological opinions, dynamic opinions (X-ray, CT, internal police matters, hearts, blood tests, etc.), clinical opinions, and clinical observations, or clinical dogs.

Article 18 (Types and Grounds for Payment of Mutual Aid Funds) The E organization shall pay the Insured Mutual Aid Fund (referred to as “Mutual Aid Fund Payment Schedule” 1) to the Beneficiary of Mutual Aid (hereinafter referred to as “beneficiary”) during the period of mutual Aid Agreement when any of the following events occurs:

except as provided in subparagraphs 3 and 3.

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