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(영문) 서울중앙지방법원 2017.12.15 2016가단5304334
보험금
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. Basic facts

A. On December 3, 1998, the Plaintiff entered into a non-dividendd Women's Health Insurance Contract (hereinafter "instant insurance contract") as shown in the attached Form with the Defendant.

B. The main contents of the insurance terms and conditions of the instant insurance contract (hereinafter “instant terms and conditions”) are as follows.

Article 2(Definition and Confirmation of Diagnosis) (1) The term "in this contract, 12 severe diseases" refers to diseases falling under the following of cancer, heart disease, high blood pressure, cerebrovascular disease, inter-cerebrovascular disease, urine disease, chronic urine disease, chronic urgical disease, tragical disorder, Athropsis, tuberculosis, pulmonary pulmona, and a new urgical disease:

4. The term "cerebrovascular disease" means a disease classified as a cerebrovascular disease in the basic classification of the Korean Standard Classification of Patients;

In addition, the term "stroke" of the cerebrovascular disease refers to a disease classified as mathal typhosis, cerebral cerebral typhism, and other non-cerebral typosis, cerebral typhism, cerebral typhism, cerebral typhism, or cerebral typhism, which is not caused by the cerebral typhism (in addition, classification 160-163, 165-166).

Article 4 (Definition and Place of Hospitalization) In this contract, the term “hospitalize” shall mean that a person qualified as a doctor, dentist, or oriental medical doctor (hereinafter referred to as “doctor”) is admitted as requiring medical treatment due to the 12 large-scale disease, the upper cancer, or the traffic disaster as prescribed in the attached Table 4 (Traffic Classification Table) (hereinafter referred to as “traffic disaster”) and it is difficult to provide medical treatment at his own house, etc. and is therefore unable to do so, he shall be admitted to a hospital or clinic under Article 3(2) of the Medical Service Act, or a foreign medical institution recognized by the company as equivalent to the above, and shall concentrate on medical treatment under the control of the doctor.

Article 10 (Grounds for Payment of Insurance Money) (1) The Company shall provide the insured with the following information during the insurance period:

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