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(영문) 서울중앙지방법원 2016.10.07 2016나35146
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. Facts of recognition;

A. On December 24, 2007, the Plaintiff concluded an insurance contract with the Defendant, a company running the insurance business, as indicated in the separate sheet (hereinafter “instant insurance contract”).

B. Around 2009, the Defendant received surgery, navigation cancer treatment, and radiation treatment at the Seoul Asan Hospital after receiving a diagnosis of the left-hand rock, and from April 3, 2015.

7. Until September (98 Day), and from July 11, 2015, the same year.

8. Until November (32 days), he/she was hospitalized in a B hospital and received medical treatment, such as pressure exposure and the administration of accelerators;

(hereinafter “instant hospitalized treatment”). C.

According to the terms and conditions of the insurance contract of this case, cancer hospitalization benefits under the special agreement for cancer hospitalization are paid when the insured has diagnosed and confirmed as cancer and been hospitalized for at least four consecutive days for the direct purpose of the treatment, and hospitalization under the said agreement refers to the case where it is acknowledged that the treatment is necessary by a person who is qualified as a doctor, dentist, or oriental medical doctor, and it is difficult to provide treatment at his own house, etc. and it is committed to the care under the control of the doctor.

[Ground of recognition] Facts without dispute, Gap evidence 1, 2, 4, Eul evidence 1, the purport of the whole pleadings

2. The plaintiff's assertion and judgment

A. The Plaintiff asserted that the Plaintiff received surgery, navigation cancer treatment, and radiation treatment due to the left-hand breast cancer in 2009, but continued to undergo the instant hospital cancer treatment after being transferred to the chest in 2013, and received the instant hospital treatment. Since the instant hospital was hospitalized for the purpose of direct treatment of cancer, the Defendant is obliged to pay the insurance proceeds to the Plaintiff in accordance with the insurance contract of this case.

B. According to the terms and conditions of the instant insurance contract 1, the insured was paid for the “when the insured was hospitalized for a direct purpose of cancer treatment.” Here, the term “hospitalized for a direct purpose of cancer treatment” refers to cancer disease itself, such as surgery.

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