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(영문) 의정부지방법원 2018.05.03 2018나200199
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. As a result of examining the validity of the Plaintiff’s appeal cited in the judgment of the court of first instance compared to the evidence submitted by the parties, the court’s reasoning on this case is as follows: “Total KRW 100,240,000” in Part 16 of the judgment of the court of first instance, “total KRW 102,40,000,” and the Plaintiff’s reasoning is as stated in the judgment of the court of first instance, except for adding the following judgments as to the matters alleged in the judgment of the court of first instance, and thus, it is acceptable in accordance with the main sentence of Article 420 of the Civil Procedure Act.

2. Additional matters to be determined;

A. The purport of the Plaintiff’s assertion is that “In the case of subparagraphs 4 and 5 of paragraph (1), the beneficiary will pay hospital allowances or medical care benefits for the continued period of hospitalization when the period of mutual aid expires during the period of hospitalization” under Article 15(5) of the instant mutual aid agreement. The phrase “when the period of mutual aid expires” under the above provision refers to the case where the beneficiary reaches the maximum limit set forth in the criteria for

Therefore, if the beneficiary continued to be hospitalized even after being paid the maximum amount of hospitalization benefits and medical care benefits, it is possible to additionally receive hospitalization benefits and medical care benefits after the lapse of 180 days of exemption period in accordance with the above provision.

B. According to the statement in Eul evidence No. 1, it is recognized that "I, in the case of paragraph (1) 4 and 5, pay the amount of hospitalization or the amount of medical care benefits for the continued period of hospitalization when the insured terminates during the period of hospitalization" under Article 15 (5) of the mutual aid agreement.

However, "the period of mutual aid" refers to the period until the defendant's liability commences and ends upon the conclusion of a mutual aid agreement, and Article 15 (5) of the mutual aid agreement of this case does not cover the whole period of hospitalization, including after the period of mutual aid, even if the period of mutual aid expires while the beneficiary is hospitalized.

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