The case holding that, in a case where the clause of the insurance contract entered into with Eul insurance company provides that "a urine disease, etc. is diagnosed and confirmed as nine major diseases during the insurance period, and the surgery is performed directly for the purpose of treating nine major diseases," Gap received urine urine urine urine urine urine urine urine urine urine urine urine urine urine urine urine urine urine urine urine urine, the case holding that the radine ur urine urine urine urine urine urine urine urine was performed directly for the purpose of treating the nine major disease."

In a case where Party A entered into an insurance contract with Party B (hereinafter “E10-E14”) provides that “the term of the insurance contract provides that urines, etc. shall be included in the unit of subdivision, which falls under the category of the Korean Standard Zines Classification (E10-E14), and that “the term of the insurance contract provides that “the insured shall be diagnosed and confirmed as nine diseases after the commencement date of responsibilities, and the surgery shall be performed for the direct purpose of treatment of nine diseases,” and “A” receives urines from Party B to undergo the diagnosis of urines and the treatment for the witness urines, the case holding that the term of the urines (E10-E14), which falls under the category of 9 of the Korean Standard Zines Classification (E10-E14), and that the term of the urines (hereinafter “A”), which included the specific type of urines for the purpose of treatment of Party A’s disease and that the term of the urine’s treatment is not clearly defined.

Article 5 of the Regulation of Standardized Contracts Act

Heung Life Insurance Co., Ltd. (Law Firm Song-tae, Attorney Park Jong-soo, Counsel for the defendant-appellant)

Defendant (Attorney Hong-man et al., Counsel for the defendant-appellant)

Suwon District Court Decision 2011Na7162 decided May 10, 2012

The appeal is dismissed. The costs of appeal are assessed against the plaintiff.

The grounds of appeal are examined.

1. Regarding ground of appeal No. 2

A. The content of a standardized contract ought to be objectively and uniformly interpreted on the basis of the average customer’s understanding potential, without considering the intent or specific circumstances of an individual contractor. In addition, when the content of a standardized contract is not clear or doubtful, it is reasonable to interpret the standardized contract in favor of the customer and disadvantageously to the originator of the standardized contract (see Supreme Court Decision 2011Da30147, Jul. 28, 2011, etc.).

B. Review of the reasoning of the lower judgment and the record reveals the following facts.

(1) On July 11, 2003, the Defendant entered into the instant insurance contract with the Plaintiff, which contains a special agreement for guaranteeing a specific disease, and a special agreement for guaranteeing an operation. Of the aforesaid specific diseases, Article 9(1)2 of the terms and conditions of the instant special agreement for guaranteeing a specific disease provides that “ Nine diseases” means urine disease, heart disease, high blood pressure, cerebrovascular disease, chronic absorption disease, chronic absorption disease, throopic disease, throopic disease, Athroopic disease, throopic disease, and throopic disease classified as a new throopic (see attached Table 3’9). Article 12 provides that “The Company shall pay the insurance money (see attached Table 1’s insurance payment table) agreed upon to the beneficiary if any of the following causes occurs during the insurance period of the said special agreement, and shall not be paid for the purpose of the surgery for the first time after the period of liability insurance.” Article 9(1)3 provides that “In the instant special agreement for the insurer shall be paid for a specific 90th of the disease.

(2) Attached Table 3 of the Terms and Conditions of the Special Agreement on the Guarantee of Specific Diseases states that “The disease classified as nine diseases under Article 9 of the Terms and Conditions refers to the following diseases among the Korean Standard Disease Classification (Enforcement Date of the Statistics Korea Notice No. 2002-1, January 1, 2003) of the 4th revised Korean Standard Disease Disease Death Classification (Enforcement Date of the Statistics Korea Notice No. 2002-1, January 1, 2003).” However, in the Korean Standard Disease Classification after the fifth amendment, if there is a disease other than the following diseases, the disease shall be included in the terms and conditions.” Of the diseases, the term “disease subject to the urology” in the Classification Table is written as “urology” and “E10-14”.

Meanwhile, among the nine diseases listed in the attached Table 3 of the terms and conditions of the instant specific disease guarantee agreement, seven diseases, such as heart diseases, cerebrovascular diseases, high blood pressure, liverer diseases, acute disorders, and scarcitys, etc., are indicated as the "subject diseases" and the "classification Number" in the Korean Standard Disease Identification Classification.

(3) The Korean Standard Disease Classification consists of the head, item group, three unit classification, four unit classification, and five unit classification. The "Items" group consists of three units classification, and the "Class 4 unit classification is intended to distinguish different types of autopsy or various factors in the case of a single disease. If the three unit classification is a single disease, it is intended to distinguish different types of autopsy or multiple factors, or if the three unit classification is a sick soldiers, it is intended to distinguish individual diseases.

C. From the Korean Standard Zatology Classification (Chapter 4) to E10 (C), E11 (Aculinology-related culpology), E12 (Aculinology-related culinology-related culpology), E13 (Aculinology-related culpologyology), and E14 (Aculin disease accompanied by culinology) are classified as e10.3, E11.3, E1.3, E12.3, E13.3, E14.3, and E14.3. For example, Iculine disease accompanied by culinology culinology, 6th revised Korean Classification of Zatology (Statistical Notice No. 2010-150, E13, 2131.21.31, E131.21.31).

(4) The Defendant received a diagnosis of catherosis and asked the Plaintiff as to whether cater catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal catal.

C. Examining these facts in light of the legal principles as seen earlier, considering the step-by-step classification system of the Korean Standard Disease Classification and the details stated in the attached Table 3 of the Clause of the Specific Disease Guarantee Agreement, “urine diseases among nine diseases” in attached Table 3 of the same Clause subject to guarantee of the specific disease of this case shall be deemed to include the diseases included in the subdivision of the Korean Standard Disease Classification (Dbes Ma10-E14) group (E10-E14) group. Moreover, since the urine disease classification is written in the 4 unit and 5 unit classification of the Korean Standard Disease Classification (Dbebes Ma10-E14) group (E10-E14), it is clear that the defendant received urine for the direct purpose of treatment of the urine disease of this case, the defendant is not sufficiently restricted from the terms and conditions of the instant specific urine disease of this case and thus, it is reasonable to view that the urine disease of this case falls under the scope of the terms and conditions of the instant surgery.

Therefore, the judgment of the court below to the effect that the racer’s luminous surgery with the direct purpose of treating the 9th-class disease and the 9th-class disease surgery allowance under the special agreement for guaranteeing the specific disease of this case is just and there is no error in the misapprehension of legal principles as to the interpretation of the terms and conditions, contrary to what is alleged

2. Regarding ground of appeal No. 1

A. Upon entering into an insurance contract, an insurer or a person engaged in the conclusion or solicitation of an insurance contract has a duty to specify and explain in detail and in detail the important contents of the insurance contract, such as the content of the insurance product, the insurance premium rate system, changes in the entries in the written application for insurance, and reasons for exemption of the insurer’s liability as stated in the terms and conditions of the insurance contract. If the insurer entered into an insurance contract in violation of such duty to specify and explain the terms and conditions of the insurance contract, the content of the terms and conditions cannot be asserted as the content of the insurance contract (see Supreme Court Decision 2005Da38713, 38720, Oct.

B. The lower court determined that, in light of the fact that Article 13(2) of the instant insurance contract provides that the surgery shall be limited to the case of a surgery accompanied by hospitalization, and that the Defendant’s personal insurance contract signed at the time of the conclusion of the instant insurance contract includes a printed phrase that “the insurance clauses, the individual cancellation refund sheet, and the subscription form for storage of the subscriber was received, and was received guidance on the key contents of the terms and conditions,” but the insurance policy does not state the limited provisions of the instant hospitalization operation in the insurance policy, but did not state the content of the instant hospitalization operation, and that the Defendant asked the Defendant whether the Plaintiff would be entitled to the Rabre Malaysia surgery benefit in the event of having asked the Defendant about whether he would be subject to the 9th illness surgery, it is difficult to view that the written application of the instant personal insurance contract alone fulfilled the duty to explain and explain the limited provisions of the instant hospitalization at the time of the conclusion of the instant insurance contract, and there was no other evidence to acknowledge it as otherwise.

Examining the reasoning of the lower judgment in light of the aforementioned legal principles and records, the lower court’s fact-finding and determination are justifiable. In so doing, contrary to what is alleged in the grounds of appeal, there were no errors by misapprehending the legal doctrine regarding the duty to explain and prove the burden of proof,

The Supreme Court precedents cited in the grounds of appeal are inappropriate to be invoked on the grounds of different cases.

3. Conclusion

Therefore, the appeal is dismissed, and the costs of appeal are assessed against the losing party. It is so decided as per Disposition by the assent of all participating Justices.

Justices Ko Young-han (Presiding Justice)