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(영문) 서울중앙지방법원 2019.09.20 2018나56628
보험금
Text

1. Of the judgment of the court of first instance, the part against the defendant exceeding the following amount ordered to be paid shall be revoked.

Reasons

1. On October 5, 2012, the Plaintiff entered into a C insurance contract with the Defendant with the amount of KRW 100 million, the insured and the beneficiary as the Plaintiff (hereinafter “instant insurance contract”).

According to the disability classification table of the instant insurance contract, “when the insured completely loses his/her hearing ability” (hereinafter “instant disability”) is determined as an obstacle of 25% of the insurance proceeds payment rate.

On January 16, 2017, the Plaintiff received the opinion of “NOS in the left-hand ear” from the DBama Hospital. On the same day, the Plaintiff was diagnosed by E Hospital as “one-month ear in the left-hand side of the Cheongbaology test,” and was diagnosed by F University Hospital as “the pro facto diaf conditions” on the 18th day of the same month.

On July 19, 2017, the Plaintiff, based on the foregoing diagnosis, was faced with the left-hand ear in the laund of the laundry season while the circumstances of the accident go beyond the bathing room on December 20, 2016.

hereinafter referred to as "the accident of this case"

"Written claim for insurance money" was submitted.

[Reasons for Recognition: Evidence A(including each number; hereinafter the same shall apply)

each entry of the evidence No. B 1

2. Assertion and determination

A. The Plaintiff asserted that the instant disability occurred due to the instant accident, which is an accident of the Republic of Korea, and sought payment of KRW 25,000,000 based on the insurance contract against the Defendant.

In this regard, the Defendant did not prove the occurrence of the instant accident except the Plaintiff’s statement, and did not discover two traumas that are likely to cause the instant accident. However, the Plaintiff visited the hospital only after the lapse of a considerable time from the date of the instant accident that the Plaintiff asserts, and the instant disability rather than the instant accident, was due to the instant accident, but rather due to the instant accident, such as the Meurian disease, which was suffered by the Plaintiff.

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