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(영문) 대전지방법원 2015.08.19 2015나845
보험금
Text

1. The appeal by the counterclaim defendant is dismissed.

2. The costs of appeal shall be borne by the counterclaim Defendant.

Purport of claim and appeal

1..

Reasons

1. The reasons for the court's explanation concerning this case are as follows. The evidence Nos. 8 of the first instance court's 3, 5, 8, Eul's 1 to 4, and 9 to 11 (the number of pages No. 1 to 3, 5, 8, and Eul's 1 to 4, 9, and 11 (the number of pages No. 1 to 3; hereinafter the same shall apply) are as follows. In the case of the second 13, "the following items" are added. The part of the first instance court's decision is as stated in the part of the reasons for the first instance court's judgment, except for the following parts, and this is cited in accordance with the main sentence of Article 420 of the Civil Procedure Act.

[Supplementary to the part of the judgment of the first instance court, “The Special Clause (3) of the instant insurance contract provides that “The amount equivalent to 90% of the total amount of the patient’s charges and non-benefits (excluding the difference of the patient’s injury and disease compensation fees) among the medical benefits prescribed in the National Health Insurance Act or the Medical Care Assistance Act (excluding the difference of the patient’s injury and disease compensation fees), shall be compensated within the limit of the purchase price of the insurance.”

Part 2 of the judgment of the first instance, the following table shall be added after the second sentence of the first instance.

After the third part of the judgment of the first instance court, “The insurance money that the Plaintiff is entitled to receive as hospitalization medical expenses in relation to the instant insurance contract shall be KRW 8,604,288 in relation to the instant accident.”

After the third page of the judgment of the first instance court, "Therefore, the defendant is obliged to pay 8,604,288 won to the plaintiff with the insurance money due to the accident of this case in accordance with the insurance contract of this case."

The third part of the judgment of the court of first instance is not an exception period, but an additional compensation provision is more favorable to the plaintiff who is the insured, and it is based on the standard terms and conditions prepared by the Financial Supervisory Service. Thus, the terms and conditions of this case are not subject to the duty to explain.

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