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(영문) 서울중앙지방법원 2017.09.26 2015가단5299152
채무부존재확인
Text

1. An insurance contract entered in the separate sheet with regard to cancer diagnosis made against the defendant on July 1, 2015.

Reasons

1. Basic facts

A. On February 3, 2009, the Plaintiff entered into an insurance contract with the Defendant on February 3, 2009, respectively, and entered into a special agreement to guarantee cancer diagnosis expenses and a special agreement to guarantee high-amount cancer diagnosis expenses, each of which covers KRW 20 million when the diagnosis becomes final and conclusive with high-amount cancer when the Defendant, who is the insured, has confirmed that there was cancer.

B. Of the terms and conditions related to cancer diagnosis expenses, which are incorporated into the terms and conditions of the insurance contract, the contents of this case are as follows, and such terms and conditions also include the high-amount cancer diagnosis expenses special terms and conditions.

Article 2 (Compensation for Loss) When the insured becomes final and conclusive by cancer, it shall be compensated in accordance with this special terms and conditions.

Article 3 (Determination and Determination of Cancers) (1) In this Special Terms and Conditions, the term "Cancer" means a disease classified as malicious life in the 5th Korean Standard Disease Disease Classification.

⑥ 「암」의 진단 확정은 해부병리 또는 임상병리의 전문의사 자격증을 가진 자에 의하여 내려져야 하며, 이 진단은 조직(fixed tissue)검사, 미세침흡인검사(fine needle aspiration biopsy) 또는 혈액(hemic system)검사에 대한 현미경 소견을 기초로 하여야 합니다.

However, if it is not possible to conduct the above pathological diagnosis, the clinical diagnosis of the Cancer is recognized as evidence of the Cancer Act.

In such cases, I shall have a documented record or evidence proving that the insured is under diagnosis or treatment as the Cancer Act.

C. On May 28, 2015, the Defendant: (a) received catheral and catal catal surgery at the Subdivision Hospital; (b) received diagnosis on July 1, 2015; and (c) filed a claim for cancer diagnosis expenses and high-amount cancer diagnosis expenses with NOS’s malicious life (Korean Disease Classification C71.0) under an insurance contract on July 1, 2015.

[Ground of recognition] Unsatisfy, Gap 1, 2, and 3 evidence, the purport of the whole pleadings

2. Summary of the parties’ assertion

A. The Defendant’s disease as a result of the organizational examination conducted after the Defendant’s surgery.

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