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(영문) 서울중앙지방법원 2020.10.22 2019나81812
보험에관한 소송
Text

The plaintiff's appeal against the claim for money and the plaintiff's claim for confirmation changed in exchange at this court.

Reasons

1. The reasoning for this part of the lower court’s reasoning is as follows: (a) inasmuch as the part of the reasoning of the first instance judgment is as stated in Article 420 of the Civil Procedure Act, the reasoning for this part of the reasoning is identical to that of the first instance judgment, except where the “this court” was used as “the first instance court”.

2. Summary of the plaintiff's assertion

A. Of the Defendant’s hospitalization period of 511 days, 446 days of the Defendant’s hospitalization was unfair, and the Defendant, even though there was no need for hospitalization, acquired the insurance money by intentionally and repeatedly receiving hospitalized treatment.

As a result, the trust relationship between the Plaintiff and the Defendant was destroyed to the extent that it is difficult to maintain the insurance contract of this case, and thus, the Plaintiff, upon delivery of the application for modification of the purport of claim and cause of claim as of January 22, 2020, shall cancel the insurance contract of this case

B. The Defendant, without any legal ground, obtained a benefit from receiving insurance proceeds related to hospitalization for 446 days exceeding the reasonable number of days of hospitalization, and thereby incurred loss to the Plaintiff equivalent to the same amount. Therefore, the Defendant is obligated to return the insurance proceeds related to hospitalization for 446 days to the Plaintiff as unjust enrichment.

3. Determination as to whether the instant insurance contract has been terminated

A. The relevant legal principles are based on the trust relationship between the parties. If the trust relationship, which serves as the basis of the contract, is destroyed during the existence of the contract, due to a breach of the contractual duty of one of the parties or any other wrongful act, etc. and thus it is difficult to maintain the contract relationship as it is, the other party may terminate the contract relationship, thereby extinguishing its validity in the future, but the party who asserts the termination of the contract relationship is liable to prove the circumstances that make it difficult

(see, e.g., Supreme Court Decision 2011Da19102, 19119, Apr. 23, 2015). “Hospitalization” means the resistance against a patient’s disease.

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