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(영문) 광주지방법원 2018.06.15 2017가단506863
보험금
Text

1. The plaintiff's claim is dismissed.

2. The costs of lawsuit shall be borne by the Plaintiff.

Reasons

1. Basic facts

A. On October 16, 2012, the Plaintiff entered into the instant insurance contract, such as the Defendant and the “Attached Insurance Contract Terms” (Hi1204) basic franchise (hereinafter “instant insurance contract”).

B. On December 1, 2015, at around 20:00, the Plaintiff suffered from injury, such as marble damage, etc., by leaving the apartment in the 12th floor located in the Dong-gu, Gwangju Metropolitan City.

(hereinafter referred to as "the accident of this case")

The main contents of the instant insurance contract are as follows.

Article 16 (Types and Grounds for Payment of Insurance Money) (1) Where the insured is in a state of disability corresponding to the disability payment rate set forth in the Disability Classification Table (referring to the Disability Classification Table 1) as a direct result of an injury during the insurance period, the company shall pay the following amounts to the beneficiary as insurance money:

(2) If the insured (person subject to insurance) is in a state of disability with a higher rate than 80% as a direct result of an injury or disease during the insurance period, the company is exempted from the payment of the insurance premium after the second time.

3. The term "injury" in this contract means an injury sustained by a person (excluding bodily assistance equipment, such as artificial organs or parts, but including artificial organs or parts, which are transplanted and substituted for its function) due to a sudden and incidental external accident that occurred during the insurance period.

Article 17 (Detailed Provisions concerning Payment of Insurance Proceeds) (5) Where at least two residual disabilities have occurred due to the same injury or disease, the rate of payment of the residual disability shall be added to the rate of payment of the remaining disability.

Provided, That where criteria for determining each physical parts of the disability classification table are separately prescribed, such criteria shall be determined.

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