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(영문) 대구지방법원 2019.11.20 2019나310854
보험금
Text

1. The defendant's appeal is dismissed.

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

3. The judgment of the court of first instance is subject to Paragraph (1).

Reasons

1. Basic facts

A. On October 31, 2008, the Plaintiff entered into a contract with the Defendant with C (hereinafter “instant insurance contract”) with the period of insurance from October 31, 2008 to October 31, 2061 as the Plaintiff, the insured, the period of insurance from October 31, 2008 to October 31, 206, and once insurance premium 51,493, and paid insurance proceeds.

B. Of the terms and conditions of the instant insurance contract, the terms and conditions of the instant special terms and conditions related to disease hospitalization II (Renewal), are as follows.

34. The amount equivalent to 100% of the personal charges and the cost equivalent to non-payment (50% in case of difference between the difference between the amount of the medical care benefits and the amount of the non-payment (50% in case of the difference between the medical care benefits and the amount of the non-payment) out of the medical care benefits prescribed by the National Health Insurance Act, where the insured under Article 1(2) of the Special Terms and Conditions for the Admission of Disease II (Renewal) receives medical treatment due to the disease (excluding the case of the diagnosis or treatment for the disease within the past five years from the date of subscription for the insurance contract) during the insurance period, according to the evidence 2(2) of the insurance amount under the insurance contract of this case.

To the extent, it is rare to compensate for expenses incurred in hospital treatment for diseases.

Even if the insurance period has expired while the insured was hospitalized and received treatment after the date of the commencement of guarantee, compensation for medical expenses for the continuous period of hospitalization from the date of the final outbreak of the insurance period before the expiration of the insurance period shall be set up for up to 365 days.

Section 2 (Non-Compensation for Loss) The Company shall not pay compensation for any loss arising from the following causes:

2. Expenses for stable treatment to treat skins, dye, mental or physical weakness, etc.;

B. On November 22, 2016, the Plaintiff discharged the Plaintiff, under the opinion of medical personnel, who was diagnosed 2A cancer 2A at D Hospital, undergone surgery, such as climatic agents under the jurisdiction of the Plaintiff, and subsequently requires medical treatment in the future on December 8, 2016.

C. Since January 12, 2017, the Plaintiff from January 12, 2017 to April 2017.

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