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(영문) 서울중앙지방법원 2016.02.16 2013가단261745
보험금
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. On January 12, 2005, the Plaintiff’s spouse B entered into a non-dividend indemnity insurance contract (long-term damage insurance) between the Defendant, an insurance company, and the Plaintiff as the insured (hereinafter “instant insurance contract”).

According to Article 1 of the Clause on Special Expenses for Diagnosis of Brain Diseases in the Insurance Contract of this case, if the plaintiff who is the insured has been diagnosed and confirmed as the first cerebrovascular disease during the insurance period, the defendant is obliged to pay insurance proceeds of KRW 40 million under the name of expenses for diagnosis of cerebrscular diseases.

(2) Around July 29, 2013, the Plaintiff was hospitalized in each of the instant special terms and conditions from July 29, 2013 to August 27, 2013. The Plaintiff was diagnosed as being subject to examination of brain self-explosion test (MRA), brain self-explosion test (MRA), light-to-closion test (TRA), and light-slosion test, etc., and was hospitalized in each of the instant special terms and conditions from July 29, 2013 to August 29, 2013 to August 27, 2013, 2013.

Article 2 of the Insurance Terms and Conditions of the instant case provides that “the definition and confirmation of diagnosis of cerebrovascular diseases” shall be as follows:

(1) The term "cerebrovascular disease" means a disease (see attached Table 5) classified as a cerebrovascular disease under the third-level Korean Standards for Brain Death Classification, which is classified as a cerebrovascular disease.

(2) The diagnosis and confirmation of a brain-related disease shall be conducted by a person with a physician's license (excluding dentists) of a domestic hospital prescribed in Article 3 of the Medical Service Act or a foreign medical institution overseas recognized by the defendant as equivalent thereto, and such diagnosis shall be conducted based on medical history, negonomic calcan, nuclear calcan (MRI), cerebrovascan calcan (PET), cerebral calcan (PET), bielectronic emitting calcan (PET), calcan (SPECT), cerebral calcan examination, etc.

[Attachment 5] Brain disease.

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