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1. The plaintiff's appeal is dismissed.
2. The costs of appeal shall be borne by the Plaintiff.
Purport of claim and appeal
The first instance court.
Reasons
1. Basic facts
A. On September 21, 1998, the Plaintiff and the Defendant entered into the health insurance for women without dividends (hereinafter “instant insurance contract”) with the Plaintiff as the principal insured.
B. The plaintiff's left-hand side of February 26, 2000
c. A diagnosis of brain cerebrovascular disease was conducted due to the increase in the establishment of the facility and the reduction of the use of the inside and outside of the area, the number of fire extinguishing, etc.
C. From September 23, 2011 to November 4, 2011, the Plaintiff was hospitalized in the Korean Senior Citizens Special Hospital for 43 days in total.
(hereinafter “First Hospitalization”). After that, the Plaintiff was hospitalized in a large-scale large-scale convalescent hospital from February 13, 2012 to May 12, 2012 (hereinafter “Second Hospitalization”) and was under rehabilitation treatment for male, a brain fladin, etc., for a total of 90 days (hereinafter “second Hospitalization”).
① The Defendant paid KRW 4,00,000 [the maximum period of hospitalization amounting to KRW 1,60,000 for a long-term illness amounting to KRW 400,00 (40 days x daily hospitalization amounting to KRW 40,000) with a special contract for hospitalization of KRW 1,00,000 for a long-term illness amounting to KRW 1,00,000 for a special contract for hospitalization per day x 10,000 for a special contract for recovery of health), which is calculated for 40 days after deducting 3 days from the first hospitalization period. ② The Defendant recognized the appropriate period of hospitalization necessary for the direct treatment of cerebrovascular diseases during the second period of hospitalization as two weeks after the lapse of the second period of hospitalization period of KRW 90,00 for a second period of hospitalization. However, according to Article 19(6) of the Insurance Terms and Conditions for a new hospitalization period of at least 10,000 for each of the two days of hospitalization.
The plaintiff is from the first hospitalization to the second hospitalization.