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(영문) 광주고등법원 2019.04.05 2018나24270
보험에 관한 소송
Text

1. The plaintiff's appeal and the conjunctive claim added by this court are all dismissed.

2. After an appeal is filed.

Reasons

1. The reasoning of the judgment of this court citing the judgment of the court of first instance is as follows, except for the case where the plaintiff considers the conjunctive claim added by this court as follows, and thus, it cites it as it is by the main text of Article 420 of the Civil Procedure Act.

2. Additional determination (preliminary claim);

A. The Plaintiff’s assertion 1) The Defendant received unnecessary or excessive hospitalized treatment. 2) Since the Defendant failed to faithfully perform its duty of good faith under the principle of good faith under the Civil Act, and the trust relationship between the Plaintiff and the Defendant was destroyed and thus it is impossible to maintain the insurance relationship, the Defendant’s insurance contract as stated in the separate sheet No. 1 (hereinafter “instant insurance contract”) was lawfully terminated as a copy of the instant claim and the application for modification of the cause of the claim, stating the Plaintiff’s declaration of termination of the contract, were served on the Defendant.

3) If the Plaintiff paid insurance money to the above hospitalized treatment in 31,658,374 won, the Defendant gains profits without any legal cause, and the Plaintiff suffered damages equivalent to the same amount. Therefore, the Defendant is obligated to return the above insurance money and damages for delay to the Plaintiff. (B) The relevant legal principle as to hospitalization requires continuous observation of the medical staff in relation to the side effects of the patient’s disease or the incidental effects of the drugs that are very low in resistance to the patient’s disease or administered, where the management of nutritional conditions and intakes is necessary, the pharmaceutical treatment should be continuously conducted, and thus, the patient’s pains are more inconvenience in treatment, or where the patient’s condition is unable to cope with the patient’s disease, or where the patient’s risk of infection exists, etc., and thus, the Ministry of Health and Welfare is publicly notified.

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