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1. The plaintiff's obligation to pay insurance money for diagnosis expenses for brain-cerebrovascular diseases based on the insurance contract as shown in the attached Form.
Reasons
1. Basic facts
A. A. Around June 28, 2013, the Defendant entered into an insurance contract with the Plaintiff on the attached Form stating that the Plaintiff shall pay insurance proceeds, such as expenses for diagnosis of brain-related diseases (hereinafter “instant insurance contract”). The special terms and conditions of the instant insurance contract include the definition of brain-related diseases and the confirmation of diagnosis, as follows.
1. The term "cerebrovascular disease" in this Special Terms and Conditions refers to a disease specified in [Attached Table 12] (Classification Table of cerebrscular Diseases) in the 6th Korean Standard Medical Disease Classification.
(2) The diagnosis and confirmation of cerebrovascular disease should be made by a person with a certificate of qualification (other than dentists) of a hospital under Article 3(2) of the Medical Service Act or of a medical institution deemed equivalent thereto, and this diagnosis shall be based on Computerization, e-mail, self-official image, cerebrovascular e-e-e-mail, e-mail release e-mail, etc. along with the medical and neological examination.
(3) If the insured (person insured) is diagnosed as "cerebrovascular disease" during the insurance period, the company shall pay the following amount only once for the first time to the beneficiary (if the beneficiary is not designated as the beneficiary of the insurance), at the cost of diagnosis for cerebrovascular disease:
(Article 2). [Attachment 12] The diseases classified as cerebrovascular diseases as specified in the Terms and Conditions of the Classification Schedule for Brain Diseases refer to the diseases listed below in the sixth revised Korean Standard Korean Classification for Brain Diseases:
B. From December 30, 2014, the Defendant complained for two copies, and was hospitalized until January 20, 2015, at C Hospital located in Namyang-si, Namyang-si. C Hospital physician D diagnosed the Defendant’s name on January 10, 2015 as “cerebrovascular disease with nosesesesese, and with a detailed unknown salphism” (hereinafter “the instant diagnosis”), and “the deceased patient” under the above name of C.