2014AD 20131 Confirmation of the existence of an obligation

2014Gaz. 20438 (Counterclaim Insurance Money)

lot damage insurance company

A

June 26, 2014

July 24, 2014

1. In relation to the Defendant (Counterclaim Plaintiff)’s disease and disability pension II insurance payment obligations on the Defendant (Counterclaim Plaintiff) based on an insurance contract indicated in the separate sheet, with respect to the Defendant (Counterclaim Plaintiff)’s disease and over 50% of the remaining disability pension, with respect to both sides of the knee-shne-hne-hne-hne-hne-hne-hne-hne-hne-hne-hne-hne-hne-hne-hne-hne-hne-hne-hne-hne-hne-hne-hne-h

2. The defendant-Counterclaim plaintiff's counterclaim is dismissed.

3. The costs of lawsuit shall be borne by the Defendant (Counterclaim Plaintiff) in total, with the principal lawsuit and counterclaim.

【Main Office】

The text of paragraph (1) is as follows.

[Counterclaim]

The Plaintiff (Counterclaim Defendant; hereinafter referred to as the “Plaintiff”) shall pay to the Defendant (Counterclaim Plaintiff; hereinafter referred to as the “Defendant”) 144,208,996 won with interest of 6% per annum from November 25, 2013 to the service date of a duplicate of the instant counterclaim and 20% per annum from the next day to the day of complete payment.

A principal lawsuit and a counterclaim shall be deemed simultaneously.

1. Basic facts

A. Conclusion of the instant insurance contract and the contents of the special agreement

1) On November 28, 2011, the Plaintiff entered into an insurance contract, such as the attached list, with the Defendant (hereinafter “instant insurance contract”).

2) According to the Special Terms and Conditions for Disability Pension II (hereinafter referred to as the "Special Terms and Conditions for Disability Pension") with 50% or more of the disease in the insurance contract in this case, if the defendant (the insured) becomes a disability equivalent to disability payment rate of 50% or more as set forth in the Disability Classification Table during the insurance period, the plaintiff shall pay the purchase amount of the insurance contract in the special terms and conditions for the first time only once to the beneficiary with a disability pension with 50% or more of disease for 20% or more each year from the date when the diagnosis of the disease becomes final and conclusive (Article 1), and "if two or more remaining disabilities have occurred due to the same disease, the payment rate of the remaining disability shall be paid after adding them to the beneficiary. However, if the criteria for determining each part of the physical parts of the Disability Classification Table are separately prescribed, the disability classification table attached to the Special Terms and Conditions shall be set out as follows:

Part I General Provisions 1. The term "physical disability" means a state of damage to a permanent mental or physical body remaining in the body after recovering the injury or disease; 2. 1. The physical part part means a state of damage to a body; 1. . . 2. : <1. 8 : 8. 8. 1. 8 . . . . 1. . 1. . 1. 1. . 1. 1. . 1. . 1. . . 1. . .. 1. . . .. .. 1. .. .. .. .. 1. .. ... ... ..... 1. ... ..... .... .... .... .... ... .. .. .. .. .. .. .. . . .. . . .. ... . .. . .... . . . .... ...... . ..

(b) Diagnosis of kneee-knee-knee-knee-knee-knee-knee-

1) On January 25, 2012, the Defendant began to receive treatment from the right-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free kne-free on either of them, and received the latter diagnosis on November 20, 2013

2) The Defendant asserted that “the Defendant had reached a disability status of 60% (the sum of 30% disability rates of both legs plus 30%) of the total disability payment rate as the Defendant added to knee knee with the same disease, i.e. mane infection, and claimed on November 21, 2013, the Plaintiff for payment of disability pension II insurance proceeds of 50% or more of the disease under the insurance contract of this case.

[Ground of recognition] Facts without dispute, Gap evidence 1 to 4, Eul evidence 1 to 4 (including each number), the purport of the whole pleadings

2. The parties' assertion

A. The plaintiff's assertion (the main point of claim)

The defendant constitutes a case where the defendant puts down the body knee per each other's right-free knee per knee per single body and the left-hand kne pere perne perne pernene pere perne, thereby suffering an obstacle of 30% per each payment rate on both legs. However, since each of the above diseases does not constitute the same disease, it cannot be added up, it does not constitute a case where the defendant has become a disability equivalent to the disability payment rate of at least 50%.

Therefore, there is no obligation to pay the second insurance money to the defendant with a disease of 50% or more based on the insurance contract of this case.

B. The defendant's assertion (the summary of the counterclaim)

The defendant shall pay for twenty (20) years each of the above disability insurance coverage amount of 10,00,000 won to the defendant who has suffered disability by inserting the knee and the left-hand kne-free kne, thereby suffering from disability payment rate of 30% each on each bridge. This constitutes a case where at least two aftermath disabilities have occurred due to the same disease as stipulated in the special terms and conditions of this case. Therefore, the plaintiff shall pay for twenty (3.75) years each of the above disability pension insurance amount of 50% each year to the defendant who has suffered disability payment rate of 60% per year under the insurance contract of this case. Provided, That if such payment is made in lump sum, the defendant shall pay a discounted amount of 3.75% per annum, which is an estimated interest rate of the insurance contract of this case. From November 20, 2013 to November 20, 2032.

Therefore, the Plaintiff is obligated to pay the Defendant the above insurance amount of KRW 144,208,996 and the delay damages.

3. Determination

(5) The issues of this case are whether the defendant's knee-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-fe-g.).

Therefore, it is reasonable to add up the payment rate of the following disability (30%) due to the addition of the defendant's right-free knee in missions and the payment rate of the following disability due to the insertion of the left-hand knee in mission (30%). Therefore, the defendant does not constitute a case where the payment rate of disability is 50% or more due to disease.

Therefore, with respect to the defendant, the plaintiff does not bear the obligation to pay the second disability pension insurance money with a disease of 50% or more based on the insurance contract of this case under the premise that the defendant suffered from a disability higher than 50% of the disability payment rate, and as long as the defendant contests this, he has a benefit to seek confirmation.

4. Conclusion

Therefore, the plaintiff's claim of the principal lawsuit is justified, and the defendant's counterclaim is dismissed as it is without merit. It is so decided as per Disposition.

Judges at least the presiding judge

Judges Kang Jong-sung

Judges Kang Shin-young

A person shall be appointed.