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(영문) 서울남부지방법원 2017.10.18 2016가단253918
보험금
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. Basic facts

A. On June 7, 2005, the Plaintiff entered into an insurance contract with the Defendant (hereinafter “instant insurance contract”) by designating B as the insured and the beneficiary, respectively, as the beneficiary, respectively.

The main contents thereof are as follows:

If a cause for the first diagnosis and determination occurs to the insured during the insurance period of Article 19 subparagraph 2 (a) of the General Insurance Terms and Conditions, Article 19 subparagraph 2 (a) of the General Insurance Terms and Conditions, and attached Table 1 of the Insurance Terms and Conditions (from June 7, 2005 to the end of the age of 80), the beneficiary shall be paid 64,80,000 won of the basic insurance amount and 80% of the changed insurance amount with the care insurance amount.

In this contract, in Article 16(1) of the General Terms and Conditions of Insurance, the term "serious diseases" shall be as important cancers, etc. among the diseases prescribed in the definition of "serious diseases" (see attached Table 4).

Standard Insurance Terms and Conditions 4

I.The term "serious cancer" means the form of malicious species that can be characterized by salvable proliferation of malicious species cells and its surrounding organization, except in any of the following cases:

2. 병리학적으로 전암병소(premalignant condition or condition with malignant potential), 상피내암(carcinoma in-situ), 경계성종양(borderline malignancy) 등 “중대한 암”에 해당하지 않는 질병 ② 암의 진단확정은 해부병리 전문의사 또는 임상병리 전문의사 자격증을 가진 자에 의하여 내려져야 하며, 이 진단은 조직(fixed tissue)검사, 미세침흡인검사(fine needle aspiration biopsy) 또는 혈액(hemic system)검사에 대한 현미경 소견을 기초로 하여야 합니다.

③ The clinical diagnosis of cancer is admitted as evidence only if it is not possible to conduct the above clinical diagnosis.

In such cases, the insured has been diagnosed or treated as cancer.

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