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(영문) 수원지방법원안산지원 2020.07.15 2018가단61935
보험금
Text

1. The Plaintiff (Counterclaim Defendant) paid KRW 30,000,000 to the Defendant (Counterclaim Plaintiff) and against this, from March 22, 2018 to July 15, 2020.

Reasons

A principal lawsuit and a counterclaim shall be deemed simultaneously.

1. Facts of recognition;

A. On December 14, 2006, the Defendant concluded a “C Insurance Contract” between the Plaintiff and the insured and the beneficiary with the insurance period from December 14, 2006 to December 14, 2001 (hereinafter “instant insurance contract”).

B. When entering into the instant insurance contract, the Defendant included the “cerebrovascular disease diagnosis expenses” agreement of KRW 30 million (hereinafter “the instant special agreement”).

The main contents of the insurance terms related to the instant special agreement are as follows.

1. The term "cerebrovascular disease" in this Special Terms and Conditions refers to the disease specified in [Attached Table 11] in the classification of the fourth Korean Standard Patients.

② 뇌혈관질환의 진단확정은 의료법 제3조(의료기관) 제2항에서 정한 병원 또는 이와 동등하다고 인정되는 의료기관의 전문의 자격증을 가진 자(치과의사 제외)에 의하여 내려져야 하며, 이 진단은 병력신경학적 검진과 함께 뇌 전산화단층쵤영(brain CT SCAN), 핵자기 공명영상법(MRI), 뇌혈관조영술, 양전자방출단층술(PET), 단알광자방출 전산화 단층술(SPECT), 뇌척수액검사 등을 기초로 하여야 합니다.

Article 2 (Compensation for Loss) (1) The Company shall pay to the beneficiary the following amount if the insured of this Special Terms and Conditions becomes the first diagnosis of "cerebrovascular disease" during the insurance period of this Special Terms and Conditions:

Provided, That payment shall be made only once.

(2) Before the commencement of corporate security, the insured is aware of the occurrence or decrease of “cerebrovascular disease” shall not be compensated for such disease.

(based on the insurance coverage amount of 30 million won) 15 million won for cerebrovascular diagnosis expenses for a period of less than one year after the lapse of less than one year.

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