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(영문) 대법원 2018.06.28 2018다203395
보험금
Text

The appeal is dismissed.

The costs of appeal are assessed against the Plaintiff.

Reasons

The grounds of appeal are examined.

1. The insurance terms and conditions shall be interpreted fairly and reasonably in light of the purpose and purpose of the terms and conditions in good faith, and shall be interpreted objectively and uniformly in consideration of the interests of the entire insurance organization based on the average customer’s interest, without taking into account the intended purpose and intent of the individual contracting party.

Even after such interpretation, in cases where the meaning of a standardized contract is unclear, such as the objective multiple interpretations and their respective interpretations are rational, it shall be interpreted favorably to customers.

(See Supreme Court Decision 2008Da81633 Decided May 28, 2009, and Supreme Court Decision 2009Da60305 Decided December 9, 2010, etc.). However, if the provision of a standardized contract is interpreted fairly, reasonably, and objectively and uniformly based on the average customer’s understanding potential, there is no room to interpret the provision of a standardized contract in favor of customers if it is interpreted objectively.

(see, e.g., Supreme Court Decision 2010Da92841, Jan. 12, 2012; Supreme Court Decision 2007Da5120, Sept. 9, 2010). 2. The lower court determined that: (a) although it is difficult for the instant species to completely recover from the operation; (b) it is difficult to completely recover from the operation of the instant species; and (c) there was a high possibility of recurrence; and (d) it cannot be deemed that the instant species do not constitute “a cancer” stipulated in the instant insurance terms and conditions

According to the insurance contract of this case, the diagnosis and confirmation of cancer shall be based on the present opinion on organizational inspection, etc. by the doctor of pathology, and when clinical diagnosis is not possible, clinical diagnosis is admitted as evidence of cancer.

The species of this case can be seen as having corresponded to the malicious species in light of the location, treatment method, and honor of the disease classified as the “unexploitable meine (D32.9)” under the Korean Standard Disease Death Classification.

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