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(영문) 서울중앙지방법원 2016.01.14 2015가단5008899
보험금
Text

1. All of the plaintiff's claims are dismissed.

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

Reasons

1. Basic facts

A. On December 31, 2012, the Plaintiff subscribed to the insurance policy with the Defendant to enter into an insurance policy “non-distribution, fire-fighting, fluor (1206)” and paid the insurance premium. The main content of the insurance policy is as follows.

1) The insured: The insurance period of the Plaintiff 2: From December 31, 2012 to December 31, 2057 (45 years): The coverage of the insurance contract of this case (4), Article 4(2) of the Special Terms and Conditions for Cancer Examination Expenses, and Article 3(2) of the Special Terms and Conditions for Cancer Admission Allowances, respectively, provides that "the starting date of guarantee for cancer (the starting date of responsibility) shall be the day following the 90th day including the day after the date of the insurance contract," while Article 1 of the Special Terms and Conditions for each of the above Special Terms and Conditions provide that "if the diagnosis becomes final and conclusive as cancer prior to the starting date of guarantee for cancer, each of the Special Terms and Conditions shall be null and void and the insurance premium already paid shall be refunded."

B. On March 19, 2013, the date prior to the date of commencing guarantee for cancer, the Plaintiff was diagnosed as Haskin cancer (hereinafter “the first cancer diagnosis”). C. On August 1, 2013, the Defendant returned KRW 157,660 to the Plaintiff the insurance premium paid by the Plaintiff pursuant to Article 1 of the respective special terms and conditions. D. The Plaintiff was diagnosed as Maskin cancer (hereinafter “the second cancer diagnosis”). On August 6, 2014, the Plaintiff was hospitalized as Maskin Hospital after undergoing the second cancer diagnosis (hereinafter “the second cancer diagnosis”).

[Ground of recognition] Facts without dispute, Gap 1 through 10, Eul 1, 3 (including various numbers), the purport of the whole pleadings

2. Determination

A. The Plaintiff primarily sought payment of KRW 20 million per cancer diagnosis costs and KRW 2 million per cancer hospitalization day in connection with the primary cancer diagnosis. However, according to the special terms and conditions of the instant insurance contract, the Defendant’s starting date of liability for cancer diagnosis costs and per cancer hospitalization allowances is on March 31, 2013, i.e., the day after the lapse of 90 days from the date of the insurance contract.

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