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(영문) 창원지방법원 2020.11.26 2019나4957
보험금
Text

1. The plaintiff's appeal is dismissed.

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

Purport of claim and appeal

The first instance court.

Reasons

1. Basic facts

A. On December 23, 2002, the Plaintiff entered into a D insurance contract (a certificate number: E; hereinafter “instant insurance contract”) with the Defendant as the insured Party B and the Plaintiff as the beneficiary.

At the time of the conclusion of the instant insurance contract, the Plaintiff entered into a special agreement for women’s healthy life (in the amount of KRW 10 million), and a special agreement for cancer treatment (in the amount of KRW 20 million), and the terms and conditions on the requirements for the payment of hospitalization expenses, medical care expenses, and cancer hospitalization allowances among each of the above special agreements are as follows:

Article 9 (Definition and Confirmation of Major Sex Diseases) (1) of the Special Agreement on Women's Healthy Life refers to the following diseases, among heart diseases, high blood pressure, cerebrovascular diseases, chronic urine diseases, chronic urology diseases, chronic urology diseases, tragic diseases, tragic diseases, tragic diseases, tragic diseases, tragic diseases, tragical disorder, tuberculosis, waste convergence, and tragic diseases:

annexed Table 3 (See Attached Table 3’s Major Sick Classification Table)

4. The term "liver diseases" means diseases classified as virus infections and diseases in the basic classification of the third Korean Standard Disease Disease Classification;

Article 12 (Types and Grounds for Payment of Insurance Money) The Company shall pay to the insured of this Special Agreement the insurance money agreed upon to the beneficiary (hereinafter referred to as “beneficiary”) if any of the following events occurs:

2. Where the insured is diagnosed as a major sexual disease after the commencement date of liability for the insured during the insurance period, and is hospitalized for at least 31 days for a direct purpose of treating a major sexual disease: Payment of medical care expenses;

4. Where the insured is diagnosed as a major person's disease or gymal disease after the date of commencement of liability, and is hospitalized for at least four consecutive days for the purpose of directly treating such disease: Article 12 of the Medical Care Costs of the major person subject to the payment of the expenses for hospitalization [Attached Table 1] of the payment table of insurance money (based on the purchase amount of insurance under special agreement 10 million won).

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