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(영문) 서울중앙지방법원 2019.10.25 2018나62074
보험금
Text

1. The plaintiff's appeal is dismissed.

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

The purport of the claim and appeal is the purport of the appeal.

Reasons

Facts of recognition

On February 6, 2006, the Defendant concluded a “D” (hereinafter “instant insurance contract”) with the Plaintiff, the beneficiary of the injury insurance money, the Plaintiff, and the beneficiary of the insurance period, 34 years from the date of conclusion of the contract.

According to a special contract of the instant insurance contract, the Defendant agreed to pay KRW 100,000 per day between three days and 100,000 per day when the insured C is hospitalized with four major diseases (20,000,000,000) by up to 120 days, as the contract of the instant insurance contract.

(hereinafter referred to as the “instant special agreement for hospitalization.” Of the terms and conditions concerning the instant special agreement for hospitalization (hereinafter referred to as the “instant special agreement”), the main parts relating to the instant case are as follows:

Article 16 (Definition and Place of "Hospitalization" of the Clause of the Special Agreement for Hospitalization refers to the definition and place of "Hospitalization" in this special agreement that means that a person who is qualified as a doctor, dentist or oriental medical doctor (hereinafter referred to as "doctor") deems it necessary for the direct purpose of medical treatment due to a disease or disaster of an insured person (insured), and it is difficult to provide medical treatment at his own home, etc. and therefore, he is admitted to a domestic hospital under Article 3 (Medical Institution) of the Medical Service Act or a foreign medical institution recognized by the company as equal to the above, and who

Article 17. Types and Grounds for Payment of the Subsidy Insurance Money] When a person subject to insurance (insured) has been hospitalized for at least four consecutive days during the insurance period of this special agreement, for the purpose of directly treating other skin cancer, upper cancer, bordering pattern, four large-scale diseases, five large-scale diseases, and gynite diseases, the amount of insurance covered by the special agreement per day for more than three days, 0.5% for four large-scale diseases, and 0.2% for 0.2% for 4 large-scale cancer (Provided, That 120 days per time of hospitalization) during the insurance period of this special agreement, the company shall be the person who has received the insurance (insured) if any of the following events occurs to the person subject to insurance (insured) during the insurance period of this special agreement:

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