2012Na73549 Confirmation of Non-existence of Obligation

A Cambodia

B Stock Company

1. C

2. D;

Since it is a minor, the legal representative parent;

Incheon District Court Decision 2011Gahap9050 Decided August 24, 2012

December 21, 2012

January 18, 2013

1. Revocation of a judgment of the first instance;

2. In relation to the accident described in Paragraph 2 of the attached list, it is confirmed that the Plaintiff’s succeeding intervenor’s obligation to pay the insurance money to the Defendants of the Plaintiff’s succeeding intervenor based on the insurance contract indicated in Paragraph 1 of the attached list does not exist.

3. The total costs of the lawsuit shall be borne by the Defendants.

The same shall apply to the order.

1. Basic facts

A. The insurance contract of this case

(1) On May 17, 201, the Plaintiff entered into an insurance contract between the deceased and the deceased as the deceased, with the beneficiary as the legal heir of the insured as the insured (hereinafter “instant insurance contract”).

(2) Of the instant insurance contract’s acute core examination and examination costs, the definitions of acute core examination and diagnosis confirmation are as follows.

Article 1 (Compensation for Loss)

(1) If the insured has been diagnosed and confirmed by a acute border certificate (see the attached Table 5, referring to the Classification of Grade 5, Malosophical border certificate) during the insurance period, the company shall pay the insured amount stated in the insurance policy (insurance policy) only once for the first time.

② The diagnosis and confirmation of an acute eculation shall be conducted by a person with a certificate of qualification for a domestic hospital as provided for in Article 3 (Medical Institutions) of the Medical Service Act or a medical institution abroad recognized by a company equivalent to the above, and this diagnosis shall be based on a heart test, heart test, heart high wave, ornamental scopic photographing, and heart test in blood, etc., along with the medical history. However, only when a person insured (insured) dies and cannot be based on the above method of examination, the document or evidence verifying that the person insured (insured) was diagnosed or treated by acute ecopic eculation, can be based on the diagnosis and confirmation of the document or evidence.

B. Death of the Deceased

On September 12, 2011, the deceased died before the arrival of the hospital, which was sent to the H hospital by a medical corporation located in Mayang-si G around 16:00 on the same day after he/she was killed at his/her home at around 15:15.

C. Status of the Parties

(1) The Defendants are the deceased’s children, who are legal successors of the deceased.

(2) On June 1, 2012, the Plaintiff’s succeeding intervenor was transferred from the Plaintiff all of the Plaintiff’s insurance contracts, including the status under the instant insurance contract.

[Reasons for Recognition] Unsatisfy, Gap evidence 1 to 8, Eul evidence 2 (including partial number), the purport of the whole pleadings

2. The assertion and judgment

A. The parties' assertion

The Plaintiff’s succeeding intervenor asserts that “the documents or evidence evidencing that the insured was diagnosed or treated with an acute scarcity” as stated in the special terms and conditions should be stated in order to receive the diagnosis fees under the instant insurance contract. However, the Plaintiff’s succeeding intervenor’s assertion that the examination report on the deceased’s body alone cannot be deemed as satisfying the requirements of the said special terms and conditions.

As to this, the Defendants asserted that the death diagnosis caused by acute maleculation was conducted by their will based on the deceased’s usual health condition, symptoms at the time of death, etc., and thus, it should be deemed that the requirements under the special terms and conditions of this case are satisfied.

B. Determination

(1) Article 5(1) of the Act on the Regulation of Terms and Conditions provides that "The terms and conditions shall be interpreted fairly in accordance with the principle of good faith and shall not be interpreted differently from the customers." Thus, in principle, the contents of the ordinary terms and conditions shall be based on the possibility of average customers' interests without considering the intent or specific circumstances of individual contractors, but shall be interpreted objectively and uniformly in consideration of the interests of all insurance organizations.

(2) According to the above facts, the special contract of this case provides that when the insured is diagnosed and confirmed with acute fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluoral fluor.

(3) On the other hand, it is true in light of the reasons stipulated in the instant special contract, such as the fact that the insurance proceeds for diagnosis expenses under the special contract was diagnosed with a serious disease, which is a acute fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluorial fluoral

(4) In interpreting the instant special contract in consideration of the purport and purpose of the insurance money for diagnosis expenses, in order to diagnose and determine a acute franking disorder under the instant special contract, a doctor of a medical institution must conduct a diagnosis of acute franking disorder through various examinations, and its meaning refers to the case where at least a doctor has been sufficiently recognized without reasonable doubt that the insured constitutes a acute franking disorder after undergoing a certain degree of examination on the insured, and even in a case where it is not unreasonable for the insured to conduct various inspections upon his death, it cannot be deemed that the above requirements have been met only by the presumption that the private person is a acute franking disorder.

(5) However, there is a limit that it is difficult to conduct accurate diagnosis without undergoing the autopsy in such cases, because, in the case of an acute malutism, a medical examination or treatment process cannot be conducted prior to the death, or a medical examination cannot be conducted in itself. However, as seen earlier, the purport and purpose of the medical examination expenses and the purpose of the medical examination expenses insurance are the intention of the party to the agreement on the insurance proceeds for diagnostic expenses, to pay the insurance proceeds if such a medical examination is conducted with the focus on the situation of the ‘check of a soldier without the cause of death without the cause of death'. Therefore, it is difficult to view the above case to fall under the scope of the insurance proceeds for diagnostic expenses

(6) 이 사건에 관하여 보건대, 갑 제4, 5호증의 각 기재에 변론 전체의 취지를 종합하면, 망인은 가슴이 답답함을 호소하고 식은 땀을 흘리며 눈동자가 뒤집어지는 등의 증세를 보이다가 갑자기 쓰러져 의식을 상실한 후 위 H병원으로 후송되던 중 사망한 사실, H병원의 의사 1은 망인이 3~4일간 심와부(心窩部, 명치) 불편감을 호소하였다는 유족들의 진술에 따라 시체검안서에 망인의 직접적인 사망원인을 '급성심근경색(추정)'이라고 기재한 사실을 각 인정할 수 있으나, 위와 같은 이 사건 특별 약관의 해석에 의할 때 위와 같은 추정적인 소견만으로는 이 사건 특별약관이 정한 '진단확정'의 요건이 충족되었다고 인정할 수 없으며, 달리 이를 인정할 만한 증거가 없다.

C. Sub-committee

Therefore, the defendants cannot seek insurance money from the plaintiff succeeding intervenor in accordance with the special terms and conditions of this case. Thus, in this case where the defendants are dissatisfied with seeking insurance money under the special terms and conditions of this case, the plaintiff succeeding intervenor has the interest to seek confirmation as to the existence of the debt.

3. Conclusion

The plaintiff succeeding intervenor's claim against the defendants is justified, and the judgment of the court of first instance is unfair, so the judgment of the court of first instance is revoked, and the judgment is identical to the order confirming that the plaintiff succeeding intervenor's claim against the defendants does not exist.

Judges Kim Jong-tae

Judges Hong-chan

Judges Kim Jong-min

A person shall be appointed.