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(영문) 광주지방법원 2017.11.10 2016나59767
보험계약 무효확인 등
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

The reasoning of the court's explanation concerning this case is as follows, in addition to adding the judgment on the plaintiff's argument as follows, and therefore, it is identical to the reasoning of the judgment of the court of first instance.

The plaintiff's assertion as to the plaintiff's assertion, even if the insurance contract of this case is not invalid, the defendant received insurance money by false or excessive hospitalization.

In addition, in the case of hospitalization without reasonableness and reasonableness, such as hospitalization which did not have difficulty in home-based treatment under the insurance contract of this case, it does not constitute a ground for the payment of insurance money.

Therefore, the defendant is obligated to return the insurance money received from the above false or excessive hospitalization to the plaintiff.

Judgment

According to Gap evidence Nos. 12 and 13, Eul analyzed the medical records for 352 days during the period of the defendant's hospitalization, and repeated hospitalization at 14 hospitals over 41 times in total. At the same time, Eul repeatedly rehospitalized as the name of salt base, tension, tension, stimulative sensa, and sponsa, etc. during the 352-day hospitalization, and the remaining 259 days during the 352-day hospitalization are appropriate only 93 days during the 352-day hospitalization, and most of the remaining 259 days during the 352-day hospitalization were conducted repeatedly without the need for hospitalized treatment. It is recognized that the defendant sent out or was absent for 19 times in total during the 352-day hospitalization period.

However, in full view of the following circumstances revealed by the facts and evidence revealed earlier, the above facts alone are insufficient to recognize that the Defendant obtained insurance money unfairly by receiving excessive treatment despite the need for hospitalization, and there is no other evidence to prove otherwise.

Therefore, the plaintiff's above assertion is without merit.

(1) The necessity of hospitalization may vary depending on the patient's health condition, situation, etc. at the time of hospitalization.

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