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(영문) 서울중앙지방법원 2020.08.18 2018가단5001455
부당이득금
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. Basic facts

A. On March 31, 2005, the Plaintiff entered into an insurance contract with the Defendant listed in the separate sheet No. 1 (hereinafter “instant insurance contract”).

B. As indicated in the separate sheet No. 2, the Defendant received a total of 383 days of hospitalized treatment from each hospital during the period from November 8, 2008 to March 10, 2015, and received KRW 38,715,505,000,000 as the insurance money for the instant insurance contract, based on the instant insurance contract.

[Ground of recognition] Unsatisfy, entry of Gap evidence 1 to 3, purport of whole pleadings

2. The assertion and judgment

A. The Defendant asserted that the Plaintiff had been hospitalized in the absence of a need for hospitalization due to the practical possibility of hospital treatment. Although it was a disease requiring hospital treatment, the Defendant received the insurance money by deceiving the Plaintiff as if he had received hospital treatment for a long time, as long as necessary, after having received hospital treatment for a long time, and as such, should bear liability for damages arising from tort, and return the insurance money

B. Comprehensively taking account of the following circumstances acknowledged by the respective descriptions of the evidence Nos. 1 through 9 and the purport of the entire pleadings, it is insufficient to recognize that the Defendant had committed unnecessary long-term and repetitive hospitalization or excessive hospitalization in order to receive insurance proceeds, such as daily admission allowances, and there is no other evidence to acknowledge this differently.

① The Defendant’s reasons for hospitalization, as indicated in the separate sheet No. 2, are knee-mae-mae-mane-mae-mae-mae-mae-mae-mae-mae-mae-mae-mae-mae-mae-mae-mae-mae-mae-mae-mae-mae-mae-mae-mae-mae-mae-magne, hiver-magne, high blood pressure, cerebrovase-mad-mad-ma

(2) The necessity of hospitalization may vary depending on the patient’s health condition and circumstances at the time of hospitalization, and the propriety of the period of hospitalization shall also be uniformly.

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