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(영문) 제주지방법원 2018.11.29 2018나10401
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

1. Facts of recognition;

A. On September 3, 1998, the Plaintiff concluded the C Insurance Contract and D Insurance Contract with the Defendant, and on May 22, 2001, respectively.

B. On August 6, 2013, the Plaintiff was diagnosed as “S350” at G Hospital located in the Republic of Korea in Jeju Island as the name of the disease.

C. The Plaintiff at G Hospital stated “The escape certificate of the confluence of the confluorical signboard” and “the main treatment content and progress” as the name of an injury or disease, the hospital was hospitalized in the hospital from December 26, 2014 to January 15, 2015, and the hospital was hospitalized in the hospital from August 6, 2013 to February 6, 2015. The written diagnosis of the aftermath disability issued by the said hospital from February 6, 2015, “the aftermath disability content” in the “the aftermath disability content” column.

On August 5, 2013, the Plaintiff filed a claim for the payment of insurance proceeds with the Defendant on the ground that “The Plaintiff suffered a 5th degree disability due to an accident that takes place in India’s bus terminal (hereinafter “instant accident”). However, around September 8, 2015, the Defendant sent a guide to the effect that “The Plaintiff was paid insurance proceeds for a 5th degree disability due to a disaster, but the diagnosis submitted by the Plaintiff is not indicated with the S code but only stated that it falls under class 5(16) of class 5 of the Disability Classification Table by a new landscape development certificate.”

[Reasons for Recognition] Unsatisfy, Gap 1-4 evidence, Eul 1-2 evidence (including provisional number), the purport of the whole pleadings

2. The Plaintiff’s summary of the Plaintiff’s assertion as to the cause of the claim was promised to provide medical treatment to the department located in G Hospital as of August 6, 2013 to treat the amount of the damage. However, on August 5, 2013, the day before the instant accident occurred, the Plaintiff’s promise to provide medical treatment on August 6, 2013.

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