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(영문) 서울서부지방법원 2015.06.25 2014가합38449
보험금
Text

1. The Plaintiff (Counterclaim Defendant) paid KRW 40,000,000 to the Defendant (Counterclaim Plaintiff) and against this, from July 22, 2014 to June 25, 2015.

Reasons

1. Facts of recognition;

A. On August 31, 2006, the Plaintiff entered into an insurance contract between the Defendant and the Plaintiff, the insured, and the beneficiary, the Defendant, the insurance type, the consortium integrated insurance, and the insurance period from August 31, 2006 to August 31, 2041 (hereinafter “instant insurance contract”).

The collateral of the instant insurance contract includes “the diagnostic expenses for cerebrovascular diseases,” and the insurance period of the instant insurance accident is from August 31, 201, which is the first day of the collateral, to August 31, 201, which is the first day of the collateral, to August 31, 2016, and is KRW 40,00,000.

B. Of the terms and conditions of the instant insurance contract’s medical examination expenses for cerebrovascular diseases, the part related to the instant case (hereinafter “instant special terms and conditions”) are as follows.

1. Damage compensation ① If the insured stated in the insurance policy (insurance policy) is diagnosed and confirmed as the first brain-related disease during the insurance period of this Special Terms and Conditions (hereinafter referred to as the "insurance period"), the company shall compensate for it in accordance with this Policy.

(2) The above 1st cerebrovascular disease refers to a cerebrovascular disease that has been infected or has been caused to the insured from the time when the company's guarantee began under this contract.

2. The definition and diagnosis determination of cerebrovascular diseases (see attached Table 5). The term "cerebrscular diseases" refers to diseases classified as cerebrscular diseases (see the table of classification of cerebrscular diseases in attached Table 5) of the 4th Korean Standard Classification of Patients.

(2) The diagnosis and confirmation of brain-related diseases shall be conducted by a person with a physician's license (excluding dentists) of a domestic hospital prescribed in Article 3 of the Medical Service Act or a foreign medical institution outside the country recognized by the company as equivalent thereto, and such diagnosis shall be based on medical history, negonomy (ArAin CTRI), nuclear self-defluence image method (MRI), cerebr electronic emitting e-mail (PET), e-mail-emitting e-mail, SSPECT, and cerebral e-mail examination.

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