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(영문) 대전지방법원 2018.04.26 2016나2947
보험금
Text

1. The part of the judgment of the court of first instance against the defendant shall be revoked.

2. The plaintiff's claim corresponding to the above revocation part.

Reasons

1. Basic facts

A. On October 31, 2006, the Plaintiff entered into a contract under which the insured and the beneficiary as the Plaintiff entered into a non-dividend 210 unit insurance policy (hereinafter “first insurance contract”) and a main contract under which the insured and the beneficiary as the Plaintiff (hereinafter “second insurance contract”) and the non-dividend 10 unit medical insurance policy, and a non-dividend 210 unit policy under a special contract (hereinafter “second insurance contract”).

The main terms and conditions of insurance contracts are as follows:

Article 15 (Payment of Insurance Proceeds (Main Obligations of Company) 1. In this contract, the term "ortho cancer" means a disease (see attached Table 5, e.g., Table 1, e., Table 5) classified as a new life in the upper and upper tier in the Korean Standard Disease Classification.

② 상피내암의 진단 확정은 해부병리 또는 임상병리의 전문의사 자격증을 가진 자 또는 회사가 이와 동등한 자격을 가진 것으로 인정하는 자에 의하여 내려져야 하며, 이 진단은 조직(fixed tissue)검사 또는 미세침흡인검사(fine needle aspiration biopsy)에 대한 현미경 소견을 기초로 하여야 합니다.

However, if it is not possible to conduct the above clinical diagnosis, the clinical diagnosis of the upper cancer is admitted as evidence of the upper cancer.

In such cases, I shall have a documented record or evidence proving that the insured person (insured) is under diagnosis or treatment as the upper cancer.

Article 16 (Definition and Confirmation of Boundary Species) (1) In this contract, the term "refinite species" refers to diseases classified as either behavior patterns or unregistered new organisms (in the 4th Korean Standard Disease Classification, referring to the attached Table 6 of the 4th Standard Disease Classification).

(2) A person who has a professional doctor's license of autopsy pathology or clinical pathology shall be diagnosed and confirmed.

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