2014Na22766 Insurance proceeds

2014Na22773 Insurance proceeds

State Fire & Marine Insurance Corporation

A

Daegu District Court Decision 2013Gahap1624 Decided October 17, 2014

July 8, 2015

August 19, 2015

1. All appeals filed by the Plaintiff (Counterclaim Defendant) are dismissed.

2. The costs of appeal shall be borne by the Plaintiff (Counterclaim Defendant).

1. Purport of claim

A. Main Action: It is confirmed that there is no general cancer diagnosis expenses and general cancer surgery insurance premium payments for the Defendant (Counterclaim Plaintiff; hereinafter referred to as “Defendant”) based on the insurance contract of the Plaintiff (Counterclaim Defendant; hereinafter referred to as “Plaintiff”) based on the attached list (2) related to the insurance accident stated in the attached list (1).

B. Counterclaim: The plaintiff shall pay to the defendant 42,40,000 won with the interest of 5% per annum from May 15, 2013 to the rendering of a judgment in the first instance of this case, and 20% per annum from the next day to the day of full payment.

2. Purport of appeal

The part of the judgment of the first instance against the plaintiff shall be revoked, and the judgment as stated in the plaintiff's claim shall be sought, and the defendant's counterclaim claim corresponding to the above revoked part shall be dismissed.

1. Quotation of the first instance judgment

The reasoning for this Court’s explanation is as stated in the reasoning of the judgment of the court of first instance, except for modification or addition as follows. Thus, this Court’s reasoning is cited in accordance with the main sentence of Article 420 of the Civil Procedure Act.

2. A corrected or added portion;

A. (1) Each entry in Eul evidence Nos. 1, 2, and 3 in the second sentence of the judgment of the first instance shall be amended to "each entry in Eul evidence Nos. 1 through 4 (including paper numbers)", and (2) Each entry in the fifth sentence of the judgment of the first instance shall be amended to "each entry in Gap Nos. 3 and 5 and the result of appraiser E's appraisal" in the fifth sentence of the judgment of the first instance, "as a result of the entrustment of the medical records to the head of the High School of the first instance, the result of the entrustment of the medical records to the head of the High School of the first instance, the result of the entrustment of the supplementation to the head of the High School of the second instance," and (3) "as a result of the appraisal of Gap evidence No. 4, Eul No. 3 and 4, and the result of the appraisal of appraiser E" in the fifth sentence of the first instance judgment, "as a result of the entrustment of the correction of the medical records for the second sentence of the first instance."

(b)in addition, between the sixth and Twelve of the first instance judgment, the following shall be added:

The following:

The plaintiff asserts in the trial that the species diagnosed by the defendant do not fall under the category of 'the malicious life of the fire extinguishing agency', as the Korean Standard C.S. S. S. S. S. S. S. S. S. S. S. S. S. S. S. S. S. S. S. S. S. S. S. S.C.

However, in light of the legal principles that "the terms and conditions of an insurance contract shall be objectively and uniformly interpreted based on the average customer's understanding possibility, and, even after such interpretation, if the meaning of the terms and conditions is not clear, such as objectively and objectively interpreted and their respective interpretations are rational, it shall be interpreted favorably to the customer (see, e.g., Supreme Court Decision 2009Da60305, Dec. 9, 2010) and the circumstances that issued a final diagnosis to the defendant that "the terms and conditions of an insurance contract shall be interpreted favorably to the customer" (see, e.g., Supreme Court Decision 209Da60305, Dec. 9, 2010). In light of the aforementioned circumstances, it is reasonable to deem that the terms and conditions diagnosed by the defendant constitutes a workplace malicious life (Korean disease classification C20) based on the result of the organized examination by medical specialists (see, e.g., Supreme Court Decision 2011Da1398, May 24, 2012).

Therefore, the plaintiff's assertion cannot be accepted.

3. Conclusion

Therefore, the plaintiff's main claim is dismissed as it is without merit, and the defendant's counterclaim is justified within the scope of the above recognition, and the remainder is dismissed as it is without merit. The judgment of the court of first instance is just in this conclusion, and the plaintiff's appeal is dismissed as it is without merit. It is so decided as per Disposition.

Judges of the presiding judge;

Judges Kim Tae-tae

Judges Dok-si

A person shall be appointed.