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(영문) 서울중앙지방법원 2020.10.23 2020나15996
보험금
Text

1. Revocation of a judgment of the first instance;

2. The defendant shall pay to the plaintiff KRW 10,000,000 and its amount from July 12, 2019.

Reasons

1. Facts of recognition;

A. On September 28, 2007, the Plaintiff entered into an insurance contract with the Defendant a C contract with the Plaintiff as the insured and the beneficiary (if the Plaintiff died, a statutory heir) (hereinafter “instant insurance contract”).

B. The terms and conditions of the instant insurance contract include the content of the instant insurance contract to compensate for the 16th specific disease treatment costs and women-only disease treatment costs based on the purchase amount of insurance as follows:

16. Specific disease treatment fees for the amount of security coverage coverage;

1. When he/she is hospitalized or operated in a hospital or clinic for at least four days directly for the purpose of treating 16 major specific diseases;

2. One percent (120 days limit) of the subscription amount per day exceeding three days but exceeding three days in the case of hospitalization;

3. Medical treatment costs for women's exclusive diseases of 5,00,000 won in full at the time of surgery;

1. When he/she is hospitalized or operated for at least four days to a sick person or a clinic for the direct purpose of treating a disease exclusively for women;

2. One percent (120 days limit) of the subscription amount per day exceeding three days but exceeding three days in the case of hospitalization;

3. The provisions of the 16th specific disease treatment expenses and the 16th specific terms and conditions concerning women's exclusive disease treatment expenses (hereinafter "the instant special terms and conditions") under the insurance contract of this case in full at the time of surgery are as follows.

[16. Special Terms and Conditions for Guarantee of Specific Diseases] Article 1 (Compensation for Loss) of the Insurance Contract (Insurance Policy) provides that the insured, as stated in the Insurance Policy (Insurance Policy), under the Insurance Policy (Insurance Policy), has been performed for a direct purpose of the treatment of 16.0 specific diseases during the Insurance Period of this Special Terms and Conditions, the Insurance Company is bound to compensate for

Article 2(16)(Definition and Confirmation of Diagnosis of a 16th Specific Disease) ① The term “16th Specific Disease” in this Agreement refers to urine disease, heart disease, high blood pressure, cerebrovascular disease, liver disease, liver disease, the above and tensurtic tradic tradic tragic tragic tragic tragic tragic tragic tragic tragic tragic tragic tragic lagic lagic lagic lagic lagic lagic lagic lagic lag.

Article 3 (Definition and Place of Hospitalization and Operation)

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