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(영문) 광주지방법원 2017.09.19 2015가단522359
부당이득금
Text

1. The Defendant shall pay to the Plaintiff KRW 8,307,277 and the interest rate of KRW 15% per annum from August 11, 2015 to the date of complete payment.

Reasons

1. Basic facts

A. On December 12, 2008, the Plaintiff entered into an insurance contract with the insured and the beneficiary as the Defendant indicated in the “Indication of the Insurance Contract” (hereinafter “instant insurance contract”) and changed the contractor of the instant insurance contract to the Defendant on September 17, 2014.

B. The Defendant received KRW 73,022,703 from the Plaintiff on January 31, 2009, including the Plaintiff’s hospitalization at D Hospital for 5 days due to symptoms of acute erocon infection, from around October 29, 2009, due to the Plaintiff’s symptoms of being hospitalized for 462 days in total, and received hospital treatment until February 2, 2015.

The details of insurance accidents, such as the insurance money paid to the Defendant by the Plaintiff, the name of the diagnosis and the number of hospitalization days, shall be as specified in attached Form 1.

C. Meanwhile, in the foregoing period of hospitalization, stating “the details of payment of insurance proceeds” in the attached Form ① (1) 7 days out of 14 days of E Hospital’s 14 days due to an insured event on August 12, 201; ② 7 days out of 23 days of F Hospital’s 23 days due to an insured event; 21 days out of 21 days of G oriental medical hospitals’ 21 days; ③ 7 days out of 22 days of H oriental medical hospitals due to an insured event on April 16, 2012; 22 days out of 22 days of I oriental medical hospitals’ 22 days out of 22 days of J oriental medical hospitals’ 16 days, 21 days out of 21 days of K oriental medical hospitals’ 21 days; and ⑤ 16 days out of 16 days of oriental medical hospitals’ 16 days out of the total number of 16 days of oriental medical hospitals and 16 days of hospitalized treatment, there was no need for hospitalized treatment.

[Ground of recognition] Evidence Nos. 1-1, 2, and 2-4, each entry of Evidence Nos. 1-1, 1-2, and 2-4, each entrustment of appraisal to the president of the Korean Medical Association, and the purport of the whole pleadings

2. As seen above in the facts of recognition, 139 days in total during the total period of hospitalization for which the defendant received insurance money according to the insurance contract of this case did not need hospital treatment as false or excessive hospitalization.

(c).

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