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(영문) 대구지방법원 2016.05.24 2015가단15549
보험금
Text

1. The Defendant (Counterclaim Plaintiff) paid KRW 1,050,000 to the Plaintiff (Counterclaim Defendant) and the Plaintiff’s counterclaim from March 14, 2014 to May 24, 2016.

Reasons

1. Basic facts

A. On September 12, 2005, the Plaintiff entered into an insurance contract with the Defendant (at the time, the Plaintiff’s trade name was “Seoul Green Cross Life Insurance Co., Ltd.” but, on March 29, 2012, the trade name was changed to “Nandae Life Insurance Co., Ltd.”; hereinafter “Defendant” regardless of whether it was before or after the mutual change; hereinafter “instant insurance contract”) and entered into an insurance contract “Class 1” (hereinafter “instant insurance contract”).

- Securities Number: B - Policyholders, Main Insured, Beneficiary: Plaintiff - whose maturity date: September 12, 2031.

The types and methods of calculating insurance proceeds under the terms and conditions of the instant insurance contract shall be as follows:

[Article 22 (Types and Grounds for Payment of Insurance Money]

6. Where an insured person has been hospitalized for at least four consecutive days for the direct purpose of treating a disease during the insurance period: Payment of expenses for hospitalized treatment (Provided, That the maximum of 50,00 won per day exceeding three days, per one time of hospitalization); 50,000 won.

7. When the insured has been hospitalized for at least 31 days for a direct purpose of treating a disease during the insurance period: The amount of insurance proceeds equivalent to the excess of 30 days (number of days of hospitalization treatment - 50,000 won x 10,000 won) of the amount of insurance proceeds equivalent to the amount of insurance proceeds (number of days of hospitalization treatment - 3 days) under Article 22 subparag. 6 of the terms and conditions, if the number of days of hospitalization is more than 4 days but not more than 30 days, the amount of insurance proceeds under Article 22 subparag. 6 of the terms and conditions shall be paid, and if the number of days of hospitalization exceeds 30 days, the amount of insurance proceeds under subparagraphs 6 and 7 of Article 22 of the terms and conditions as to the excess of 30 days shall be paid respectively.

[Article 23 (Detailed Provisions concerning Payment of Insurance Money) (5) The number of days of payment of the hospitalized treatment expenses under Article 22 (Types and Grounds for Payment of Insurance Money) subparagraph 6 shall be the maximum limit of 120 days per hospitalization, and the number of days of payment of the hospitalized treatment expenses under subparagraph 7 of the same Article shall be the maximum limit of 90 days per hospitalization.

(6) Cases under subparagraphs 6 through 7 of Article 22.

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