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(영문) 창원지방법원 2019.09.18 2017가단119366
보험금
Text

1. The Defendant’s KRW 3,360,000 as well as the Plaintiff’s annual rate of KRW 6% from April 24, 2019 to September 18, 2019.

Reasons

1. Where an insured person suffers from a disease after the date of commencing his/her responsibility and continues to be hospitalized for at least four days for the direct purpose of treatment during the insurance period: 60,000 won per day (per day exceeding three days, per day, and per 120 days) of the hospitalization benefit shall be the maximum limit of 120 days per hospitalization, and where he/she has been hospitalized for the purpose of treating a disease or a disaster on at least two occasions, the total number of days of hospitalization shall be 120 days per hospitalization; and where he/she has been hospitalized for the purpose of treating a disease or a disaster, the total

However, even in case of hospitalization due to the same disease or accident, the hospitalization commenced after the lapse of 180 days from the date of the final hospitalization for which the hospitalization benefit was paid is considered to be a new hospitalization.

A. On May 3, 2005, the Plaintiff and the Defendant entered into a DNA insurance contract (hereinafter “instant insurance contract”) with the insured C (the Plaintiff’s mother), the beneficiary, the Plaintiff’s insurance premium amounting to 32,800 won per month, and the insurance period from May 3, 2005 to the end of life (hereinafter “instant insurance contract”). The payment criteria for “inwards” under the instant insurance contract are as follows:

B. C received hospital treatment under the relevant diagnosis’s name in the Evalescent hospital, F hospital, G internal medical clinic, H hospital, and I convalescent hospital for a total of 660 days from May 11, 2015 to October 14, 2017, in total, 32 days, as shown in the attached Table (including the progress of hospitalization).

C. The Plaintiff received from the Defendant totaling KRW 80,109,027 of the hospitalization allowances, etc. under the instant insurance contract from the J Co., Ltd., and KRW 218,080,000, respectively, including the hospitalization allowances, etc. under the K Insurance Contract and L Insurance Contract, from the J Co., Ltd.

【Reasons for Recognition】 Evidence Nos. 1 through 4, 1, 12-1, and the purport of the whole pleadings

2. The parties' assertion

A. The plaintiff C was hospitalized in the Evalescent Hospital, etc. for the purpose of treating diseases as shown in the attached Form (including hospitalization) for a total of 660 days, and the defendant was hospitalized in accordance with the insurance contract of this case (including the process of hospitalization) Nos. 2 and 8 (the name of diagnosis disease: 32 days out of the total of 52 days, and 52 days.

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