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(영문) 광주지방법원 2016.01.21 2014가합53747
보험금
Text

1. With respect to the insured events described in paragraph 1 of the attached list, the plaintiff is based on the insurance contract described in the attached list 2.

Reasons

1. Basic facts

A. On March 15, 2007, the Defendant concluded an insurance contract between the Plaintiff and the Defendant as the insured (hereinafter “instant insurance contract”) as shown in the attached Table No. 2, which read the Defendant as the insured.

B. On August 6, 2013, the Defendant: (a) was examined by the Gyeongnam National University Hospital; and (b) was examined by the Gyeongnam National University Hospital.

The defendant did not immediately undergo an operation, and received an operation first at the Seoul Asan Hospital without undergoing an operation. On September 30, 2013, the above hospital received an operation, such as e-pathic surgery.

After and after the above treatment period, the Defendant received hospitalized treatment in the B convalescent as shown in the attached Table No. 1, and in this regard, the Defendant claimed the Plaintiff for payment of the cancer hospitalization allowance stipulated in the insurance contract of this case.

C. Of the instant insurance contract, the relevant coverage concerning cancer hospitalization daily allowances among the coverage content of the instant insurance contract are as follows.

After the date of commencement of guarantee, the insured is diagnosed and confirmed as cancer, stove cancer, stove cancer, and other skin cancer, and is hospitalized for more than three consecutive days for the direct purpose of the treatment, the insured shall be paid for the day of cancer hospitalization as follows:

[Ground of recognition] Facts without dispute, Gap evidence 1 through 5, Eul evidence 1 and 2, the purport of the whole pleadings

2. The parties' assertion and judgment

A. The Plaintiff’s assertion that the Defendant received hospitalized treatment as stated in the attached list No. 1 cannot be deemed as being hospitalized for a direct purpose of cancer treatment.

B. The insurance contract of this case asserted by the defendant does not guarantee only navigation cancer treatment which is recognized as a standard in the medical community. Thus, the plaintiff is obligated to pay the defendant a cancer hospitalization allowance in relation to the receipt of hospitalized treatment as shown in the attached Table No. 1.

C. The instant insurance contract is directly aimed at treating cancer.

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