logobeta
본 영문본은 리걸엔진의 AI 번역 엔진으로 번역되었습니다. 수정이 필요한 부분이 있는 경우 피드백 부탁드립니다.
텍스트 조절
arrow
arrow
(영문) 의정부지방법원 2020.06.23 2019나213055
보험금
Text

1. The defendant's appeal is dismissed.

2. The costs of appeal shall be borne by the Defendant.

Purport of claim and appeal

1..

Reasons

1. The mutual aid agreement of this case provides that the beneficiary shall pay seven disease hospitalization allowances when the beneficiary was diagnosed for seven diseases during the period of mutual aid, and was hospitalized for at least four consecutive days for the direct purpose of the treatment.

In addition, when examining the seven-year disease classification table attached at the time of entering into the instant mutual aid agreement, the first revised Korean Standard Industrial Disease (I60 to I69), deeming the cerebrovascular disease as one of seven-year diseases, and the above classification number "I69" means the cerebrscular disease after cerebrscular disease.

[Grounds for recognition] Evidence Nos. 1 through 7, Eul evidence No. 1, the purport of the whole pleadings

2. According to the above facts, inasmuch as the Plaintiff, who was a mutual aid recipient, was hospitalized and received rehabilitation treatment due to the cerebrovascular disease that occurred during the period of mutual aid (from April 29, 2003 to April 29, 203), due to the cerebrovascular disease that occurred during the period of mutual aid (from April 29, 2003 to August 5, 2018), the Defendant is obligated to pay the Plaintiff a seven-year hospitalization allowance corresponding to the said period of hospitalization pursuant to the instant mutual aid agreement.

3. As to this, the Defendant asserts that hospitalization for the purpose of relaxing or treating the legacy does not constitute “hospitalize” as referred to in the above 7th hospitalization benefit.

In light of the circumstances that the term “after-cerebrovascular disease” in the instant mutual aid agreement includes one of the seven primary diseases, and particularly where cerebrovascular disease worsens differently from the ordinary aftermatha, it may cause a fatal result. In light of the circumstances, the provision that the insured, like the Plaintiff, who was used for cerebrscular transfusion, did not immediately discharge cerebrscular, and continued to be hospitalized to prevent the aggravation of cerebrscular, should be interpreted as falling under “inpatient” as referred to in the above 7 primary hospital hospitalization benefits.

The defendant's argument is without merit.

4. If so, the defendant is the plaintiff.

arrow