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(영문) 광주지방법원순천지원 2016.06.23 2014가단76766
채무부존재확인
Text

1. Insurance money for the defendant based on the insurance contract stated in the attached Form concerning the insurance accident.

Reasons

1. Basic facts

A. On December 20, 207, the Defendant entered into an insurance contract entered into with Green Damage Insurance Co., Ltd. as the insured and entered into an insurance contract entered in the separate sheet (hereinafter “instant insurance contract”). On May 3, 2013, the Plaintiff subscribed the instant insurance contract.

B. The insurance contract of this case includes the details of security that the insured would pay surgery allowances when he/she undergoes surgery “for the purpose of direct treatment” due to a 16th specific disease or a female-only disease during the insurance period as follows.

C. On July 5, 2014, the Defendant was diagnosed on July 7, 2014, after undergoing a self-glusium and resistant tissues test (hereinafter “first surgery”) at the Madrostrisia and the disease classification number: N851).

The 16th specified diseases and women's exclusive diseases as stipulated in the insurance contract of this case.

After September 30, 2014, the defendant received another spacific and organizational inspection from the same hospital under the same name.

(hereinafter referred to as "second operation") d.

On October 27, 2014, the Defendant filed a claim with the Plaintiff for insurance proceeds with respect to the first and second alcohol, and on October 30, 2014, the Plaintiff rejected the payment of insurance proceeds on the ground that the Plaintiff’s payment of KRW 10,162,40,00, including KRW 5 million in total and KRW 5 million in operating benefits for women-only diseases, but on the ground that the second alcohol cannot be deemed as a new operation separate from the first surgery.

[Ground of recognition] Facts without dispute, Gap's 2 through 6, and 10 evidence (each number is included; hereinafter the same shall apply), the purport of the whole pleadings

2. The parties' assertion

A. The Plaintiff performed the second surgery to verify the progress after the first surgery. Thus, the Plaintiff’s 16th specific disease and women’s exclusive disease as stipulated in the insurance terms and conditions of the instant insurance contract are “the first surgery for the direct purpose of treatment.”

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