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(영문) 전주지방법원 2017.04.27 2016나5866
보험금
Text

1. The plaintiff's appeal is dismissed.

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

The purport of the claim and appeal is the purport of the appeal.

Reasons

1. Facts of recognition;

A. On September 14, 2001, the Plaintiff entered into an insurance contract with the Defendant (the change from the Gold Life Insurance Co., Ltd. to the present trade name on June 14, 201) with the Plaintiff as the insured, and entered into an insurance contract with the Plaintiff’s insured policy with the “individual type (type 1) type of gold Life Insurance Co., Ltd.” (the insurance premium was KRW 138,60 per month for the insurance premium, KRW 138,60 for the payment period, KRW 15 for the payment period, and the insurance period was an insurance

(hereinafter “instant insurance contract”). B.

Of the coverage stated in the insurance policy of the instant insurance contract, the parts relating to the instant case are as follows.

On the other hand, urology is included in the 16th disease stipulated in the insurance contract of this case (Classification No. E10-E14). The amount of the coverage of the policy of this case - The health recovery fund: 31 days for the first time diagnosed and confirmed as 16th disease or urine cancer, and for the direct purpose of the treatment, 31 days for the first time of the insured, 31 days to 1.20 million won when the insured is hospitalized for at least 120 days, but not less than 3 million won when he/she is hospitalized for at least 30 days after he/she is hospitalized for the first time after diagnosis as 16th disease or urine cancer, and 50,000 won per day after the insured is hospitalized for at least four days (120 days) for the purpose of treatment after diagnosis as 16th disease or urine cancer.

C. The terms and conditions of the instant insurance contract concerning the disease treatment agreement include the following:

Article 11 (Definition and Place of Hospitalization and Operation) (1) In this special agreement, the term "hospitalize" means entering a domestic hospital or a foreign medical institution as defined in Article 3(2) of the Medical Service Act or under the control of a doctor, who is deemed to be in need of medical treatment due to 16 major diseases or a person who is qualified as a dentist, dentist or oriental medical doctor (hereinafter referred to as "doctor"), and it is difficult to provide medical treatment at home, etc.

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