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TITLE Supreme Court Decision 2023Da283913 Decided January 25, 2024 ¡¼Insurance Proceeds¡½ [full Text]
Summary
¡¼Main Issues and Holdings¡½ [1] Cases where the Supreme Court may determine the erroneous application of substantive law despite the nonfulfillment of the requirement for the filing of a final appeal against a court decision or order on small claims, which stipulates that the said decision or order shall be ¡°in contravention of the judicial precedents of the Supreme Court¡± [2] In an interpretation of the terms and conditions, where there is a unitary interpretation of a clause in the terms and conditions when interpreting the said clause fairly and reasonably, in light of the contra proferentem rule and the purpose and intention of the terms and conditions as well as objectively and uniformly based on the understandability of an average customer, whether the contra proferentem rule applies (negative) [3] In a case where: (a) Party A concluded an insurance agreement with Incorporated Company B, which includes a ¡°special agreement guaranteeing compensation for hospitalization caused by diseases (renewal type),¡± and filed an insurance claim as per the said special agreement; (b) Company B rejected the said claim on the grounds that the amount in excess of the copayment ceiling under the National Health Insurance Act is coverable by the National Health Insurance Service; and (c) Party A filed a lawsuit seeking payment of insurance proceeds including the amount in excess of the copayment ceiling against Company B, the case holding that the amount Party A received as a refund from the National Health Insurance Service may not be considered coverable by the above special clause [4] In a case where an appellant did not write a specific and express reason why the lower judgment is in violation of a statute in a final appellate brief, whether the appellant is considered not having submitted a final appellate brief (affirmative)
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