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[교통사고후유증 자살보험금 상해사망보험금]YES365건강보험약관 교통상해사망특약 2018 KB손해보험 사인미상 병사 급사 상해사망보험금
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- 2018.05.25
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[교통사고후유증 자살보험금 상해사망보험금]YES365건강보험약관 교통상해사망특약 2018 KB손해보험 사인미상 병사 급사 상해사망보험금
http://insclaim.co.kr/21/8635655
[사망진단서 병사, 상해재해사망보험금수령한 손해사정사례 No.7052] 사망의 유발요인 외인요인, 사망진단서상 병사이고 사망의 직접원인은 다발성장기부전-패혈증-복막염-직장천공 등이었으나 외인사를 입증하여 상해재해사망보험금을 수령한 손해사정사례
본 건은 보험사에서 사망진단서상 병사이므로 상해재해사망보험금을 지급할 수 없다는 주장에 본 손해사정사에게 의뢰하여 사망의 유발요인이 외부요인인 것을 입증하여 외인사로서 상해재해사망보험금을 수령한 손해사정사례입니다.
http://insclaim.co.kr/21/8635656
[내인성급사 사망원인미상 상해재해사망보험금 수령한 손해사정사례]국과수 부검결과 사인미상 - 내인성급사로 추정, 술집에서 술마시던중 의식을 잃고 쓰러져 돌연사(청장년급사증후군)한 사건으로 상해재해사망보험금 수령한 손해사정보상사례.
http://insclaim.co.kr/21/8635644
[우울증자살, 재해상해사망보험금 손해사정사례]우울증에피소드로 유서작성후 목멤(액사)자살, 우울증자살보험금으로 재해사망보험금을 수령한 손해사정사례
http://insclaim.co.kr/21/8635643
[교통사고후유증 자살, 재해상해사망보험금수령사례]경미한 교통사고로 치료중 사고후유증인 외상후스트레스, 우울증이 발병하여 목멤자살한 경우, 교통사고 손해배상금 및 재해상해사망보험금을 수령한 손해사정사례 No7046.
http://insclaim.co.kr/21/8635472
[공무원단체보험 우울증자살 상해사망인정사례]우울증으로 아파트 투신자살(추락사)하여 공무원단체보험의 상해사망보험금을 수령한 손해사정사례
http://insclaim.co.kr/21/8635536
[급성약물중독 재해사망인정사례]우울증으로 치료중 고관절전치환술후 고생하다가 음주후 수면제-자나팜정, 우울증약-에나프정 등 우울증약 과다복용으로 인한 약물중독으로 사망한 사건(추정)에서 재해사망보험금 수령한 손해사정사례입니다.
http://insclaim.co.kr/21/8635431
[폐렴사망, 사고기여도100% 상해사망보험금인정사례] 고령의 피보험자가 넘어져 두부손상으로 1년8개월 치료중 폐렴사망, 기왕증공제70%주장에 상해사망보험금 전액인정받은 사례
http://insclaim.co.kr/21/8635568
[암우울증 암후유증 통증 스트레스 자살, 자살재해사망보험금 수령한 손해사정사례 No7030.]
http://insclaim.co.kr/21/8635548
[알콜중독 자살재해사망보험금인정사례] 알콜의존증, 알콜성간염, 우울증에피소드 등으로 과거에 치료받았던 병력이 있는 변사자가 사망당시 갑자기 주거지 아파트에서 투신자살(추락사망)사건에서 재해사망을 인정한 자살 재해사망보험 손해사정사례입니다.
http://insclaim.co.kr/21/8635587
[부부싸움 투신자살, 부부싸움중 음주만취 아파트 추락사 재해사망보험금 수령한 손해사정사례 No.7041] 직장의 업무스트레스로 음주 만취하여 격렬한 부부싸움중 아파트창문으로 투신하여 추락사망 사건으로 재해사망보험금 수령한 손해사정사례입니다.
[교통사고후유증 자살보험금 상해사망보험금]YES365건강보험약관 교통상해사망특약 2018 KB손해보험 사인미상 병사 급사 상해사망보험금
2. 일반상해사망추가 특별약관
1-2-1. 일반상해사망【갱신계약】특별약관
(【갱신계약】은 자동갱신으로 운영합니다)
제1조(보험금의 지급사유)
회사는 피보험자가 이 특별약관 보험기간 중에 상해의 직접결과로써 사망한 경우에는 이 특별약관의 보험가입금액 전액을 일반상해사망보험금으로 보험수익자(수익자의 지정이 없을 때에는 피보험자의 법정상속인)에게 지급합니다.
제2조(보험금 지급에 관한 세부규정) 제1조(보험금의 지급사유)의‘사망’에는 보험기간에 다음 어느 하나의 사유가 발생한 경우를 포함합니다.
1. 실종선고를 받은 경우: 법원에서 인정한 실종기간이 끝나는 때에 사망한
것으로 봅니다.
2. 관공서에서 수해, 화재나 그 밖의 재난을 조사하고 사망한 것으로 통보
하는 경우: 가족관계등록부에 기재된 사망연월일을 기준으로 합니다.
【실종선고】
어떤 사람의 생사불명의 상태가 일정기간 이상 계속 될 때 이해관계가 있는 사람의 청구에 의해 사망한 것으로 인정하고 신분이나 재산에 관한 모든 법적 관계를 확정시키는 법원의 결정을 말합니다.
【민법 제27조(실종의 선고)】
1. 부재자의 생사가 5년간 분명하지 않은 때에는 법원은 이해관계인이나 검사의 청구에 의하여 실종선고를 하여야 합니다.
2. 전지에 임한 자, 침몰한 선박 중에 있던 자, 추락한 항공기 중에 있던 자,
기타 사망의 원인이 될 위난을 당한 자의 생사가 전쟁 종지 후 또는 선박의
침몰, 항공기의 추락, 기타 위난이 종료한 후 1년간 분명하지 않은 때에도
제1항과 같습니다.
보험수익자와 회사가 제1조(보험금의 지급사유)의 보험금 지급사유에 대해 합의하지 못할 때는 보험수익자와 회사가 함께 제3자를 정하고 그 제3자의 의견에 따를 수 있습니다. 제3자는 의료법 제3조(의료기관)에 규정한 종합병원소속 전문의 중에 정하며, 보험금 지급사유 판정에 드는 의료비용은 회사가 전액 부담합니다.
제3조(특별약관의 소멸) 회사는 제1조(보험금의 지급사유)에서 정한 일반상해사망보험금을 지급한 때에는 그 지급사유가 발생한 때부터 이 특별약관은 소멸되며 이 특별약관의 해지환급금을 지급하지 아니합니다. 제1조(보험금의 지급사유)에서 정하지 않는 사유로 피보험자가 사망하였을
경우에는 이 특별약관 계약도 소멸되며 회사는 『보험료 및 책임준비금 산출방법서』에서 정하는 바에 따라 피보험자의 사망 당시 이 특별약관의 책임준비금을 계약자에게 지급합니다.
제4조(특별약관의 갱신) 이 특별약관의 【갱신계약】은 “제도성 특별약관 - 보장특약 자동갱신(추가납입형) 특별약관”에 의해 계약자의 선택에 따라 자동갱신으로 운영합니다. 제1항에 의해 자동갱신을 적용할 경우 보험증권에 그 내용을 기재하여 드립니다.
제5조(준용규정)
이 특별약관에서 정하지 않은 사항은 보통약관 일반조항을 따릅니다. 다만,
이 특별약관에서는 보통약관 일반조항 제10조(만기환급금의 지급), 제25조
(계약의 소멸) 및 제37조(중도인출)는 제외합니다.
의무부가관련 특별약관
1. 일반상해80%이상후유장해 ·····································································89
2. 질병80%이상후유장해 ············································································90
상해관련 특별약관
1-1. 일반상해후유장해(20~100%) ·······························································91
1-2. 일반상해사망추가 ·············································································92
1-2-1. 일반상해사망【갱신계약】···························································92
1-3. 일반상해50%이상후유장해 ··································································93
1-3-1. 일반상해50%이상후유장해【갱신계약】··········································93
1-4. 교통상해사망후유장해(자가용,영업용) ··············································94
1-4-1. 교통상해사망후유장해(자가용,영업용)【갱신계약】······················94
1-5. 교통상해사망후유장해(비운전자) ·······················································96
1-5-1. 교통상해사망후유장해(비운전자)【갱신계약】······························96
1-6. 대중교통이용중교통상해사망후유장해 ················································98
1-6-1. 대중교통이용중교통상해사망후유장해【갱신계약】·······················
1-18. 자전거탑승중상해사망후유장해 ·······················································112
1-18-1. 자전거탑승중상해사망후유장해【갱신계약】······························112
1-19. 자동차사고부상보장(자가용,영업용) ··············································114
1-19-1. 자동차사고부상보장(자가용,영업용)【갱신계약】······················114
1-20. 자동차사고부상보장(비운전자) ·······················································123
1-20-1. 자동차사고부상보장(비운전자)【갱신계약】······························123
1-21. 자동차사고치아보철보장 ································································124
1-21-1. 자동차사고치아보철보장【갱신계약】········································124
1-22. 일반상해수술입원일당(20일한도) ···················································125
1-22-1. 일반상해수술입원일당(20일한도)【갱신계약】···························125
1-23. 일반상해신체장애(A~B급) ·······························································127
1-23-1. 일반상해신체장애(A~B급)【갱신계약】······································127
1-24. 일반상해신체장애(A~C급) ·······························································163
1-24-1. 일반상해신체장애(A~C급)【갱신계약】······································163
1-25. 일반상해신체장애(A~D급) ·······························································164
1-25-1. 일반상해신체장애(A~D급)【갱신계약】······································164
1-26. 중대한화상및부식진단비 ································································165
1-26-1. 중대한화상및부식진단비【갱신계약】········································165
1-27. 일반상해사망가족생활지원금(10년매월지급형) ································166
1-27-1. 일반상해사망가족생활지원금(10년매월지급형)【갱신계약】········166
1-28. 일반상해80%이상후유장해생활지원금(10년매월지급형) ·····················167
1-28-1. 일반상해80%이상후유장해생활지원금(10년매월지급형)【갱신계약】··167
질병관련 특별약관
2-1. 질병사망․80%이상후유장해 ································································168
2-1-1. 질병사망․80%이상후유장해【갱신계약】·······································168
2-2. 질병사망 ························································································169
2-2-1. 질병사망【갱신계약】································································169
2-3. 질병50%이상후유장해 ·······································································170
2-3-1. 질병50%이상후유장해【갱신계약】··············································170
2-4. 질병입원일당(1일이상) ···································································171
2-4-1. 질병입원일당(1일이상)【갱신계약】···········································171
2-5. 암진단비(유사암제외) ·····································································173
2-5-1. 암진단비(유사암제외)【갱신계약】·············································173
2-6. 재진단암진단비【갱신계약】···························································175
2-7. 유사암진단비 ··················································································180
2-7-1. 유사암진단비【갱신계약】··························································180
2-8. 암수술비Ⅰ ·····················································································182
2-8-1. 암수술비Ⅰ【갱신계약】·····························································182
2-9. 암수술비Ⅱ ·····················································································184
2-9-1. 암수술비Ⅱ【갱신계약】·····························································184
2-10. 암직접치료입원일당(4일이상) ························································186
2-10-1. 암직접치료입원일당(4일이상)【갱신계약】································186
2-11. 5대고액치료비암진단비 ··································································189
2-11-1. 5대고액치료비암진단비【갱신계약】··········································189
2-12. 10대고액치료비암진단비 ································································191
2-12-1. 10대고액치료비암진단비【갱신계약】········································191
2-13. 뇌졸중진단비 ················································································194
2-13-1. 뇌졸중진단비【갱신계약】························································194
2-14. 뇌출혈진단비 ················································································195
2-14-1. 뇌출혈진단비【갱신계약】························································195
2-15. 급성심근경색증진단비 ···································································197
2-15-1. 급성심근경색증진단비【갱신계약】···········································197
2-16. 중증루푸스신염진단비 ···································································198
2-17. 발가락의후천변형수술비 ································································199
2-18. 조혈모세포이식수술비 ···································································201
2-19. 21대질병수술비Ⅱ ··········································································202
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