Classification contract date Contract date Contractor’s insured surgery date guaranteed (no)** Disease insurance 1998. 9. 7. Gap disease 2010. 3. KRW 5.3 million1. Facts. Insurance contract details □ The policyholder has entered into an insurance contract with the insurance company as follows4. Conclusion □ If so, it would be reasonable to pay the surgical benefits stipulated in the insurance terms and conditions for arteriovenous fistula composition for the treatment of chronic renal failure of the insured[No. 2010-80]2. Claimant Claimant vs. Claimant Claimant □ It is unfair for the insured not to pay surgery benefits even though he underwent arteriovenous fistula to treat chronic renal failure (Korean standard disease cause classification: N18). Claimant of insurance company □ This is a measure to secure the path of hemodialysis, such as connecting veins and arteries, and it is not acceptable because it is considered as “measures such as puncture (穿刺)” rather than as a definition of general surgery such as ◦ amputation (切斷) and redness (摘除). The payment of surgery benefits twice was due to the elimination of civil complaints
