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본 건은 보험사에서 사망진단서상 병사이므로 상해재해사망보험금을 지급할 수 없다는 주장에 본 손해사정사에게 의뢰하여 사망의 유발요인이 외부요인인 것을 입증하여 외인사로서 상해재해사망보험금을 수령한 손해사정사례입니다.

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브라보 단체보험약관 1801 동부화재 DB손해보험

특별약관
제1장 상해관련 특별약관
1. 상해사망 ································································································· 44
2. 상해80%이상후유장해 ············································································· 44
3. 상해50%이상후유장해생활자금(매년10년간지급)
4. 상해80%이상후유장해생활자금(매년10년간지급)
5. 상해입원일당(1일이상180일한도) ····························································· 47
6. 교통상해사망 ··························································································· 48
7. 교통상해80%이상후유장해 ······································································· 50
8. 교통상해80%미만후유장해 ······································································· 54
9. 교통상해50%이상후유장해생활자금(매년10년간지급)
10. 교통상해80%이상후유장해생활자금(매년10년간지급)
11. 교통상해입원일당(1일이상180일한도)
12. 화상진단비 ······························································································ 68
13. 5대골절진단비 ························································································· 68
14. 골절진단비(치아제외) ··············································································· 69
15. 상해흉터복원수술비 ················································································· 69
16. 중대한 특정상해수술비(1회지급)
17. 자동차부상치료비 ···················································································· 71
18. 상해80%미만후유장해 ············································································· 74
19. 상해수술비(동일사고당 1회지급)
20. 상해중환자실입원일당(1일이상180일한도)
21. 화상수술비(동일사고당 1회지급)
22. 골절수술비(동일사고당 1회지급)
23. 자동차사고치아보철지원금79
24. 폭력피해보험금 ························································································ 80
25. 상해후유장해(20~100%) ········································································ 81
26. 산업재해장해진단비(상해) ······································································· 82
제2장 질병관련 특별약관
1. 암진단비(유사암제외) ··············································································· 84
2. 유사암진단비(대장점막내암포함) ······························································· 85
3. 3대고액치료비암진단비 ············································································ 87
4. 암수술비Ⅰ ······························································································ 88
5. 암수술비Ⅱ(1회지급) ················································································ 91
6. 암직접치료입원일당(4일이상120일한도)
7. 암사망

8. 암80%이상후유장해 ················································································ 96
9. 특정3대성인질병사망 ··············································································· 98
10. 특정3대성인질병80%이상후유장해
11. 질병사망 ······························································································· 100
12. 질병80%이상후유장해 ··········································································· 101
13. 질병입원일당(1일이상180일한도) ··························································· 102
14. 식중독입원일당(4일이상120일한도)
15. 뇌졸중진단비 ························································································· 105
16. 중대한 뇌졸중진단비 ············································································· 106
17. 뇌출혈진단비 ························································································· 107
18. 급성심근경색증진단비 ············································································ 108
19. 산업재해장해진단비(질병) ····································································· 109
20. 레이저시력교정수술합병증(각막혼탁·각막확장)진단 및 재수술비
제3장 질병 및 상해관련 특별약관
1. 깁스치료비 ···························································································· 116
2. 소득상실유발특정상해․질병입원일당(1일이상180일한도)
3. 운전자관절증(엉덩,무릎)수술비(이차성 및 상세불명 제외)
4. 추간판탈출증수술비 ··············································································· 119
제4장 비용손해관련 특별약관
1. 자동차사고 변호사선임비용(실손) ··························································· 122
2. 벌금(실손) ····························································································· 123
3. 교통사고처리지원금(실손) ······································································· 125
3-1. 자가용운전자 교통사고처리지원금(실손) ········································· 125
3-2. 영업용운전자 교통사고처리지원금(실손) ········································· 127
4. 중상해교통사고처리지원금(실손) ····························································· 130
4-1. 자가용운전자 중상해교통사고처리지원금(실손)
4-2. 영업용운전자 중상해교통사고처리지원금(실손)
5. 면허취소보험금(영업용) ·········································································· 134
6. 면허정지일당(영업용) ············································································· 135
7. 자동차사고성형수술비 ············································································ 137
제5장 배상책임관련 특별약관
1. 일상생활배상책임(실손) ·········································································· 140
2. 가족일상생활배상책임(실손) ··································································· 145
제6장 무배당 프로미라이프 실손의료비 특별약관1704
1. 기본형 실손의료보험 특별약관 ······························································· 152
2. 비급여 도수치료·체외충격파치료·증식치료 실손의료보험 특별약관
3. 비급여 주사료 실손의료보험 특별약관 ···················································· 182
4. 비급여 자기공명영상진단(MRI/MRA) 실손의료보험 특별약관
제도성 특별약관
1. 배우자추가 ···························································································· 190
2. 특정신체부위ㆍ질병 보장제한부 인수
3. 이륜자동차 운전중상해 부담보 ······························································· 192
4. 보험료 자동납입 ···················································································· 192
5. 선지급 서비스 ······················································································· 193
6. 지정대리청구서비스 ··············································································· 194
7. 전자서명 ······························································································· 195

상해사망 특별약관
1. (보험금의 지급사유)
회사는 보험증권에 기재된 피보험자가 「이 특별약관의 보험기간」 중에 상해의 직접결과로써 사망한 경우 이 특별약관의 보험가입금액을 상해사망보험금으로 지급합니다.
2. (보험금 지급에 관한 세부규정)