최초요양급여불승인처분취소
1. The plaintiff's claim is dismissed.
2. The costs of lawsuit shall be borne by the Plaintiff.
1. Details of the disposition;
A. On September 8, 2012, the Plaintiff applied for the first medical care benefits under the diagnosis of “the structural more of the upper part of the upper part of the upper part of the upper part of the upper part of the upper part of the upper part of the upper part of the upper part of the upper part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the lower part of the case.”
B. The Defendant original disposition rendered the first non-approval disposition (hereinafter the instant disposition) on the ground that the total construction cost of the instant construction constituted KRW 16,500,000, which constitutes a business excluded from the Industrial Accident Compensation Insurance Act pursuant to Article 2 of the Enforcement Decree of the Industrial Accident Compensation Insurance Act.
[Ground of recognition] Facts without dispute, Gap 1, 2, Eul 1, the purport of the whole pleadings
2. Whether the disposition is lawful;
A. The Plaintiff’s assertion is a construction directly established by the non-party company pursuant to a contract with the buyer of the product that is regularly produced by the non-party company, which constitutes a special case of the establishment of the product under Article 4 of the Enforcement Rule of the Industrial Accident Compensation Insurance Act and included in the manufacturing industry
Therefore, even though the industrial accident compensation insurance does not constitute a business excluded from the Industrial Accident Compensation Insurance Act, the instant disposition based on a different premise is unlawful.
(b) Article 6 (Scope of Application) of the Industrial Accident Compensation Insurance Act shall apply to all businesses or workplaces which employ workers (hereinafter referred to as "business");
This Act shall not apply to projects prescribed by Presidential Decree in consideration of the risk rate, scale, place, etc.: Provided, That this Act shall not apply.
Article 2 (Business Excluded from Application of the Act) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act.