요양불승인처분취소
209Guhap649 Revocation of Disposition of Non-approval for Medical Care
Park 00 (53*********)*
Jeju-si Eup *-*
Attorney Jeong-tae, Counsel for defendant-appellant
Korea Labor Welfare Corporation
Jeju Island 2. Eastern****
Gwangju Northern-dong *-*-00 building (Uiju Regional Headquarters) at the place of delivery
President Kim 00
Litigation Performers 100
April 14, 2010
June 23, 2010
1. The Defendant’s disposition of non-approval of the medical care for the Plaintiff on July 27, 2009 is revoked. 2. The litigation cost is assessed against the Defendant.
The same shall apply to the order of the Gu office.
1. Details of the disposition;
The following facts may be acknowledged, either as a dispute between the parties, or as a whole, as a whole by taking into account the respective descriptions of evidence A4 and 5 and the purport of the whole pleadings:
A. On June 30, 2009, the Plaintiff suffered from 00 of 10 fisheries farms, which were members of the East-gu, Jeju District ** on 30 June 30, 2009, the Plaintiff applied for medical care on July 7, 2009 (hereinafter referred to as the “disaster”) such as 'Dan Dan Dom Ham Ham Ham Ham Hamn', Mam Ham Ham Hamn', Mam Mamn', Mam Mamn', Mam Mamn', Mam Mamn', Mam Mamn', the right mam, the right man', the upper part, the upper part of the upper part of the 1st part of the river, and the Defendant applied for medical care on July 1, 2009.
B. On July 27, 2009, the Defendant rendered the instant disposition that rejected medical care on the ground that the instant accident against the Plaintiff was caused by the perpetrator’s private sentiment, and that it cannot be deemed that it was in the course of performing duties under the control and management of the business owner, or that it was related to the business.
2. Whether the disposition is lawful;
A. The plaintiff's assertion
Since the Plaintiff was out of a night house in the workplace and was out of the instant accident, it shall be deemed as a disaster that occurred under the control and management of the business owner during recess hours, and the Plaintiff was in charge of management affairs, including personnel affairs, within the company. This is a job of the nature that may cause a harmful act by a third party due to the nature of the business, and thus, the instant accident shall be deemed an occupational accident.
B. Relevant statutes
It is as shown in the attached Form.
(c) Fact of recognition;
The following facts may be recognized by adding up the whole purport of pleadings to the statements of Gap 2, 6, Eul 4, 5, and 6 and the testimony of Park 00.
(1) On July 21, 2007, the Plaintiff joined the aquaculture and performed overall duties such as management of the aquaculture business and human resources management. On March 5, 2008, the Plaintiff joined the aquaculture and assisted the Plaintiff to perform the duties of cleaning the feed cycle and the aquaculture.
(2) In 00 fisheries, there are buildings used as offices and staff accommodation separate from aquaculture facilities, and the second floor of this building, the Plaintiff, the Plaintiff, the Plaintiff, and the other employees used and resided in one room respectively.
(3) On June 29, 2009, which was the day before the instant accident, the said persons were to retire, and the said persons met together, and the Plaintiff first returned to the boarding house, and the Plaintiff was to return home to the boarding house, and the amount of 00 and 00 gambling were to return home to the boarding house after having a higher drinking place.
(4) On June 30, 2009, around 06:20 on June 30, 2009, Gangwon 00 followed the Plaintiff’s room and followed the instant disaster by taking advantage of the knife, hacks, pipes, and heads inside the building.
(d) Markets;
(1) The term "occupational accident" as a requirement for medical care benefits refers to an accident caused by an employee's occupational accident while performing his/her duties, and there is a proximate causal relation between the occupational accident and the accident. In this case, the causal relation between the occupational accident and the accident of the employee should be proved by the claimant. However, Article 33 of the Enforcement Decree of the Industrial Accident Compensation Insurance Act provides that "if an accident occurred to an employee due to a third party's act, the accident is deemed an occupational accident if the worker's duties are of a nature that may cause a harmful act by social norms."
(2) With respect to the instant case, the following circumstances acknowledged by the evidence adopted earlier, namely, ① the issue of entry and retirement of employees in the aquaculture was determined entirely by the Plaintiff and the business owner only made payment as determined by the Plaintiff; ② the Plaintiff was informed of his dismissal. The Plaintiff’s dysium dynasium dynasium dynasium dynasium dynasium dynasium dynasium dynasium dynasium dynasium dynasium dynasium dynasium dynasium dynasium dynasium dynasium dynasium dynasium dynasium dynasium dynasium dynasium dynasium dynasium dynasium dynasium dynasium dynasium d.
3. Conclusion
Thus, the disposition of this case, which judged that the disaster of this case was unrelated to the business, should be revoked illegally. Thus, the plaintiff's claim is justified and it is so decided as per Disposition by admitting it.
The presiding judge, Judge Park Jae-in
Judges Kim Gin-tae
Judges Park So-young