beta
(영문) 광주지방법원 2015.08.21 2015나50879

부당이득금

Text

1. The defendant's appeal is dismissed.

2. The costs of appeal shall be borne by the Defendant.

Purport of claim and appeal

1..

Reasons

Basic Facts

A. The Plaintiff is a non-profit special public corporation established pursuant to the National Health Insurance Act for the purpose of improving the national health and promoting social security by providing citizens with insurance benefits for the prevention, diagnosis, and treatment of diseases, injuries, etc., and the Defendant is an insurer established pursuant to the Industrial Accident Compensation Insurance Act (hereinafter “Industrial Accident Insurance Act”) with the aim of contributing to the protection of workers by compensating workers promptly and fairly for occupational accidents.

B. A was an employee of the Company B, and suffered injury, such as the thalone of the e-mail, etc., due to occupational accidents that occurred on December 21, 2001 (hereinafter “instant accident”).

C. A received medical treatment at C Hospital from November 27, 2003 to February 24, 2004 due to the instant accident. The Plaintiff paid KRW 3,557,470 to the relevant medical care institution, excluding KRW 889,360, out of the medical expenses incurred from the said medical treatment 4,446,830. The Plaintiff paid KRW 852,850 to D’s representative of B Co., Ltd.

A applied for medical care benefits to the Defendant after the accident of this case, and the Defendant decided to approve industrial accidents on November 29, 2005.

E. On May 20, 2014, the Plaintiff filed a claim with the Defendant for payment of the settlement amount equivalent to KRW 2,704,620 (= KRW 3,557,470 – KRW 852,850). The Defendant did not accept the claim on the ground that the extinctive prescription has expired.

[Based on the fact that there is no dispute, each statement in Gap evidence 1 through 6, and Article 42(1) of the Industrial Accident Insurance Act regarding the grounds for a claim for the purport of the entire pleadings, a person who filed an application for medical care benefits under the Industrial Accident Insurance Act (hereinafter “industrial accident insurance medical care benefits”) shall receive medical care benefits under the National Health Insurance Act (hereinafter “health insurance medical care benefits”) from the plaintiff before receiving a decision on medical care benefits (hereinafter “decision on approval for additional medical care”).