요양급여불승인처분취소
2010Nu282 Revocation of Non-approval for Medical Care Benefits
A person shall be appointed.
Korea Labor Welfare Corporation
Representative President 000
Legal representative 000
Daegu District Court Decision 2010Gudan2789 Decided November 12, 2010
April 8, 2011
April 29, 2011
1. The defendant's appeal is dismissed.
2. The costs of appeal are assessed against the defendant.
1. Purport of claim
The Defendant’s disposition of non-approval of medical care benefits against the Plaintiff on June 29, 2010 is revoked.
2. Purport of appeal
The judgment of the first instance is revoked. The plaintiff's claim is dismissed.
1. Details of the disposition;
A. On May 26, 2010, the Plaintiff was a taxi driver belonging to Bsi Co., Ltd. (hereinafter referred to as “non-party company”). Around 00, the Plaintiff suffered injury of Non-party company’s trade union (hereinafter referred to as “the disaster of this case”) organized by the non-party company’s headquarters B taxi branch in Daegu-gu, 00-gu (hereinafter referred to as “trade union”) at the sports conference for the labor union in 2010 (hereinafter referred to as “the sports competition of this case”) organized by the non-party company (hereinafter referred to as “non-party company’s headquarters B taxi branch in Daegu-gu, the Korean taxi industry trade union”) and suffered from not less than 30 percent of the injury of “a party saf and kne during a stable-si and kne-si.”
B. On June 14, 2010, the Plaintiff filed an application with the Defendant for approval of medical care by asserting that the instant accident constituted an occupational accident.
C. However, the Defendant, however, did not recognize the time during which he participated in the event at the non-party company and submitted a report of absence from work. ② In light of the fact that the employer did not instruct the non-party company to participate in the event, and that the labor union hosts the event and encouraged the participation, the instant sports competition does not constitute occupational accidents, and it does not constitute occupational accidents. < Amended by Act No. 1037, Oct. 201
6. On 29. 29. The Plaintiff notified the Plaintiff of the refusal of medical care (hereinafter “instant disposition”).
[Grounds for Recognition] Unsatisfy, Gap evidence 1, Eul evidence 1-2, Eul evidence 2-2, Eul evidence 2, the purport of the whole pleadings
2. Whether the instant disposition is lawful
A. The plaintiff's assertion
The instant sports competition was held once a year under the supervision of the non-party company with full subsidies for expenses under the collective agreement between the non-party company and the non-party company pursuant to the labor-management collective agreement between the non-party company and the non-party company. However, since the event was not specified as a paid holiday and was inevitably absent from the attending party, the instant sports competition was in the status of being controlled and managed by the employer. Thus, the instant disaster constitutes an occupational accident.
Therefore, the instant disposition that was reported differently is unlawful.
B. Relevant statutes
As shown in the attached Form.
C. The facts of recognition (1) pursuant to Article 59(3) of the collective agreement and wage agreement (hereinafter “collective agreement”) concluded on September 3, 2009 between the non-party company and the trade union, “the company shall hold a union member night conference once a year between March and October every year in order to raise the morale of union members and enhance their will to work, and subsidize 45,000 won per unit in the labor union. (2) The trade union decided to hold a meeting on April 22, 2010, to hold a meeting for the extension of the standing committee and to hold a meeting for the sports of this case. (3) The notice was given on September 23, 201, stating that “in the name of the chairman of the trade union on September 23, 2009, the company shall hold a collective agreement and apply for a union member’s participation in the sports of 10 years and 20 years in order to improve the members’ desire to work.”
(3) On April 23, 2010, the trade union sent to the non-party company a document 2010 'the notification of the PPP and the request for the payment of subsidies' to the non-party company. At the same time, pursuant to Article 59(3) of the collective agreement, the trade union made a request for the payment of a subsidy of 45,00 won per vehicle to the expenses required for the PPPPPP by May 20, 2010. (4) The non-party company supported the 3,195,000 won for the event expenses of the trade union (vehicle 71 x 45,000 won) as total expenses for the PPPP in accordance with the provisions of the collective agreement. On the other hand, the total amount of 4,045,000,000 won for the employees who participated in the sports, 3,099,70 won for the PPPPP and the number of its members who participated in the sports.
(6) The participants at the instant sports competition were submitted to the non-party company on a yearly basis through the labor union, and the company dealt with the above participants on a yearly leave and absence from work. A total of 76 members, including the head of the association, participated in the sports competition, and approximately 40 members, including the head of the association, participated in the sports competition, and the remaining members were absent or long-term absence. (7) The representative director of the non-party company, at the request of the chairperson of the labor union, arrived at the event at around 12:0 at around 12:0 and 10 minutes after arrival at the event site.
(8) In addition to 76 members who are taxi drivers, the non-party company is comprised of five management officers, including the representative director, one chief management officer (general maintenance officer, dispatch and accident handling), one maintenance engineer (vehicle maintenance), two female employees (cash management, document, administrative work).
[Ground of recognition] Gap evidence 2 through 6, Eul evidence 9, Eul evidence 3, Eul evidence 4-1, 2, Eul evidence 5, Eul evidence 6-1 through 7, Gap evidence 7-1 and Eul evidence 7-2, and the purport of the whole pleadings
D. Determination
(1) In a case where a disaster occurred while participating in an event or a meeting other than a company, which is not prescribed as a matter of duty to be ordinarily engaged in by an employment contract, and where it is intended to recognize it as an occupational accident, the overall process of the event or meeting must be under the control or management of the employer in light of the circumstances such as the organizer, purpose, contents, number of participants, forcedness, operation methods, burden of expenses, etc. of the event or meeting (see Supreme Court Decision 97Nu7271 delivered on August 29, 197, etc.).
In addition, Article 37 (1) 1 (d) of the Industrial Accident Compensation Insurance Act provides that "accidents occurred during the course of exercising or preparing for an event by an employer's direction" shall be prescribed by Presidential Decree. Article 30 of the Enforcement Decree of the same Act provides that "An employee's participation in various events, such as sports events, camping, and mountain games (hereinafter referred to as "exercises") shall be deemed as an occupational accident under Article 37 (1) 1 (d) of the Act if the employee falls under any of the following cases, and the employer's participation in the above events (including preparation and practice for participating in such events) is deemed as not having been able to participate in the sports meets because it is difficult for the employee to participate in such events; 2. Where the employer orders the employee to participate in the sports meeting on condition that the employee would not have been able to participate in the sports meeting on condition that the employee would not have been able to participate in the sports meeting on condition that the employee would not have been able to participate in such sports."
In addition to the above circumstances, the sports meets of this case where it is necessary to manage the labor of the non-party company, and where it is necessary to participate in the event with the witness of the non-party company, or the business owner usually recognized the participation, and thus, its overall process was in the state of being controlled or managed by the business owner under the social norms. Thus, the accident of this case occurred during the sports meeting of this case constitutes occupational accident, and thus, the disposition of this case which rejected the plaintiff's application for medical care on a different premise should be revoked illegally.
3. Conclusion
The judgment of the court of first instance accepting the plaintiff's claim is justifiable, and the defendant's appeal is dismissed.
Judges Kim Chang-soo - - Judges
Judges Kim Senior -
Judges Lee - free of charge -
A person shall be appointed.