The plaintiff is a national health insurance policyholder.

On March 23, 2017, around 08:35, the Plaintiff: (a) driven a motorcycle on a one-lane road (hereinafter referred to as “instant road”); and (b) obstructed the median line while driving from Cridges to D, while driving on a two-lane road (hereinafter referred to as “instant road”); and (c) driven by the median line while driving on a two-lane road from Cridges.

(hereinafter “instant traffic accident”). The Plaintiff received insurance benefits to treat the injury, such as the alleys of the Hashes E Hospital, etc. caused by the instant traffic accident from the medical corporation.

Based on Articles 53(1) and 57(1) of the National Health Insurance Act, on the ground that “the instant traffic accident occurred due to gross negligence of the Plaintiff’s central crime,” the Defendant issued a disposition to recover the insurance benefits received by the Plaintiff from KRW 3,333,170 (on January 8, 2018), and KRW 6,161,090 (on January 15, 2018, the date of the decision) as unjust enrichment (hereinafter “instant disposition”).

After that, the Plaintiff filed an objection with the Defendant on May 10, 2018, but the Defendant dismissed the objection on June 29, 2018.

[Reasons for Recognition] Facts without dispute, Gap evidence Nos. 2 through 6 (including the number of branch numbers; hereinafter the same shall apply), and the purport of the entire argument as to the legitimacy of the disposition of this case as to the legitimacy of the disposition of this case, the plaintiff's main purport of the argument is that the plaintiff did not commit an accident due to the age of 78 years old at the time of the traffic accident of this case by mistake or error of decision, and that the plaintiff intentionally caused an accident with the awareness of the same degree

The instant disposition that deemed that the Plaintiff violated the central line constitutes a ground for restriction on benefits under the National Health Insurance Act is unlawful.

Judgment

Article 53 (1) 1 of the National Health Insurance Act provides that a criminal act caused by intention or gross negligence shall be caused or intentional.