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red_flag_2(영문) 서울서부지방법원 2011. 8. 12. 선고 2009가합6752 판결

[진료비지급][미간행]

Plaintiff

The Korea Institute of Arts, the Korea Institute of Arts, the Korea General Meeting of the Korea Institute of Education (Law Firm Sejong, Attorneys Gyeong-chul et al., Counsel for defendant-appellant)

Defendant

National Health Insurance Corporation and two others (Attorneys Kim Han-eng et al., Counsel for the plaintiff-appellant)

Conclusion of Pleadings

May 4, 2011

Text

1. The plaintiff

A. The Defendant National Health Insurance Corporation shall pay 263,159,770 won, and 5% interest per annum from June 19, 2009 to August 12, 201, and 20% interest per annum from the next day to the day of full payment;

B. Defendant Busan Metropolitan City shall pay 131,188,120 won and 20% interest per annum from June 19, 2009 to the date of full payment.

sub-payment.

2. The plaintiff's remaining claims against the defendant National Health Insurance Corporation and the defendant's claims against the Republic of Korea are dismissed.

3. Of the litigation costs, 3/4 of the portion arising between the Plaintiff and the Defendant National Health Insurance Corporation shall be borne by the Plaintiff; the remainder shall be borne by the Defendant National Health Insurance Corporation; the portion arising between the Plaintiff and the Defendant Busan Metropolitan City shall be borne by the Plaintiff; and the portion

4. Paragraph 1 can be provisionally executed.

Purport of claim

The defendant National Health Insurance Corporation shall serve 1,247, 286, 370 won and 3,082,90 won from January 1, 202 to 14, 714,00 won from January 1, 2004 to 124, 658, and 30 won from January 1, 2005 to 124, 319, 64, 620 won from 20.1.6% from 1.6% from 1.6% from 207, from 208 to 3.6% from 3.6% from 1.6% from 205, from 205 to 3.6% from 3.6% from 1.6% from 205, from 208 to 3.6% from 30% from 19,691,460 won respectively,

Reasons

1. Basic facts

A. The Plaintiff is a school juristic person operating a high-tech college uniform hospital (Seoul-dong, Seo-gu, 34) under Article 9(1)1 of the Medical Care Assistance Act, which is a medical care institution under Article 40(1)1 of the National Health Insurance Act (hereinafter “Health Insurance Act”), and the Defendant National Health Insurance Corporation (hereinafter “Defendant Corporation”) is an insurer of health insurance established under Chapter 3 of the Health Insurance Act, and the Health Insurance Review and Assessment Service (hereinafter “Review and Assessment Service”) is a juristic person established on June 29, 200 pursuant to Article 55 of the Health Insurance Act in order to examine medical care benefit costs and evaluate the appropriateness of medical care benefits.

Meanwhile, according to Articles 5, 10, 25, and 26 of the Medical Care Assistance Act, duties concerning medical benefits are entrusted to the Review Board with the payment of expenses to an institution providing medical benefits according to the above results, and the Mayor/Do Governor shall establish expenses for estimated benefits from the Medical Care Fund to the Si/Gun/Gu having jurisdiction over the place of residence of a beneficiary (a person eligible to receive medical benefits who has difficulty in living, such as recipients prescribed by the National Basic Living Security Act), and expenses for medical benefits. The Medical Care Fund is established in the City/Do, and the Medical Care Fund is established with government subsidies and local government contributions. The above fund is formed with government subsidies and local government contributions. Of the duties of the head of Si/Gun/Gu under Articles 27(1) and 33(2) of the same Act, Article 20 of the Enforcement Decree of the same Act, and Article 30 of the Enforcement Rule of the Medical Care Assistance Act, the review and adjustment of expenses for medical benefits requested by the institution providing medical benefits to the institution providing medical benefits to the Corporation.

B. 1) The payment of the health insurance benefit under the Health Insurance Act is to examine whether the insured received the medical care institution from the medical care institution, and then, the health care institution makes a request for review of the health care benefit to the Review and Assessment Service. The Review and Assessment Service examines whether the claimed details meet the standards of the health insurance benefit standard established by delegation under Article 39(2) and (3) of the Health Insurance Act and the detailed matters of the standards and methods for the application of the health insurance benefits publicly notified by the Minister of Health and Welfare (hereinafter collectively referred to as the “standards for the health care benefit”) and to determine the amount of payment, and notify the health care institution and the Defendant Corporation of the results thereof, and Defendant

2) In the case of expenses for benefits under the Medical Care Assistance Act, as seen earlier, the Review and Assessment Service is entrusted with review duties, and the payment duties of the insurance benefits costs entrusted by the Defendant Corporation are the same as the payment procedures of the insurance benefits costs. The criteria for review by the Review and Assessment Service for the medical benefits costs are governed by Article 5(2) and (3) of the Regulations on the Standards for Medical Care Benefits under the National Health Insurance Act and attached Table 1 (excluding subparagraph 2(b)) of the Enforcement Rule

3) The provisions of the Health Insurance Act, the Enforcement Rule of the Health Insurance Act, the standards for health care benefit and medical care assistance, the Enforcement Rule of the Medical Care Assistance Act, and the Enforcement Rule of the Medical Care

C. Since a medical institution conducted medical treatment, treatment, and medicine preparation before the previous medical institution was conducted, it filed a claim for reimbursement of medical care benefit costs or medical care benefit costs (hereinafter “medical care benefit costs, etc.”) with the National Medical Insurance Corporation. When the National Medical Insurance Management Corporation determines that the claim for medicine costs violate the legal standards, it was reasonable to collect medical care benefit costs, etc. from the medical institution in accordance with Article 45(1) of the former Medical Insurance Act (amended by Act No. 5854, Feb. 8, 199; hereinafter “former Medical Insurance Act”) and Article 44(1) of the former National Medical Insurance Act (amended by Act No. 5854, Feb. 8, 199; hereinafter “former National Medical Insurance Act”) (amended by Act No. 6474, May 24, 2001) or Article 19(1)(1) of the former Medical Care Assistance Act (amended by Act No. 6474, May 24, 2001).

D. However, as a result of the division of medical care benefits and medical care benefits (hereinafter “medical care benefits, etc.”) into the medical treatment of a medical institution and the preparation of a pharmacy, the medical institution that received the medical care benefits, etc. corresponding to the medicine expenses was not a medical institution in question but a pharmacy. However, if the issuance of prescriptions by a medical institution is still notified of violation of the medical care benefits standards as before the division of medicine, the Defendant collected medical care benefits, etc. equivalent to the medicine expenses, etc. paid by a pharmacy based on Article 52(1) of the Health Insurance Act and Article 23(1) of the Medical Care Assistance Act from the medical institution that issued the relevant prescriptions

E. The relationship between the issuance of prescriptions, claims for medical care benefit costs, etc. (medical and pharmaceutical expenses), reductions, and collection disposition is as listed below. As such, the Defendant reduced or collected the medical fees received by the medical institution (which is not problematic in this case) and the pharmaceutical expenses received by the pharmacy from the medical institution.

A person shall be appointed.

F. Following the judgment to the effect that a medical institution's filing of a lawsuit disputing the collection disposition of medicine expenses against the above Defendant's medical institution's collection disposition should be revoked illegally (Supreme Court Decision 2005Du7037 Decided September 29, 2005). As examined below, the above collection disposition was sentenced to the judgment that the above collection disposition becomes void as it is significant and obvious (Supreme Court Decision 2006Du6642 Decided December 8, 2006).

G. Meanwhile, from November 2001 to March 2009, the Plaintiff issued a medical prescription for beneficiaries under the Medical Care Assistance Act from July 2002 to March 2009, and filed a request for review with the Review and Assessment Service. The Review and Assessment Service notified the Defendant Corporation of the result of review that the Plaintiff’s doctors should reduce the amount of the medical license exceeding the permitted scope by violating the medical care benefit standard in issuing the medical care benefit standard (hereinafter “the Commissioner of the Food and Drug Administration”). Accordingly, the Defendant Corporation notified the Plaintiff of the purport that the collection would be made by deducting the drug cost received from the Review and Assessment Service at the time of the payment of the next medical care benefit cost, etc., and made a disposition of collection of the medical care benefit cost on November 7, 2001, after deducting the amount of the above medicine cost from the medical care benefit cost paid to the Plaintiff from March 2009.

I. According to the above method, the amount of the medical care benefit cost paid by the Defendant Corporation from November 2001 to March 2009 is the sum of KRW 1,355,918,820 (i.e., the Defendant Corporation’s charges of KRW 1,092,759,050 + Defendant Corporation’s charges of KRW 263,159,770). Of the medical care benefit cost from July 2002 to March 2009, the amount of which the payment was deducted and refused is the sum of KRW 131,18,120 (no one’s charges).

[Ground of recognition] Unsatisfy, Gap evidence 1, Eul evidence 1, Eul evidence 1, 5, and 6 (which include branch numbers; hereinafter the same shall apply)

2. Determination as to the claim against the defendant Corporation

A. Determination on the cause of the claim

Article 52 (1) of the Health Insurance Act provides that the defendant Corporation shall collect all or part of the amount equivalent to the relevant benefits or the expenses for benefits from the medical care institution that has received the insurance benefit costs by deceit or other improper means, and Article 52 (2) of the same Act provides that in the case of paragraph (1) of the same Article, when the insurance benefits have been provided by false diagnosis by the medical care institution, the defendant Corporation may be jointly and severally liable for the payment of

However, a person subject to collection of unjust enrichment pursuant to Article 52(1) of the Health Insurance Act is a medical care institution that received insurance benefit costs by deceit or other unjust methods. Even if the Plaintiff increased the expenditure of the Defendant Corporation by over-the-counter handling, a medical care institution that received the insurance benefit costs equivalent to the medicine costs from the Defendant Corporation is not a third party, such as a pharmacy, but a pharmacy, etc., and a medical care institution that received the insurance benefit costs such as a pharmacy, etc. in relation to over-the-counter handling, does not directly receive the benefit costs by deceit or other unjust methods. Thus, the Plaintiff and the person who received the insurance benefits such as a pharmacy, cannot be deemed to bear the duty of collection based on Article 52(1) of

Furthermore, regarding the application of Article 52(2) of the Health Insurance Act, the mere fact that the Plaintiff was in an excessive place cannot be deemed to have conducted a false diagnosis, and it cannot be deemed that the Plaintiff was jointly and severally liable for collection with the person who received insurance benefits pursuant to Article 52(2) of the Health Insurance Act.

Therefore, the defendant Corporation's collection of the amount equivalent to the above medicine expense from the plaintiff on the basis of Article 52 (1) or (2) of the Health Insurance Act is not only a legal ground, but also a disposition is deemed null and void as the defect is significant and obvious (see Supreme Court Decision 2006Du6642 delivered on December 8, 2006).

Thus, the above collection disposition of Defendant Corporation also becomes null and void and thus the act of appropriation or deduction becomes null and void. Therefore, Defendant Corporation is obligated to pay unjust enrichment equivalent to the sum of the above medical care benefit cost, which was refused to pay to the Plaintiff, and damages for delay therefrom (the costs of health care benefit for which Defendant Corporation refused to pay to the Plaintiff shall be KRW 1,355,918,820, or shall be subject to the claim by the Plaintiff).

B. Determination as to Defendant Corporation’s defense, etc.

1) The defense of extinction of prescription period

Defendant Corporation, according to Article 79(1)3 of the Health Insurance Act, “the right to receive insurance benefit cost” is complete unless it is exercised for three years. Thus, the Plaintiff’s claim for medical care benefit cost corresponding to the portion that was deducted from and collected as “the cost of an out-of-the-counter medicine” before June 1, 2006, which was instituted on the instant lawsuit from June 1, 2009, was extinguished due to the completion of prescription.

On the other hand, as seen above, the Plaintiff’s claim of this case does not mean “the right to receive insurance benefit cost,” but the Defendant Corporation’s claim for the return of unjust enrichment equivalent to the portion that was deducted and collected on the ground that a disposition taken by the Review and Assessment Service to deduct and collect medicine cost that was received from a notice of reduction from the Review and Assessment Service based on Article 52 of the Health Insurance Act is null and void as a matter of course. As such, the ten-year extinctive prescription under Article 162(1) of the Civil Act shall apply to the Plaintiff’s claim for return. The Plaintiff’s claim for return shall be governed by the ten-year extinctive prescription under Article 162(1) of the Civil Act. The amount of the Plaintiff’s claim for return from November 201 to March

2) Offset defense

A) Defendant Corporation’s assertion

The medical care benefit standard has the nature as a mandatory provision. The issue of the medical care benefit standard by the plaintiff against the medical care benefit standard is illegal as a violation of the compulsory provision. Accordingly, the defendant Corporation has suffered from the loss of paying the unnecessary medicine cost of KRW 1,247,286,370 to the pharmacy, etc. in accordance with the above prescription. Accordingly, the damage claim equivalent to the above amount due to the tort against the plaintiff is offset against the above obligation against the plaintiff by the automatic claim.

B) Whether a prescription violating the medical care benefit standard is unlawful

The purpose of national health insurance is to improve national health and promote social security by providing insurance benefits to realize the national health in accordance with Article 36(3) of the Constitution (Article 1 of the National Health Insurance Act). The National Health Insurance Act requires all citizens to subscribe to the National Health Insurance Act, calculate insurance premiums in accordance with statutory standards, and restrict the discretion of medical institutions in determining the scope or method of health insurance as well as in order to prevent unnecessary health care benefits and ensure reasonableness of health care benefits and expenses, and to grant maximum health insurance benefits to only limited health insurance finance funds (see Constitutional Court Order 2006Hun-Ma417, Aug. 30, 2007). Accordingly, the above medical care benefits standards are established by the Minister of Health, Welfare and Family Affairs to ensure that new health care institutions are subject to delegation of Article 39(2) of the National Health Insurance Act, and have the nature of medical care benefits as mandatory provisions before being determined and publicly notified by the Minister of Health, Welfare and Family Affairs (see Supreme Court Decision 201Du13719, Jul. 29, 2001). 201).

C) Whether the Plaintiff violated the medical care benefit standard

Comprehensively taking account of the overall purport of the statements and arguments submitted by Eul as follows: (a) the plaintiff issued an extinctive prescription against the medical care benefit standards to the patients who were born from November 2001 to March 2009; and (b) caused the defendant Corporation to pay unnecessary medical care benefit costs to his/her pharmacy, etc.; and (c) the Review and Assessment Service may recognize the fact that the plaintiff notified each medical institution through the Korean Medical Association, the Korean Hospital Association, etc. of the purport that it would adjust improper medicine expenses, prescription fees, and preparation fees, in cases where it is deemed that the contents of the medical care benefit standards and the notice were inappropriate or excessive compared with the medical name of the injury or disease, such as prescribed prescriptions that are already inappropriate from a medical point of view, or that the plaintiff notified each medical institution of the fact that he/she did not meet the medical care benefit standards, or did not recognize it by negligence, or that it was intentional or negligent in the performance of an ex officio prescription

D) Scope of damages

As seen earlier, the defendant Corporation paid KRW 1,092,759,050 as medicine expenses for unnecessary medicine due to the tort committed by the plaintiff's violation of the medical care benefit standard. Therefore, the amount equivalent to the above amount is the damage suffered by the above defendant.

Defendant Corporation shall finally refund to the insured total amount of 263,159,770 won paid by the insured by prescribing that the Plaintiff violated the medical care benefit standard. Defendant Corporation, as an insurer of the health insurance, is obligated to collect and recover the medical care benefit paid by the insured to the medical care institution as prescribed by the law, or is secured through the collection and reduction disposition as above. Of the money secured by Defendant Corporation, the part of the above principal charge is ultimately the money kept in the position of the manager for the purpose of refunding it to the insured who is the final right holder. The Plaintiff’s claim against the Defendant Corporation seeking the return of it to the individual insured by denying the duty of return to the individual insured would result in filing a daily lawsuit against the individual insured, and thus, the above part of the principal charge should also be included in the damages suffered by the Defendant Corporation.

However, Article 43(3) of the Health Insurance Act provides that if the Defendant Corporation has already paid the medical care benefit costs to a medical care institution, the amount shall be deducted therefrom and refunded to the subscriber. However, this provision is only a provision prepared for procedural convenience in recovering the excessive amount of the medical care benefit costs. In this case where the Defendant Corporation claims damages for tort to the Plaintiff, the above provision is not applicable or applied by analogy (see Supreme Court Decision 2010Da21276, Jul. 8, 2010). Article 52(4) of the Health Insurance Act provides that if the medical care institution receives the medical care benefit costs from the policyholder or dependent by fraud or other improper means, it shall be collected from the relevant medical care institution and shall be paid without delay to the policyholder or dependent. However, this case’s provision is based on the premise that the collection disposition by the Defendant Corporation is valid or analogically applicable to cases where it becomes null and void, and it cannot be viewed that the Defendant Corporation’s duty to collect damages from the policyholder or dependent under the Civil Act cannot be viewed as its entire legal status of the insurer.

3) Sub-decisions

Therefore, the plaintiff's claim for return of unjust enrichment equivalent to the defendant Corporation's charges against the above defendant Corporation is set off against the damage claim equivalent to the same amount as the above defendant's tort against the above defendant, and the plaintiff's claim for return of unjust enrichment against the above defendant was extinguished by set-off due to the service of the reply of the above defendant, which includes the declaration of set-off. Thus, the plaintiff's remaining claim for return of unjust enrichment is 263,159,70 won, which is equivalent

Therefore, the defendant Corporation is obligated to pay to the plaintiff 263,159,770 won and the amount equivalent to 5% per annum prescribed by the Civil Act from June 19, 2009 to August 12, 201, which is the sentencing day of this case where it is deemed reasonable for the above defendant to dispute about the existence or scope of the obligation to perform as to the above 263,159,770 won and the following day of the delivery day of the complaint of this case, and 20% per annum prescribed by the Act on Special Cases Concerning the Promotion, etc. of Legal Proceedings from the following day to the day of full payment (the plaintiff sought compensation from the time of unjust enrichment, but there is no evidence that the above defendant is the beneficiary of bad faith, the above defendant is obligated to pay only damages for delay from the day after the delivery day of the complaint which is regarded as the beneficiary of bad faith pursuant to Article 749(2) of the Civil Act, and therefore the plaintiff'

3. Determination as to the claim against the defendant Busan City

A. Determination on this safety defense

The defendant Busan City did not pay medical expenses equivalent to the amount recovered by the defendant Corporation if the disposition that the defendant Corporation recovered the medical expenses from the plaintiff according to the review result of the Review and Assessment Service. Thus, the defendant Busan City merely claims the payment against the defendant Corporation. The defendant Busan City's claim against the defendant Busan City is an illegal lawsuit against a non-qualified person. Thus, the defendant's claim against the defendant Busan City in the lawsuit in this case is asserted as an illegal lawsuit against the non-qualified person. Thus, in the performance lawsuit, the plaintiff's claim against the plaintiff is qualified for the defendant, and the issue of whether the defendant is the person responsible for the performance is actually the defendant (see Supreme Court Decision 95Da18451 delivered on November 28, 1995). Thus, the above claim against the defendant Busan City is without merit.

B. Determination on the cause of the claim

(1) The managing body of the Medical Care Fund

As seen earlier, duties related to medical benefits are under the jurisdiction of the head of Si/Gun/Gu having jurisdiction over the place of residence of a beneficiary, while the Medical Benefits Fund which bears medical benefits costs is established in the City/Do. Thus, the management entity of the above Fund is a City/Do. In this case, in this case, the management entity of the Medical Benefits Fund, which is the financial resources for medical benefits expenses to be paid to the Plaintiff by the defendant Busan City, the location

Therefore, if there is no legal ground in the Medical Benefits Fund by means of not paying medical benefits expenses to be paid to an institution providing medical benefits from the Medical Benefits Fund, or unfairly recovering medical benefits expenses paid, etc., it is reasonable to view that an institution providing medical benefits resulting from such act may seek the return of unjust enrichment against Defendant Busan City, which is the subject of management of the Medical Benefits Fund.

On the contrary, Defendant Busan City is performing the duty of paying the medical benefits cost to the Plaintiff, and Defendant Busan City does not pay the medical benefits cost equivalent to the recovered amount if the disposition of recovering the medical expenses from the Plaintiff according to the result of the review by the Review Board is invalidated, and the Plaintiff’s claim against the Defendant Corporation for payment. However, as seen earlier, Defendant Corporation is merely performing the duty of paying the medical benefits cost within the scope of the medical benefits cost deposited with the Mayor/Do Governor every month, and it is insufficient to view that it is the managing body of the Medical Benefits Fund or the final owner of the medical benefits fund because it is difficult to deem that it has the authority to create, manage, or operate the medical benefits fund because it is difficult to regard it as the managing entity of the Medical Benefits Fund or as the final owner of

2) Whether unjust enrichment occurred

Article 23(1) of the Medical Care Assistance Act provides that the head of a Si/Gun/Gu shall collect all or part of the amount equivalent to benefits or expenses for medical benefits from an institution providing medical benefits that has received medical benefits costs by fraud or other improper means as unjust enrichment.

However, a person subject to collection of unjust enrichment under Article 23(1) of the Medical Care Assistance Act is a medical care institution that received medical care costs by deceit or other unjust means. Even if the Plaintiff increased the expenditure of medical care costs by overcoming the medical care costs, a medical care institution that received medical care costs equivalent to the medicine costs from the Medical Care Fund is not a third party, such as a pharmacy, but a pharmacy, etc., and a medical care institution that received medical care costs such as a pharmacy, etc. in relation to excessive outpatient, does not directly receive medical care costs by deceit or other unjust means. Thus, the Plaintiff and the person who received medical care costs such as a pharmacy, cannot be deemed to bear the duty of collection based on Article 23(1) of the Medical Care Assistance Act

Therefore, the disposition that Defendant Corporation entrusted with affairs such as the payment of medical expenses by the head of Si/Gun/Gu collects from the Plaintiff on the basis of Article 23(1) of the Medical Care Assistance Act as well as the disposition that collects the amount equivalent to the above medicine expense from the Plaintiff on the basis of the said medicine expense is deemed null and void as the defect is significant and obvious (see Supreme Court Decision 2006Du6642, Dec. 8, 2006)

Thus, the above collection disposition by Defendant Corporation also becomes null and void and thus the act of appropriation or deduction becomes null and void. Therefore, since the sum of 131,188,120 won of the above medical benefits expenses which Defendant Corporation refused to pay should have been disbursed from the Medical Benefits Fund, which is the source of medical benefits expenses, the medical benefits fund should have been disbursed, it is ultimately the benefit of the Medical Benefits Fund. As seen earlier, Defendant Busan City, which is the managing body of the Medical Benefits Fund, is liable to pay the Plaintiff the above 131,18,120 won and damages for delay.

C. Judgment on the defendant Busan City defense

According to Article 31(1)2 of the Medical Care Assistance Act, Defendant Busan City's right to receive medical care costs is complete unless it is exercised for three years. Thus, the Plaintiff's claim for medical care costs related to the portion that was deducted from and collected as "the cost of an out-of-the-counter medicine" before June 1, 2006, which was filed by the instant lawsuit, was extinguished by the completion of prescription.

On the other hand, as seen above, the Plaintiff’s claim of this case is not “the right to receive insurance benefit costs,” but the Defendant Corporation claims the return of unjust enrichment equivalent to the portion that was deducted and collected on the ground that the disposition, which was obtained by deducting and collecting the drug costs from the Review and Assessment Service, based on Article 23 of the Medical Care Assistance Act, was null and void as a matter of course. As such, the ten-year extinctive prescription under Article 162(1) of the Civil Act shall apply to the Plaintiff’s claim for return. The Plaintiff’s claim for return was made from July 2002 to March 2009, and the payment was still deducted and refused by the collection disposition among the medical care benefit costs from around 2002 to March 2009 and the ten

D. Sub-committee

Therefore, Defendant Busan City is obligated to pay to the Plaintiff 131,188,120 won and the amount equivalent to 20% per annum from June 19, 2009 to the day of full payment on the record that it is clear that the delivery day of the complaint in this case is the day following the delivery day of the complaint in this case (the Plaintiff sought damages for delay from the time of the occurrence of unjust enrichment, but there is no evidence that the above Defendant is deemed a malicious beneficiary. Thus, the above Defendant is obligated to pay only damages for delay from the day following the delivery day of complaint which is deemed a malicious beneficiary under Article 749(2) of the Civil Act, and therefore, the Plaintiff’s assertion exceeding the above recognition scope is without merit).

4. Determination on the claim against Defendant Republic of Korea

A. Determination on this safety defense

Defendant Republic of Korea is under the jurisdiction of the head of a Si/Gun/Gu, and the Medical Care Fund is established in a City/Do. Thus, a claim related to the payment of medical benefits costs must be filed against a basic or metropolitan local government, and the Defendant Republic of Korea merely claims against the National Treasury of the Medical Care Fund. Of the instant lawsuit, the part of the claim against the Defendant Republic of Korea against an unqualified person is an illegal lawsuit against the unqualified person. However, as seen earlier, in the performance lawsuit as seen earlier, the person alleged by the Plaintiff as an obligor has the standing to be the Defendant (see Supreme Court Decision 95Da18451, Nov. 28, 1995). The above assertion by the Defendant Republic of Korea is without merit

B. Determination on the cause of the claim

The plaintiff asserts that since the disposition to recover unfair medical care benefit costs by defendant Corporation is invalid, the joint management authority of the Medical Care Fund shall jointly and severally return the amount equivalent to the medical care benefit cost recovered to the plaintiff as unjust enrichment.

On the other hand, as seen earlier, the management entity of the Medical Benefits Fund is Defendant Busan City and Defendant Republic of Korea is merely a person who has contributed to the National Treasury subsidy, and thus, it does not belong to Defendant Republic of Korea since such profit has accrued from the Medical Benefits Fund. Thus, Plaintiff’s claim against Defendant Republic of Korea is without merit without further review.

5. Conclusion

Thus, the plaintiff's claim against the defendant Busan City is justified, and the claim against the defendant Corporation is accepted within the extent of the above recognition. The remaining claim against the defendant Corporation and the claim against the defendant Republic of Korea are dismissed as it is without merit.

[Attachment Form 5]

Judges Jeon Ho-ho (Presiding Judge) (Presiding Judge), Park Jae-hee

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