Expenses for appeal shall be borne by the plaintiff.

The purport of the claim and the purport of the appeal are the judgment of the first instance.

A. The Plaintiff entered into a D insurance contract with the Defendant’s mother C and the insured with the content that the Plaintiff would pay insurance proceeds under the pretext of hospitalization expenses, medical expenses for hospitalization, etc. (hereinafter “instant insurance contract”).

B. From December 24, 2011 to January 6, 2012, the Defendant received hospital treatment for 14 days from Hanwon, for 1,825,180 won in total, according to the instant insurance contract.

(c)

On April 30, 2019, the defendant is aware of the suspected criminal fact that he/she was hospitalized for 14 days without necessity for hospitalized treatment and acquired insurance proceeds equivalent to KRW 1,825,180 for 14 days, but is the first offense, and the Health Insurance Review Evaluation Institute was the number of days of normal hospitalized treatment.

In this paper, the amount of fraud is minor, the criminal intention is weak, and the number of hospitalization days is relatively short.

[Grounds for Recognition] Unsatisfy, entry in Gap evidence 1 to 6 (including branch numbers), the purport of the whole pleadings

2. The assertion and judgment

A. The gist of the Plaintiff’s assertion is to return 88,077 won, which was received in excess of the insurance amount payable on the basis of the number of days of proper hospitalization, given that the Defendant received false hospitalized treatment for the purpose of receiving the insurance money, without requiring hospitalized treatment.

B. We examine the judgment: ① the doctor in charge who examined the patient’s health condition rather than simply the patient’s request, determined the necessity of the hospitalized treatment; the defendant also received hospitalized treatment according to the decision of the doctor in charge; ② the Health Insurance Review Evaluation Institute recognized the necessity or reasonableness of the hospitalized treatment only for part of the days during which the defendant was hospitalized.

However, this does not observe the defendant based on the records of medical treatment after the fact.