2. Determination

A. The legal doctrine refers to the treatment under the observation and management of a medical staff while staying in a hospital for more than six hours in accordance with the following provisions: (a) where continuous observation of a medical staff is necessary with respect to side effects or incidental effects of the patient’s disease, where the treatment of medication and food is needed; (b) where the patient’s pains are in a situation where the patient’s condition is unable to cope with pain or where the patient’s risk of infection exists; and (c) where the patient resides in the hospital and receives treatment; and (d) where the patient lives in the hospital for more than six hours pursuant to the aforementioned provisions, such as “detaileds on the criteria and methods for the application of the medical care benefits,” which is the notice of the Ministry of Health and Welfare, the patient’s stay in the hospital and the patient’s symptoms, diagnosis and treatment procedures, and the patient’s actions, etc., as well as where the treatment is not the substance of the hospital treatment.

The act of claiming insurance money by asserting that the insurance company met the hospitalization period stipulated in the terms and conditions of the insurance contract without notifying the case of a long-term hospitalization more than necessary to mislead the insurance company, constitutes deception in fraud (see Supreme Court Decision 2004Do6557, Jan. 12, 2006). (b) Comprehensively taking into account the following circumstances acknowledged by the evidence duly investigated and adopted in the court below’s specific determination, the Defendants do not actually need to be hospitalized even if there is no need to do so.