beta
(영문) 부산지방법원 2020.11.03 2018가단305297

구상금

Text

1. The plaintiff's claim is dismissed.

2. The costs of lawsuit shall be borne by the Plaintiff.

Reasons

1. Basic facts

A. On December 7, 2010, the Defendant concluded a C contract with the Plaintiff to compensate for losses sustained by receiving hospitalized treatment due to a disease or injury that occurred during the insurance period (hereinafter “instant insurance contract”).

B. In collusion with G et al., the president of the E Hospital located in Simsi D, F, who is the operator of the said hospital. The fact was found to have not been prescribed and treated as the number of times indicated in the medical records, etc., while the patient, in collusion with H et al., did not prescribe and have received treatment for high-frequency therapy, cellate medicine therapy, etc.; even if there was no fact that the medical expenses received from the E hospital as stated in the receipt for medical expenses, the medical expenses received from the E hospital were provided to H to claim for the actual losses of the affected insurance company and received the money from H to October 18, 2012, from July 19, 2016, the judgment of the district court became final and conclusive on May 21, 2018, which became final and conclusive on the charge of fraud, such as fraud, by receiving the money in the name of the patients, including the Plaintiff, from the damaged insurance company.

C. The Defendant received KRW 91,302,870,000 from the Plaintiff during the period from February 25, 2013 to May 11, 2016, after receiving hospitalized treatment from E Hospital as Gap’s cancer, workplace cancer, etc.

[Reasons for Recognition] Facts without dispute, Gap 1, 2, 13, 19 through 21, each entry, and the purport of the whole pleadings

2. The defendant alleged the plaintiff's assertion is the side of the hospital in spite of the fact that there was no prescription and treatment from the hospital as stated in the medical records, the detailed statement of medical expenses, and the receipt of medical expenses in the case of non-benefit items.

참조조문