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(영문) 인천지방법원 2015.07.10 2014노3337

사기

Text

The defendant's appeal is dismissed.

Reasons

1. The summary of the grounds for appeal is that the Defendant was engaged in going out or going out while being hospitalized in order to care for crynas, and that the Defendant received normal hospitalization treatment, and thus, did not acquire insurance money.

2. Determination

A. The court below's determination 1) "Hospitalization" means that a patient resides in a hospital for more than 6 hours and under the observation and management of a medical team while staying there is no determination of hospitalization based on the patient's sojourn time. It should be determined by taking into account the symptoms, diagnosis and treatment details, patient's behavior, etc. Even if there are grounds for payment of insurance proceeds, if the patient receives excessive insurance proceeds through long-term hospitalization with the intention of receiving insurance proceeds more than the insurance proceeds that can be actually paid, fraud is established against the whole insurance proceeds received (see Supreme Court Decision 2008Do465, May 28, 2009). In light of the above legal principles, the court of the court below prepared the case in question; ① whether the defendant's cell phone calls were lawfully adopted and investigated; ② whether the defendant's appearance or treatment was conducted on the 14th day during the measure period; ② whether the defendant's treatment treatment was conducted on the outside, and ③ whether the above patient's treatment was conducted on the outside.