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(영문) 대전지방법원 2018.09.19 2018구합106

장기요양급여비용 환수처분 취소

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1. The plaintiff's claim is dismissed.

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

Reasons

Details of the disposition

From April 19, 2016, the Plaintiff established and operated the “C Care Center” (hereinafter “instant medical care institution”) designated as a long-term care institution in Daejeon Pream-gu B.

From April 3, 2017 to April 6, 2017, the Defendant and the head of Si/Gun/Gu conducted on-site investigations with respect to the instant medical care institution by setting the investigation period from September 3, 2016 to February 2017.

On June 16, 2017, the Defendant issued a disposition to recover expenses for long-term care benefits pursuant to Article 43 of the Long-Term Care Insurance Act on the ground that “(i) the cost of long-term care benefits is calculated and claimed to reduce the cost of long-term care benefits if the Plaintiff did not subscribe to the liability insurance for professionals; (ii) the Defendant received the cost of long-term care benefits by unfairly claiming and paying the cost of long-term care benefits without calculating the cost of long-term care benefits from May 12, 2016 to February 28, 2017; and (iii) the Defendant reported that the caregiver worked for 16 hours in October 2016 and received the cost of long-term care benefits by unfairly claiming and claiming the cost of long-term care benefits.”

(hereinafter “instant disposition”). On September 1, 2017, the Plaintiff filed a request for review with the Long-Term Care Adjudication Committee under the Ministry of Health and Welfare, but the said Committee dismissed the Plaintiff’s request for review on December 27, 2017.

[Based on the fact that there is no dispute, Gap's statements in Gap's evidence 1 through 3, 6, and 7, and the purport of the entire argument as to the legitimacy of the disposition of this case, the plaintiff's assertion that the plaintiff subscribed to business liability insurance in accordance with the direction of insurance solicitors Samsung Fire and Marine Insurance Co., Ltd., and the defendant did not notify or provide education about professional liability insurance. The plaintiff subscribed to business liability insurance and entered the above insurance policy number in the Internet website each time it claims expenses for long-term care benefits through the Internet site, and the plaintiff was treated normally.