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(영문) 대구지방법원 서부지원 2015.11.05 2015고단1472

사기

Text

Defendant shall be punished by a fine of KRW 8,000,000.

When the defendant does not pay the above fine, 100,000 won.

Reasons

Punishment of the crime

The Defendant is a person who, from December 8, 2001, operates a hospital with the trade name of “in-A” in Daegu-gu, Seogu.

1. From August 13, 2010 to December 20, 2010, the Defendant provided “A” with simple treatment for the weighting weighting for the benefit of non-benefit under the National Health Insurance Act, as if the Defendant provided treatment to “A due to symptoms such as an unidentified disease, etc., the staff in charge of the Health Insurance Review and Assessment Service, through the staff in charge of the Health Insurance Review and Assessment Service, claiming for a false claim of KRW 31,770 of the health care benefit under the name of medical expenses for the victim C, and around that time, he received the same amount from the above Corporation from June 1, 2009 to December 20, 2010, and received a total of KRW 20,667,835 won from the victim for a total of 1,636 times, as shown in attached Table 1

2. On May 30, 2012, the Defendant received KRW 9,752,719, total sum of KRW 1,169,00 from the victim from June 1, 2009 to May 30, 2012, as shown in attached Table 2, as if he/she provided medical treatment due to symptoms, such as reduction of the amount, etc., to the National Health Insurance Corporation through an employee in charge of the Health Insurance Review and Assessment Service, claiming for medical care benefits of KRW 9,090 under the pretext of medical expenses for the victim, and around that time, he/she received a false claim from the said Corporation for the medical expenses for the victim.

3. On June 18, 2009, the Defendant provided treatment to E, who is a beneficiary of medical benefits, as if he/she provided treatment for simple non-benefits only for physical exposure under the National Health Insurance Act, due to symptoms such as unknown liver diseases, etc., the Defendant, via the staff-in-charge of the Health Insurance Review and Assessment Service, filed a false claim of KRW 49,360 for medical benefits under the name of medical expenses for the victim’s competent authorities, and around that time, received the equivalent amount from the victim from the victim, and from that time until December 17, 2010, as shown in attached Table 3.