요양불승인처분취소
2016Gudan10153 Revocation of Disposition of Non-approval for Medical Care
Jeonn 00
Law Firm Multi-rate, Counsel for the defendant-appellant
Attorney Lee In-bok
Korea Labor Welfare Corporation
Litigation Performers;
June 28, 2016
July 12, 2016
1. The plaintiff's claim is dismissed.
2. The costs of lawsuit shall be borne by the Plaintiff.
The Defendant’s disposition of refusal to grant medical care to the Plaintiff on January 21, 2016 is revoked.
1. Details of the disposition;
On October 4, 2015, at around 09:10 on October 4, 2015, the Plaintiff participated in the 4-time open port promotional conference (hereinafter referred to as the “instant competition”) held at the 4-time indoor gymnasium located in Chang-si, Chang-si, Changwon-si, and led to a lusium on the lusium (hereinafter referred to as the “the instant disaster”).
On January 7, 2016, the Plaintiff filed a medical care benefit application with the Defendant for the injury and disease above, asserting that the Defendant was suffering from the injury and disease of the post-sign escape certificate No. 4-5 in the year due to the instant disaster. On January 21, 2016, the Defendant rendered a disposition of non-approval of the Plaintiff’s application for medical care benefits (hereinafter “instant disposition”) on the ground that the instant games were not in the status of being controlled or managed by the employer, and thus, the instant disaster does not constitute occupational accidents.
[Grounds for recognition] Gap evidence Nos. 1, 2, 3, 12, 13, and 14, and the purport of the whole pleadings;
A. The plaintiff's assertion
The instant accident constitutes occupational accidents under Article 30 of the Enforcement Decree of the Industrial Accident Compensation Insurance Act, which occurred after the Plaintiff participated in the table competitions held regularly each year under the approval of the business owner and subsidization of expenses. Thus, the instant disposition taken by deeming otherwise unlawful.
B. Relevant statutes
Article 37 of the Industrial Accident Compensation Insurance Act (Standards for Recognition of Occupational Accidents)
(1) If an employee suffers an injury, disease, or disability or dies due to any of the following causes, it shall be deemed an occupational accident: Provided, That this shall not apply where there is no proximate causal relation between his/her duties and accident:
1. An accident on duty:
(d) An accident under the supervision of the business owner or during preparation for an event or event in compliance with the direction of the business owner;
(3) Specific criteria for recognition of occupational accidents shall be prescribed by Presidential Decree.
Where a worker's participation in various events (hereinafter referred to as "exercises"), such as sports games, camping clubs, and mountain competitions, etc. under Article 30 (1) 1 (d) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act, is deemed necessary for labor management or business operation by social norms, and where any of the following events occurs, an accident that occurs by a worker who participates in such events (including exercises for preparation for such events) shall be deemed an accident on duty under Article 37 (1) 1 (d)
1. Where the employer recognizes hours spent by the worker participating in the event as hours worked;
2. Where the employer instructs the worker to participate in the event;
3. Where he participates in an event with the prior approval of the employer;
4. Other cases equivalent to subparagraphs 1 through 3 where the employer has usually recognized the worker's participation in the event.
C. Officers and employees have autonomously formed the club and registered the club, the club was supported with operating expenses, participation expenses, etc. of the club. Among them, the amount determined on the basis of the number of members of the club was paid every half year. The participation expenses for the club was paid to the participating members within the limit of twice a year when the member of the club participated in the competition of a certain size (the participation expenses for the club was paid when the participating members notified the creative factory of a plan to participate in the club and applied for the subsidization of the participation expenses and approved the creative plant).
The plaintiff worked as a member of the Changwon Factory's quality control team processing division of the Changwon Factory and worked in the form of the first class system per week.
The instant competition was held at the Chang-gu A Elementary School and the Indoor Sports Center located in Jinwon-si, Jinwon-si, Chang-si, which was held on October 3, 2015 ( Saturdays) and on October 4, 2015 ( Sundays) by the Chang-gu Sports Association organized by the Chang-gu Sports Association of Korea for the purpose of expanding the base of the members, etc. Of the members of the Chang-dong Factory, seven persons including the Plaintiff, etc., from among the members of the Chang-dong Factory, participated in the instant competition after voluntarily determining the participation of the instant competition and notifying the Chang-gu factory of the plan to participate in the instant competition and obtaining the approval of the Chang-gu Factory. The Plaintiff, etc., participated in the instant competition and received the settlement and payment of the participation expenses from the Chang-gu Factory after participating in the instant competition. The time was not recognized as working hours of the Chang-gu.
[Ground of recognition] The entry of Gap evidence Nos. 4 through 12, the inquiry result of the fact-finding into two automobile corporations in this court, the purport of the whole pleadings
D. Determination
If a worker suffers from an accident while participating in an event or a meeting, other than a company, which is not prescribed as an ordinary duty under a labor contract, and is not prescribed as an occupational duty, the overall process of the event or meeting is required to be controlled or managed by the employer in light of the circumstances such as the organizer, purpose, contents, number of participants, forcedness, methods of operation, burden of expenses, etc. of the event or meeting (see, e.g., Supreme Court Decisions 92Nu1107, Oct. 9, 1992; 2006Du19150, Mar. 29, 2007).
However, in full view of the following circumstances that can be seen by the above facts, i.e., the instant competition was held for the purpose of expanding the base of the persons who participated in the instant competition with other members of the Changwon Factory and the Changwon Factory, and the time during which the Plaintiff participated in the instant competition was not particularly recognized as working hours, and the approval of the Changwon Factory related to the participation in the instant competition appears to be approved not to allow the Plaintiff, etc. to directly participate in the instant competition on the day of holidays, but to recognize the subsidization of the expenses for participation in the competition. Even if the Plaintiff received the subsidization of the expenses for participation in the instant competition from the Changwon Factory related to the participation in the instant competition, it cannot be deemed that the instant competition was in the status of being controlled or managed by the employer as necessary for labor management or business operation by social norms. Thus, the instant accident cannot be deemed as an occupational accident.
Therefore, the instant disposition that deemed that the instant accident does not constitute an occupational accident is lawful.
3. Conclusion
The plaintiff's claim is dismissed as it is without merit. It is so decided as per Disposition.
Judges Jeong Sung-sung