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(영문) 의정부지방법원 2020.02.07 2018노2475

사기

Text

The defendant's appeal is dismissed.

Reasons

1. The summary of the grounds for appeal did not claim insurance money with a false receipt, and the person who purchased an indemnity insurance prior to October 2009 may claim insurance money based on the medical expenses, medical expenses, hospital expenses, etc. set at a hospital before the discount is set by the hospital;

Therefore, the defendant did not deceiving the damaged insurance company, nor did he had the intention to commit fraud.

2. The following facts and circumstances found by the evidence duly adopted and examined by the court below along with the circumstances duly explained by the court below, i.e., compensation for the difference between hospital room expenses, hospital treatment expenses, operation expenses, and higher hospital room expenses (Difference between hospital room and standard hospital room). Here, the court below determined that the total amount of hospital room expenses, hospital treatment expenses, and surgery expenses (i.e., the total amount of patient's charges or non-paid medical expenses among the medical care benefits prescribed by the National Health Insurance Act) borne by the insured under the National Health Insurance Act, and the higher hospital room expenses (i.e., the total amount of patient's charges or non-paid medical expenses), and the difference between the higher hospital room expenses. ② No provision was found to the effect that the insurance money should be paid on the basis of the discount amount if the defendant arbitrarily discounted hospital expenses at a medical institution to which the defendant was admitted, and in light of the purport of the non-life insurance system, it is difficult to view that the insurance money should be paid on the basis of the amount before discount, barring special circumstances.

2.3.