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(영문) 인천지방법원 2016.03.18 2013가합20775

미지급자동차보험진료비

Text

1.(a)

Defendant Music Damage Insurance Co., Ltd. shall be 969,040 won to Plaintiff A, 286,030 won to Plaintiff B, and 346.

Reasons

1. Facts of recognition;

A. The Plaintiffs, when operating a medical institution under the name of the medical institution as indicated in the separate sheet with the medical doctor in each address, requested the victims of traffic accidents caused by the vehicle that entered into the comprehensive automobile insurance contract with an insurance company, to conduct a CT and MIM test (hereinafter “CT and MIM test”), notified the Defendants, etc., and confirmed the intent to guarantee the payment, and received insurance money equivalent to the cost of video photographing test from the insurance company, etc. in accordance with the standards for calculating medical fees set forth in the Guarantee of Automobile Accident Compensation Act (hereinafter “Act”).

Accordingly, motor vehicle insurance medical fees are subject to the health insurance benefit act and relative value point notified by the Minister of Health and Welfare under Article 2 (1) of the National Health Insurance Act and Article 24 of the Enforcement Decree of the same Act.

B. On the other hand, on April 6, 2011, the Minister of Health, Welfare and Family Affairs publicly announced the revision of the list of health insurance benefit costs and of benefit points, which contain the contents of reducing 15% of the relative point value of CT by 2011-43, 30% of the relative point value of MRI, and 16% of the relative point value of PE.

(2) The Defendants were paid each amount of insurance money corresponding to the cost of video photographing as shown in the corresponding column as stated in the separate sheet between May 1, 201 and October 21, 2011, according to the following: (a) the Plaintiff was aware of the instant announcement and the previous announcement; and (b) the Plaintiffs were paid each amount of insurance money corresponding to the cost of video photographing as stated in the separate sheet.

C. However, in the case of Seoul Administrative Court 201Guhap13125 on October 21, 2011, Article 10(1) of the Mediation Standards, except where “the Minister of Health and Welfare adjusts ex officio the relative value by delegation of the National Health Insurance Act, medical care benefit standards, etc. (i.e., the proviso to Article 10(1) of the Adjustment Standards, and the case where the maximum amount of the materials for medical treatment is linked to the exchange rate).