부당이득반환
1. The plaintiff's claim is dismissed.
2. The costs of lawsuit shall be borne by the Plaintiff.
1. Basic facts
A. The Plaintiff is a doctor who operates “C et al.” in Sungnam-si, Sungnam-si, which is located in Sungnam-si B.
When the defendant, as an insurer of health insurance, examines the claim for the medical care benefit costs of the medical care institution that is a medical supplier, and notifies the medical care institution and the defendant of the amount paid, the health care benefit costs shall be paid to the medical care institution in accordance with such notification.
B. On September 29, 2014, the Plaintiff’s medical care benefit cost redemption period redemption notice date of the Defendant’s decision on restitution of the medical care benefit cost and the Defendant’s decision, revealed that: (a) the Plaintiff’s medical care benefit cost redemption notice was issued from January 2009 to June 709, 201; and (b) the amount of redemption notice from March 18, 2011 to March 198, 2012, KRW 172,920, and KRW 11,636,430 on April 6, 2012, each of the instant medical care benefit benefit cost redemption notice was given from May 201 to December 13, 203, 310 to March 2012, the Plaintiff received from Defendant 209 “the Privacy Act” or “the Privacy Medical Care Benefit restitution notice” (hereinafter “the instant medical care benefit cost reimbursement notice”).
C. The Plaintiff’s objection and its progress against the Defendant on December 24, 2014
9. The objection filed on February 26, 2015 seeking revocation of the restitution disposition was dismissed.
Accordingly, the plaintiff did not go through the appeal procedure such as filing a petition or administrative litigation against the Health Insurance Dispute Mediation Committee.
On December 3, 2014, the defendant's reexamination disposition is conducted on December 3, 2014. On the other hand, the appellate court recognized the plaintiff's fraudulent claims for medical care benefit costs and notified the Ministry of Health and Welfare.