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(영문) 대전지방법원 2015.07.10 2015고단1058

사기

Text

A defendant shall be punished by imprisonment for one year.

except that the execution of the above punishment shall be suspended for two years from the date this judgment becomes final and conclusive.

Reasons

Punishment of the crime

The Defendant is a person operating the “F Elderly Welfare Center” in Seo-gu, Daejeon, and the aforementioned “F Elderly Welfare Center” was designated as a long-term care institution on December 16, 2009 under the Act on Long-Term Care Insurance for the Aged.

Where a long-term care institution provides long-term care benefits to beneficiaries, it may claim expenses for long-term care benefits to the National Health Insurance Corporation. The National Health Insurance Corporation determines expenses for long-term care benefits by comparing the number of beneficiaries by occupation and the number of actual beneficiaries, and thus, the institution is obligated to claim expenses for long-term care benefits by accurately indicating the number of beneficiaries who actually provided long-term care benefits

Nevertheless, while operating the aforementioned “F Elderly Welfare Center,” the Defendant falsely reported the number of persons who actually provided benefits to the National Health Insurance Corporation, and claimed expenses for long-term care benefits from the victim to receive excessive expenses for long-term care benefits.

1. On July 5, 2010, the Defendant, based on the claim for additional placement of human resources, filed a claim for the cost of long-term care benefits as if he/she reported that the aforementioned welfare center provided medical care benefits to the employees in charge of the victims of the National Health Insurance Corporation in June 2010 and that the two caregivers were seven care workers and claimed for the cost of additional placement of human resources.

However, since the number of medical care workers is required based on the number of beneficiaries, the number of medical care workers was six, and the number of medical care workers was actually provided, and the number of medical care workers and the number of medical care workers was consistent with the above criteria, it did not constitute a case where the expenses for long-term care benefits added by the victim due to additional placement of medical care workers and caregivers are not payable.

As such, the Defendant, by deceiving the victim and deceiving him/her, shall bear expenses for long-term care benefits on July 23, 2010 from the victim.