A defendant shall be punished by imprisonment for one year.

The thirty-three days of detention days before a judgment of the court below is rendered shall be included in the above sentence.

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

To order the defendant to provide community service for 80 hours.

A. misunderstanding of facts or misunderstanding of legal principles

(1) As to the part of the lower judgment’s crime 1 fraud

The result of the review by the Review and Assessment Service, which is evidence of the fact that the instant patients, including Nonindicted Party 1 (the Nonindicted Party in the judgment of the Supreme Court), had no need to be hospitalized, cannot be identified as the originators. However, it is difficult to believe that the Defendant conducted an examination on the patients and did not reflect the medical record discovered by the need to be hospitalized.

In addition, even if the defendant was hospitalized to the patient of this case, he did not encourage the patient of this case to provide convenience such as hospital treatment, and the defendant does not have all the decision of hospitalization and treatment for the patient of this case. Thus, the defendant cannot be held liable for the details of hospitalization without the defendant's participation.

In addition, on April 27, 2005, the National Health Insurance Corporation provided a notice of recovery only to KRW 38,696,960 out of KRW 63,512,610, for which the defendant requested a retrial among the health care benefit costs for reexamination on April 27, 2005, since at least the remaining amount of KRW 24,815,650, which has not been recovered, should be excluded from the amount of damage caused

(2) As to the crime of aiding and abetting fraud in the judgment below

In the facts charged of aiding and abetting, the place and method of the principal offender's practice should be specified, but this part of the facts charged does not meet the above requirements.

In addition, the Defendant hospitalized only 20,000 patients during the pertinent criminal facts, and there is no evidence to deem that the Defendant was aware of the status of insurance coverage or the claim for insurance proceeds of the instant patients (in addition, the Defendant issued a written diagnosis to block the abuse of insurance fraud and stated that “this written diagnosis should not be referred to as “the payment of insurance money,” while the Defendant issued the written diagnosis in order to prevent the possibility of abuse of insurance fraud), and the intention was merely issued a written confirmation of hospitalization in accordance with his/her duty when the patient wishes.

In addition, it is difficult to believe that the determination on whether there was a necessity of hospitalization for each patient of this case during the period of locking is that only the doctor who directly treated the patient can be aware of the necessity of hospitalization for 3 days or 5 days as stated in the judgment of the court below. Moreover, even if following the criminal facts in the judgment of the court below, it is inconsistent with the judgment of the court below that the whole medical treatment cost should be excluded from the amount of defraudation, even though the hospitalization cost for the part

(3) As to the facts constituting the crime of the court below

The Defendant did not instruct the employees to demand excessive medical expenses, and the part of the Defendant’s excessive claim is merely an error of the employees, considering the amount of the medical expenses or the details of the claim.

The judgment of the court below which found all of the charges of this case guilty is erroneous in the misapprehension of legal principles or mistake of facts.

B. Unreasonable sentencing

Considering the fact that the Defendant was faced with excessive treatment by deceiving the fake patient of this case where he intends to obtain insurance money, the amount of profit actually earned by the Defendant is smaller than the amount stated in the judgment of the court below, the Defendant was divided into his mistake in depth, and the victims’ damage was not recovered and did not wish to be punished, the sentence of the court below (one year and six months of imprisonment and three years of suspended execution) is too unreasonable.

2. Ex officio determination

Prior to the judgment on the defendant's assertion, according to the investigation report of April 28, 2008 prepared by Non-Indicted 2, which was submitted at the trial court, the defendant was sentenced to imprisonment of one year, three years of suspended execution, and fine of 15 million won at the Suwon District Court on January 28, 2005 due to the violation of the Act on the Aggravated Punishment, etc. of Specific Economic Crimes (Embezzlement), etc., and the above judgment becomes final and conclusive on July 26, 2007. Thus, the crime of embezzlement, etc. for which judgment becomes final and conclusive and the crime of fraud of this case are concurrent crimes under the latter part of Article 37 of the Criminal Act. In such a case, the judgment of the court below should be determined after examining whether to reduce or exempt the sentence in consideration of equity and the case of judgment at the same time pursuant to Article 39 (1) of the Criminal Act. Thus, the judgment of the court below can no longer be maintained in this respect.

Therefore, the judgment of the court below is reversed ex officio prior to the judgment on the grounds for appeal by the defendant, and it is again decided as follows (the judgment on the grounds for appeal is delivered after the reversal of the judgment below).

Articles 347(1) and 32(1) of the Criminal Act

1. Aid and mitigation;

Articles 32(2) and 55(1)3 of the Criminal Act

1. Handling concurrent crimes;

The latter part of Article 37 and Article 39(1) of the Criminal Act

1. Aggravation for concurrent crimes;

Article 37 former part of Article 37, Article 38 (1) 2, and Article 50 of the Criminal Act (Aggravation of Concurrent Crimes with Punishment and Punishment provided for in Fraud against the National Health Insurance Corporation with the most severe punishment)

1. Inclusion of days of detention in detention;

Article 57 of the Criminal Act

1. Suspension of execution;

Article 62(1) of the Criminal Act

1. Social service order;

Article 62-2 of the Criminal Act, Article 59 of the Act on Probation, etc.

A. Concept of hospitalization and criteria for determining the necessity of hospitalization

In a case where continuous observation by a medical personnel is required with respect to side effects or incidental effects of a patient's disease which are very low resistance ability or that of a medication, in a case where the continuous control is required for medication and food consumption, it is necessary to continuously administer drugs, treatment, etc. and thus, the patient's pains rather inconvenience in treating the patient, such as where the patient's condition is in a situation where the patient's condition is unable to cope with the pain or where the patient's risk of infection exists, etc., and where the patient is staying in the hospital, it means receiving treatment under the observation and management of the medical personnel while the patient stays in the hospital for more than six hours pursuant to all the provisions such as "detailed matters on the criteria and method for the application of medical care benefits" as a notice of the Ministry of Health and Welfare. However, it is not possible to determine whether the patient is hospitalized based only on the patient's symptoms, diagnosis and treatment procedure, and the patient's behavior (see Supreme Court Decision 2004Do6557, Jan. 12, 2006).

Therefore, even if a patient took the form of receiving treatment by being assigned a fixed hospital after undergoing the procedure for hospitalization, and had been staying in a hospital for more than 6 hours, determination of whether the patient was actually hospitalized for a long time beyond the scope should be made by comprehensively taking account of the time of actual treatment, the details and purpose of treatment, the patient’s behavior, etc.

(b) Fact of recognition;

According to the evidence duly adopted and examined by the court below and the statements of Non-Indicted 3 and Non-Indicted 4, the following facts are recognized:

(1) Medical treatment systems such as determination of admission and discharge of ○ Hospital

(A) ○○ Hospital is a quasi-general hospital with 300 sickbeds or less, including internal medicine, general surgery, and regular surgery, etc., and the Defendant is the head of the hospital and the medical corporation of the above hospital, the president of the Balba Medical Foundation, and there are 80 nurses and 20 employees, including 80 nurses.

(B) The Defendant, the president of the board of directors, received daily reports on the current status of patients released from the hospital and the current status of outpatients, and received reports on the details of the hospital entrance and departure from the hospital, and has overall control over all other tasks.

(C) In the case of a traffic accident or internal patient, the Defendant first identified the patient's symptoms, before the medical specialist in charge, and the decision of whether to admit the patient was a criminal defendant, not a doctor, but a criminal defendant. In addition, when the in-patient is discharged from the hospital, the discharge measure was taken upon confirmation by the chief director of the medical examination and receipt after obtaining approval from the chief director.

(D) In the event that Nonindicted 10’s nursing division, etc. wanting to discharge a patient, if Nonindicted 10’s nursing division, etc. were to be hospitalized and discharged thereafter, the above nursing division, etc., when obtaining approval from the Defendant, when the above nursing division, etc. put the Defendant into the settlement to the Defendant, the above nursing division, etc., and when the Defendant did not harm the discharge, the patient and the Defendant were wurged, and the patient was released from the hospital to his own discretion without any

(E) In fact, the Defendant recommended Nonindicted 1, 5, 7, 8, 9, 11, 12, 13, 14, 15, 16, and 17, etc. to discharge Nonindicted 1, 5, 7, 8, 9, 11, 12, 13, 15, 15, 16, and 17, etc., that “at any time, at any time, the Defendant would go to go to the house,” and that “the Defendant would be obliged to pay hospital expenses if the Defendant was hospitalized, and the hospital expenses will be reduced if the Defendant was hospitalized.”

(F) Nonindicted 18, etc., who was a medical specialist together with the Defendant, was first diagnosed and treated by the Defendant with the patient who had no big problem in the final diagnosis or treatment. However, even though the symptoms are insignificant, Nonindicted 18 entered the patient who was a long-term hospitalized patient only as “repeat” in a way that the Defendant should enter the patient’s symptoms, prescription, etc. at each time, and repeatedly entered the patient’s symptoms and prescription.

(G) The so-called “○○ Hospital” was openly spreaded in the vicinity, and its employees or nurses inside the hospital also knew that there are patients with long-term hospitalization in order to buy insurance and receive insurance proceeds, such as the instant patients, and thus, the patients are called “individual insurance patient” or “the chief organ patient,” etc., and the patients were neglected to be able to be able to check each day, and did not properly control their outing.

(H) Meanwhile, in ○○ Hospital, the method of claiming medical care benefit expenses to the National Insurance Corporation, when the Defendant decided to discharge the hospitalized patient, the Defendant claimed the remainder of the medical care benefits expenses to the National Health Insurance Corporation except for the principal’s charges. However, when the period of hospitalization exceeds 15 days, the amount of the benefits would have been reduced by 15 days, and thus, the Defendant demanded re-hospitalize the hospitalized patient after discharge.

(i) In addition, the procedure for issuing a medical certificate or a written confirmation of hospitalization was conducted in a way that the patient interviews the defendant by delivering a written confirmation of hospitalization to the nurse or staff member upon request of the patient to the nurse, etc., and the patient issued the written confirmation of hospitalization to the defendant, and then the defendant instructs the patient to issue the written confirmation of hospitalization by using a computer in the original department or by oral statement. During the process, the medical certificate was issued to the hospital’s official seal and the defendant’s seal affixed to the patient. During the process, the patient’s request for the issuance of the written confirmation to the patient to the patient who was in custody by direct issuance or demand of the defendant.

(2) The symptoms, diagnosis, and treatment of each of the instant patients and the details of hospitalization at ○○ Hospital

(A) In the case of Nonindicted Party 1

Nonindicted Party 1 initially visited Samsung ○○ Hospital from 0 to 19 on the ground of Non-Party 1’s recommendation. Nonindicted Party 1: (a) was hospitalized from 10 on July 16, 202 to 202; (b) was hospitalized in 200 on her chest X-how; and (c) was not indicated in the result of examination to support diagnosis such as normal temperature from the time of hospitalization; and (d) was hospitalized in 200 to 10 on August 22, 202 by 19 on the following day; (c) was hospitalized in 20 on the 20th day after the date of hospitalization; and (d) was hospitalized in 20 on the 19th day after the date of hospitalization; and (e) was hospitalized in 20 on the 1st day after the date of 20th day after the 1st day after the 20th day after the 20th day after the 1st day after the 20th day after the 20th day after the 20th day of hospitalization.

(B) In the case of Nonindicted 20

① From February 1, 2001 to March 12, 200, Nonindicted Party 2 was hospitalized with 4 poppy disorder, kidney disorder, alphar growth infection, and chronic infection. However, due to disturbance, the stability of mind was sought and hospitalized, the nephal stability was administered, the treatment was conducted, and the lephical and commercial house was frequently released to the outside. ② From August 17, 201 to September 20, the 200 were hospitalized with chronic coppy, blood cycle disorder, and high blood pressure was not conducted by the 20th copic disease, and the 2nd 3rd copic disease was not conducted at the Defendant’s request, and the 2nd 3rd copic disease was not conducted, and the 3rd 4th copic disease was not conducted at the 0th scopic disease on the 2nd scopic disease, and the 2nd 3th scopic disease was not observed.

(C) In the case of Nonindicted 5

① 2001. 7. 18.부터 같은 해 9. 1.까지 46일간 ○○병원에 혈액순환장애 및 신장기능장애, 신경쇠약 등의 이유로 입원하였다고 하나, 2001. 7. 19. 흉부 CT 촬영 결과는 정상이었고, 신장기능의 이상 여부를 판단하기 위한 Bun/Cr 검사 수치도 정상 범위 이내였으며, 소변검사 결과도 정상이었다. 간호기록지에는 “ 공소외 5가 2001. 8. 20. 11:00 걸어서 퇴원하였다”라고 기재되어 있으나, 다시 “ 공소외 5가 2001. 8. 20. 12:00 금일 퇴원 후 전신 허약감 및 현기증 증상 있어 내과 외래 통해 입원하였다”라고 기재되어 있다. ② 2002. 6. 28.부터 같은 해 7. 29.까지 위 병원에 뇌순환장애 및 위염 등의 이유로 32일간 입원하였다고 하나, 2002. 6. 28. 촬영한 두부 MRI 결과 우측 하악동염(구강과 비강위 사이의 비염) 외에는 특이사항이 없는 것으로 나타났고 위염에 대해서도 위 내시경 검사 등의 정밀검사가 시행된 바가 없고, 진료기록상에도 피고인으로부터 관련 증상 호소가 있었다는 내용의 어떠한 기재도 없다. ③ 2002. 8. 5.부터 같은 달 26.까지 위 병원에 뇌순환장애 및 만성두통, 신경쇠약증, 만성위염 등의 이유로 22일간 입원하였다고 하나, 역시 위 기간 동안 혈압, 맥박, 체온 등 활력징후가 거의 기재되어 있지 아니하고, 물리치료만 12회 받은 것으로 기재되어 있다. 한편 ○○병원에서는 물리치료를 시행하는 경우 물리치료대장에 환자의 성명, 성별, 시행횟수, 치료부위 등을 기재하여 왔는데, 그 중 2003. 1. 1.부터 2005. 1. 6.경까지의 물리치료대장을 모두 폐기하였다. ④ 2002. 10. 22.부터 같은 해 11. 12.까지 급성요부염좌 및 요배부좌상 등의 이유로 22일간 입원하였다고 하나, 요추 X-선 촬영 판독 결과가 없고, 물리치료만 19회 받은 것으로 기재되어 있고 심사평가원에 제출한 자료의 병명과 진단서에 기재된 위 병명이 상이하다. ⑤ 2003. 1. 23.부터 같은 해 2. 25.까지 위 병원에 뇌순환장애 및 만성두통, 신경쇠약, 만성위염 등의 이유로 34일간 입원하였다고 하나, 2003. 1. 27. 두부 MRI 검사 결과는 정상이었고, 위 내시경 결과도 경미한 초기 위궤양이 있는 것으로 나타났다. ⑥ 2003. 3. 14.부터 같은 해 4. 18.까지 위 병원에 뇌순환장애 및 만성두통, 신경쇠약, 만성위염 등의 이유로 36일간 입원하였다고 하나 역시 위 기간 동안 혈압, 맥박, 체온 등 활력징후가 거의 기재되어 있지 아니하고, 식사처방전에도 입원 기간 내내 아침식사를 병원식으로 하지 아니하고 “self"로만 기재되어 있는 사실, 또한 간호기록지에는 2003. 3. 15.과 16., 23., 25., 같은 해 4. 4. 하루 종일 간호사 순회 취지의 “Rounded”라고만 기재되어 있고, 같은 달 21. 16:00경에는 “환자 자리에 안 계셔서 못 드림”이라고 기재되어 있다. ⑦ 2004. 5. 10.부터 같은 해 6. 11.까지 위 병원에 뇌순환장애 및 급성위염, 전신쇠약 등의 이유로 33일간 입원하였다고 하나, 두부 CT 촬영 결과는 정상이었다. ⑧ 2004. 10. 15.부터 같은 해 11. 2.까지 위 병원에 기관지폐렴 및 전신쇠약, 뇌순환장애 등의 이유로 19일간 입원하였다고 하나 간호기록지에는 “2004. 10. 28. 10:00 독감(Local에서 맞음)”으로 기재되어 있다. 위 입원시마다 활력징후체크가 제대로 되지 않은 날이 자주 있고 간호기록지에는 낮시간 동안 “피고인이 귀원하였다”는 내용이 반복적으로 기재되어 있는데, 외출 시각과 그 시간, 외출 사유 등에 대하여는 아무런 기재가 없으며 피고인에 대한 식사처방전에도 식사를 병원식으로 하지 아니한 것으로 기재되어 있는데 공소외 5가 어떠한 식사를 하였는지에 대하여 아무런 언급이 없다.

(D) In the case of Nonindicted 6

(4) From 4.0 to 3.0, 2.0 per day after the 6th day of hospitalization, 2.0 per day after the 4th day after the 6th day after the 20th day after the 3th day after the 4th day after the 6th day after the 3th day after the 4th day after the 2nd day after the 4th day after the 5th day after the 1st day after the 5th day after the 2nd day after the 5th day after the 5th day after the 5th day after the 5th day after the 5th day after the 5th day after the 5th day after the 1st day after the 5th day after the 5th day after the 5th day after the 5th day after the 1st day after the 5th day after the 1st day after the 1st day after the 2nd day after the 3th day after the 2nd day after the 3th day after the 2nd day after the 3th day after the 2th day after the 3th day after the 1st day after the urization.

(E) In the case of Nonindicted 21

① From July 6, 201 to October 10, 201, the hospital was hospitalized with chronic infection 1, 4, 4, 6, and 1, but unlike the diagnosis submitted at the time of insurance request, the Review and Assessment Service claimed two times for hospitalization and there are many cases where active climatic diseases were not recorded. ② From April 26, 2002 to May 23, 200, the hospital was hospitalized with an emergency room for 4, 1, 6, 1, 6, 1, 6, 1, 3, 1, 6, 1, 6, 1, 3, 6, 1, 6, 1, 3, 1, 6, 1, 6, 1, 3, 6, 1, 6, 3, 1, 6, 5, 1, 5, 1, 5, 1, 5, 1, 1, 1, 2, 1, 20,2, 2,3., 2, 3.,

(F) In the case of Nonindicted 12

① At the time of hospitalization from June 24, 2002 to July 8, 2002, the hospital was diagnosed with the engine bladity, and the overall bladism, but the hospital was hospitalized on the date of hospitalization, but thereafter, the hospital was released frequently on the date of hospitalization, and the visit to the construction site was staying outside. ② From July 12, 2004 to August 11, 2004, the hospitalization was fladged, and the body was good, and the content of treatment was diagnosed as urine, urine, and flady, and fladged. However, if the period of hospitalization exceeds 30 days, the insurance money was additionally hospitalized, and the Defendant was hospitalized, and was hospitalized, and the Defendant continued to be hospitalized on the 20th day after being hospitalized, and the 10th day after being hospitalized, and the 10th day after being hospitalized at the 10th day after being hospitalized.

(G) In the case of Nonindicted 16

In the case of hospitalization from June 10, 200 to July 10, 200, Non-Indicted 16 discussed food, and went to the above hospital due to the frequent marcation of marcation and marcation. Although it was found that there was no error in the results of the examination on June 10, 200, the defendant was under treatment and it was good for treatment while being hospitalized, but it was recommended to be hospitalized to be 1,00 marcinggel at the time of hospitalization, 1,00 marcing one day, and 1,00 marcing one to 1,00 marcing one to 3,00 marcing one to 1,000 marcing one to 10,000 marcing one to 1,000 marculc one to 2,000 marc one to 9,000 marc.

(h) In the case of Nonindicted 11

① From February 5, 202 to March 6, 200, 200 were hospitalized in 200, 2000 after 20 out of the 20th day after the 5th day after the 20th day after the 20th day after the 20th day after the 5th day after the 5th day after the 5th day after the 5th day after the 5th day after the 5th day after the 5th day after the 5th day after the 5th day after the 5th day after the 5th day after the 5th day after the 5th day after the 5th day after the 5th day after the 5th day after the 5th day after the 5th day after the 5th day after the 5th day after the 5th day after the 5th day after the 5th day after the 2nd day after the 2nd day after the 2nd day after the 2nd day after the 2nd day after the 2nd day after the 3th day after the 2nd day after the 3th day after the examination.

(i) In the case of Nonindicted 13

① From April 6, 2002 to May 7, 2002, Non-Indicted 13 was hospitalized due to chronic sulphism, sulphy, electric shock, etc.: (a) was hospitalized; (b) Non-Indicted 13 was hospitalized at a hospital because of the long distance between the inner organs; and (c) was hospitalized by the Defendant after being hospitalized; and (d) was hospitalized after having conducted various inspections; and (e) continued to be hospitalized after having been discharged. ② From December 3, 2002 to December 29, 2002, the Defendant was hospitalized in the instant sulphy, hepatitis, sulphy, and pule; (d) was hospitalized from March 8, 2005 to March 31, 2005; and (e) was hospitalized at the hospital by the Defendant’s recommendation to use the said sule; (e) was hospitalized from the first day to the first day; and (e) was hospitalized outside the hospital, and was frequently hospitalized.

(j) In the case of Nonindicted 22

① From April 23, 202 to May 7, 200. 5, 200: (a) the patient was hospitalized as 3 times per day; (b) the patient was disexploited on 24, 25, 30, and 3 occasions; (c) the patient was disexploited on 8th day after the 20th day after the 20th day after the 20th day after the 1st day after the 20th day after the 1st day after the 20th day after the 1st day after the 20th day after the 1st day after the 20th day after the 20th day after the 1st day after the 20th day after the 20th day after the 1st day after the 20th day after the 1st day after the 19th day after the 1st day after the 20th day after the 1st day after the 19th day after the 1st day after the 20th day after the 1st day after the 1st day after the 1st day after the 20th day after the 20th day.

(l) In the case of Nonindicted 17

① 2002. 1. 17.부터 2. 28.까지 기관지 천식, 기관지 폐렴으로 입원했다고 하나 폐렴의 진단에 필요한 방사선 검사 판독결과가 없어 진단의 객관적 근거가 미비하며 폐렴의 경우 적절한 수분공급과 필요에 따른 산소공급, 적극적인 객담배출이 필요하고 항생제는 열이 떨어지고 3일간 더 사용하는 것이 원칙이고 흉수나 폐농양이 합병된 경우에 장기간 항생제 치료를 요하는데 반해 공소외 17에 대해 투약에 따른 상태나 효과에 대한 관찰, 기록이 없이 항생제를 2주 이상 투여한 것으로 기록되어 있고, 의사기록상 repeat오더가 반복되며 환자 관찰과 치료기록이 없고 간호기록상 부재중, 외출 다녀온 후 호흡곤란 등의 기재가 있으며 의사오더상 1일 3회의 활력징후측정이 지시되었으나 그에 대한 기록이 없다. ② 2002. 4. 8.부터 5. 27.까지 식중독(의증), 대장염, 기관지 천식으로 입원했다고 하나 대장염 진단에 필요한 방사선 검사의 판독결과가 없고 입원 이후 설사 증상에 대한 간호기록이나 환자호소가 나타나지 않았다. 간호기록상 외출이 잦고 천식환자로 호흡곤란을 호소한다면서도 호흡수 측정 기록이 거의 없고, 의사 처방에 따른 병원식이를 제대로 시행하지 않다가 2002. 5. 16. 의사처방에 퇴원 오더 없이 퇴원하였다가 당일 재입원한 것으로 기재되었는데 응급상태임이 관찰되지 않는다. ③ 2002. 6. 2.부터 6. 20.까지 기관지천식, 폐렴으로 입원하였으나 의사기록상 repeat오더가 반복되고 환자관찰과 치료기록, 진단명이 없다. 간호기록지에 입원 첫날부터 외출중이라고 기록되어 있는 등 잦은 외출기록이 보이고 식사처방전상 14회 병원식하고 44회 병원식을 하지 않았다. ④ 2002. 8. 13.부터 2002. 9. 16.까지 기관지염, 허혈성 심장병, 간기능장애, 기관지천식, 당뇨병으로 입원하였으나 의사기록상 환자관찰 내용이 없고 repeat 오더가 반복되며 심장질환을 확진할 수 있는 자료가 부족하고 입원기간 동안 간호기록 대부분이 rounded로 환자의 외출이 잦고 입원환자로서 관리가 되지 않았다. 환자의 주호소가 흉통이며 진단명상 염분제한과 고단백 식이제공이 중요한 치료사항이며 의사 오더상 저염죽으로 지시되었음에도 8. 13.부터 매일 저녁 self로 되었고 9. 10. 이후 3식 모두 self로 제공되었다. ⑤ 2002. 12. 11.부터 12. 19.까지 기관지폐렴, 천식 등으로 입원했다고 하나, 진료기록부상 12. 14. 이후는 거의 외출 중으로 보이고, 투약기록지상 투약이 시행되지 않은 날도 자주 있다. ⑥ 2003. 1. 8.부터 2003. 2. 17.까지, ⑦ 2003. 3. 18.부터 5. 9.까지 각 기관지폐렴, 기관지천식, 허혈성 심장병 등으로 입원했으나 입원기간 동안 의사 오더지나 검사결과지가 진료기록부에 첨부되어 있지 않아 정확한 진단 여부를 확인할 수 없고 간호기록지상 외박이 계속되고 퇴원 후 다음날 다시 입원한 것으로 되어 있다. 실제 치료는 아침, 저녁으로 링거와 주사를 맞았으며 식사나 목욕을 위해 외출하기도 하였다. ⑧ 2003. 9. 1.부터 9. 17.까지 둔부 좌상, 골반부 염좌, 흉부 좌상 등으로 입원했으나 9. 9.경부터 상습적으로 외출하였고 투약이 안 되는 날도 있었다. ⑨ 2003. 12. 9.부터 12. 29.까지 만성 기관지 천식, 위염, 식도염으로 입원하였으나 입원 당일 밤 10시에 귀원하심이라는 기록이 있고 병원식을 절반 정도 하지 않았으며 2. 15. 간호기록상 호흡곤란과 산소처치, 2. 20. 산소처치를 했음에도 환자의 활력징후나 환자의 상태에 대한 기록이 없고, 12. 10. 이후 의사기록지에는 repeat 오더만 반복되고 있다. ⑩ 2004. 1. 6.부터 1. 30.까지 좌중수지 신전건 파열로 입원했는데, 당초 1. 6. 호흡곤란으로 응급실 통해 입원했다가 3일 후인 1. 9. 외출 나갔다가 손가락 찧어 1. 13. 정형외과 수술을 받은 것으로 되어 있다. 당시 정형외과가 아닌 내과 의사 오더가 계속되는 한편 진단서는 정형외과 진단명으로 발급되었다. 입원기간 중 1. 20. 이후 활력징후체크가 이뤄지지 않았고 간호기록에도 rounded 라고만 기재되어 있거나 외출로 귀원하지 않았다는 기재가 잦다.

(m) In the case of Nonindicted 9:

① From April 26, 202 to May 31, 200. From 200, the Defendant was hospitalized with the above 1st hospitalization period of 5, and the period of hospitalization with the insurance company was almost different from each other, but no 3rd a day after climatic disease was measured. On the other hand, the Defendant was hospitalized with the 1st hospitalization period of 6th hospitalization, and the Defendant was hospitalized with the 1st hospitalization period of 1st 6th 7th 2nd 7th 2nd 4th 7th 2nd 6th 7th 7th 7th 7th 7th 7th 7th 7th 7th 1st 6th 6th 6th 1st 6th 1st 6th 1st 6th 1st 6th 20 2nd 1st 6th 6th 1st 20 2nd 1st 2nd 203.

(n) In the case of Nonindicted 7 and 8

Nonindicted 7, upon Nonindicted 9’s recommendation, entered the causes of Non-Indicted 9 as tensions, tensions, telegramss from April 27, 2002 to May 29, 200, 200, 3. From June 21, 2003 to July 12, 200, 2.0 to 3.10 until December 22, 2004; 4. From April 15, 2004 to May 7, 2004, Non-Indicted 7, Non-Indicted 1, 200 to 3.5 to 8.5 to 3.5 to 8.5 to 3.5 to 3.5 to 8.5 to 200 to 3.5 to 3.5 to 3.5 to 28.5 to 200 to 3.6.5 to 20 to 3.5 to 3.5 to 28 to 200 to 3.5 to 26.5 to 20 to 3.5 to 26.2.

From March 18, 2002 to April 22, 2005, Non-Indicted 8 made a recommendation from Non-Indicted 9: (a) Dozine, high-heat, engine salt, and chronitis; (b) from May 27, 2003 to June 23, 200; (c) chronic chlogram and chlogram from February 24, 2004 to March 23, 204; (d) from April 9, 2004 to April 19, 5, from December 22, 2004 to from December 24, 2005, the Non-Indicted 8 requested hospitalization to be taken into account during the period of hospitalization; and (d) Non-Indicted 8 failed to meet the requirements for re-treatment and re-treatment during the period of hospitalization; and (e) during the period of hospitalization to the left-hand side of the patient.

(o) In the case of Nonindicted 15

① From March 19, 200 to May 22, 200, it was necessary to re-hospitalize the above-mentioned main body of YA, and to re-hospitalize the above-mentioned main body of 1,000, from September 14, 2001 to November 14, 2001, so as to make it difficult to re-hospitalize the patient’s treatment period without any specific reasons such as brain dynasium disorder and brain circulation disorder. ③ From October 7, 2002 to November 29, 200, it was also necessary to re-hospitalize the patient’s treatment period without any specific reasons such as hospitalization, and to re-hospitalize the patient’s treatment period from 3rd to 19 March 200 to 24, 200, and to re-hospitalize the patient’s treatment period without any specific reasons such as ladical disorder, liver function disorder, and laver laver laver 2, 2004.

(p) In the case of Nonindicted 14

(1) From 201 to 26. of 20, Nonindicted Party 14 was hospitalized with 20 marculatory disease register and 20 marculatory disease register; however, there was no 3 marculatory disease register and no 2 marculatory disease register; however, there was no 3 marculatory disease register and no 2 marculous marculatory disease register; however, there was no 2 marculous marculatory disease register and no 2marculculatory marculseculatory disease register and no 2marculculatory marculeculic 2. From 201 to 20 marculculic marculculic marculcule.

(3) Deliberation by the medical evaluation and assessment review committee of the instant case

The issue of each insurance fraud of the above patients and each of the crimes of this case by the defendant is that the Financial Supervisory Service established the insurance fraud recognition system (the system that evaluates insurance fraud in comparison with the insurance fraud index, which is the certain standard determined by the Financial Supervisory Service, after measuring and compromiseing the contents of each insurance contract of each insurance company, and database of the contents of the insurance payment, several insurance products within a certain period, several times of the occurrence of several insurance accidents occurred during a certain period, and the receipt of insurance proceeds during a certain period, in which the nationwide hospital used an insurance fraud suspicion index for the nationwide hospital as a result of examining the insurance fraud suspicion index for the above patients. As of 6th, 2000, 00 from 3th, 200 as of 2nd, 202, 3th, 200 as of 202, 202, 203, and 00 ○○ Hospital had been issued with a diagnosis certificate from the hospital, and the Financial Supervisory Service began to make a claim for the payment of insurance proceeds due to a certain disease.

As a result, the Seoul Central District Prosecutors' Office requested the Central Review and Assessment Coordination Committee of the Health Insurance Review and Assessment Service to cooperate in an investigation with regard to the suspicion of insurance fraud by 27 persons including the instant patients of ○○ Hospital, the above Coordination Committee reviewed the details of the medical care benefit claim of ○○ Hospital and the records of medical examination, compared to the comparison of the contents of the medical care claim of ○○ Hospital and the records of medical examination, and deliberated on each of the hospitalization table 1 and 2 of the annexed crimes table 2 of this case,

(4) Recognition of the details of the instant patient’s insurance coverage and insurance fraud for the patients

(A) In the case of Nonindicted Party 1, a person who was employed as a living designer at the Korea Life Company from February 1998 to July 30, 199, and was employed as a living designer at the Korea Life Company. From March 6, 1995 to July 12, 2002, Non-Indicted Party 1, as described in the attached Table 2, purchased 20 insurance policies (monthly insurance premium 1,195,550) such as life radar insurance (monthly insurance premium 1,195,50) as described in the attached Table 2, and was discharged from the said district court on five occasions from July 16, 202 to June 30, 204, and was discharged from the said insurance company on five occasions with a written confirmation of hospitalization from August 5, 2002 to March 2, 2005, and was found guilty of the above KRW 101,285,297.6.

(B) In the case of Nonindicted 20, from July 8, 1996 to November 14, 200, 12 insurance companies, including Ganyang Life Insurance Co., Ltd. (hereinafter “Nonindicted 20”) purchased 12 insurance policies, including Non-Indicted 2, including Non-Indicted 2 and Non-Indicted 20, 4 times from February 1, 2001 to July 9, 2002, as shown in attached Table 2, were hospitalized in ○○ Hospital four times as shown in attached Table 2, and submitted a written confirmation of hospitalization from ○ Hospital, and submitted it to each of the above insurance companies from March 13, 201 to September 4, 200, and received a total of 41,330,897 won under the pretext of hospitalization for a short period from March 13, 201 to September 4, 200, the judgment was dismissed on the ground that it was not necessary to be hospitalized for a short period of time, and was dismissed.

(C) In the case of Non-Indicted 5, he was hospitalized at ○ Hospital from October 10, 1997 to March 19, 201 with four insurance companies, including Ganyang Life Insurance Co., Ltd. (an amount equivalent to KRW 2.80,00 per month insurance premium), and was charged eight times from July 18, 201 to November 2, 2004 as shown in attached Table 2, and was discharged on eight occasions, from August 30, 2005 to September 5 of the same year with a written confirmation of hospitalization from September 26, 2001 to the above insurance company with a written confirmation of hospitalization from September 23, 2005 and submitted the insurance money to the above insurance company with a written confirmation of hospitalization from the Defendant, and was discharged from the court below on the ground that he was released on September 26, 2001 to November 23, 2005 for the total amount of hospitalization expenses, etc. as stated in attached Table 2, and thus dismissed.

(D) In the case of Nonindicted 14, Nonindicted 6 had a career of serving as a living designer at the Japan Life Company. Nonindicted 14 was a person who was in a de facto marital relationship with the above Nonindicted 14. In excess of its economic capacity, Nonindicted 14 was hospitalized in five insurance contracts, including soft Family Love Insurance Co., Ltd. from October 14, 1999 to December 13, 2000 (amounting to KRW 182,140 per month insurance premium), and was transferred to ○○ Hospital nine times from April 30, 201 to March 21, 203, as shown in the attached Table 2, and filed a written confirmation of hospitalization with the Defendant, and received a total amount of KRW 368,67,67, as shown in the attached Table 2, and received hospitalization from June 13, 2001 to April 16, 2003.

In addition, from January 20, 200 to April 8, 2002, the above non-indicted 6 purchased 7 insurance policies, such as the Young Life Integrated Life Insurance Co., Ltd. (the monthly insurance premium of 616,88 won) from 200 to 7 insurance companies (the amount equivalent to 616,888 won), and as shown in attached Table 2, was hospitalized in ○○ Hospital seven times from March 4, 2002 to July 26, 2004, and was issued a written confirmation of hospitalization from the defendant, and received a total of 27,013,768 won from April 11, 200 to July 27, 2004. The above non-indicted 14 and non-indicted 6 were convicted of committing fraud on the ground that they did not need to be hospitalized and prosecuted, and the judgment was sentenced to 37,207.17.27.27.207

(E) In the case of Nonindicted 21, when he was hospitalized in ○○ Hospital five times from July 6, 2001 to December 17, 2001, he was issued a summary order of KRW 20,562,06 in total under the name of hospitalization expenses, etc. between October 111, 2001 and December 30, 2001, and was issued five insurance companies including Samsung Bio-stock Co., Ltd. (an amount equivalent to KRW 203,30, monthly insurance premium) and five times from December 6, 200 to December 11, 203, and was hospitalized in ○○ Hospital, and was issued a written confirmation of hospitalization by the Defendant, and was charged with the above summary order of KRW 20,562,06 in total on 13 occasions, as shown in attached Table 2. The above Nonindicted 21 was not required to be hospitalized, and thus, he could not be charged for fraud.

(F) In the case of Nonindicted 9, 11, and 12, the above Nonindicted 11 work as a life designer at Samsung Life Insurance Co., Ltd. from around November 20, 195 to October 31, 197; Nonindicted 9 was a person who has an internal relationship with Nonindicted 11 and was in the same delivery business with Nonindicted 11, and Nonindicted 12 exceeded the economic capacity of 11, as stated in [Attachment 2] 20 to 20. 5, including the total insurance premium of Samsung Life Insurance Co. 2, 205, and 10 to 30. 6. 5, as stated in [Attachment 2] 10 to 4. 7. 8, 206, including the total insurance premium of Samsung Life Insurance Co. 2, 205, and 17, including the total insurance premium of Samsung 20 to 30. 5, 205, as stated in [Attachment 2].

In addition, the above non-indicted 9 shall be hospitalized in ○○ Hospital for ten times from September 8, 1998 to February 15, 202, including 11 insurance companies, and 21 insurance policies (type 1 monthly insurance premium 924,685), as shown in attached Table 2, from April 26, 202 to July 5, 2005, and shall be hospitalized in 200 to 27.48 times in total from June 4, 2002 to 27.48 times in total as shown in attached Table 2, and from 209 to 208.48 on July 14, 2005, it shall be issued KRW 61,50,358 as the total amount of hospitalization expenses for 200 to 29.27 times in total as shown in attached Table 2, and it shall be delivered from 209 to 208.288.195.19

In addition, the above non-indicted 12 was hospitalized at ○ Hospital four times from June 4, 2002 to May 13, 2002, when he was admitted to 22 insurance companies, including Samsung Bio-resources, including 10 insurance companies, with an intensive charge of 22 non-indicted 12, including the 1,073,587 won of monthly insurance premium), and received a written confirmation of hospitalization from the defendant during four times from June 4, 2002 to May 21, 2005 as shown in attached Table 2, and received a total of 35,945,974 won from August 2, 2002 to June 23, 2005 as shown in attached Table 2.

The above non-indicted 9, 11, and 12 were indicted on the ground that they and their children were obtained by being hospitalized and receiving insurance money as above, even though they did not need to be hospitalized, and was convicted on February 21, 2007 of the Suwon District Court Decision 2006Kadan2509, which became final and conclusive on March 1, 2007.

(G) In the case of Nonindicted 16 and Nonindicted 15, Nonindicted 16, and Nonindicted 15 were hospitalized in ○○ Hospital on April 10 through November 21, 2003, and they were in de facto marital relationship with the said Nonindicted 16. In excess of their economic capacity, Nonindicted 16 was hospitalized in 4 insurance companies, including Korea Life Insurance Co., Ltd., from April 13, 1993 to June 14, 201, and were hospitalized in 206 to 34 times on June 10 to November 21, 203, on the ground that they were hospitalized in 200, and were hospitalized in 200 ○ Hospital on April 28, 208, and were issued a total of KRW 160 to 300,000,000 from August 1, 200 to December 4, 203.

(h) In the case of Nonindicted 17, as indicated in the attached Table 2, Nonindicted 17 was hospitalized in ○○ Hospital on 27 occasions from January 17, 2002 to September 21, 2005 and submitted a written confirmation of hospitalization from the above hospital to the above insurance company on 68 occasions in total from March 28, 2002 to November 14, 2002, and was paid KRW 74,258,341 won in total as hospitalization expenses, etc. 68 times from November 28, 2001, on the ground that Nonindicted 17 was guilty on the ground that he was charged with the insurance money by being taken out by being hospitalized as above, even though there was no need for hospitalization, and thus, he could not be prosecuted on the ground that he was convicted of the insurance money on 17th day from January 17, 200 to September 21, 205.

(i) Meanwhile, in the case of the insurance purchased by the above patient, the amount of security is higher than five times the amount of security, such as cancer, heart disease, high blood pressure, cerebrovascular disease, cerebrovascular disease, urine disease, urine disease, chronic smoking disease, urology, urology, thalopic disease, surgical disorder, surgical disorder, tuberculosis, waste convergence, and surgical urgical disease, etc. (the content of which is somewhat different according to the terms and conditions). In the event that the above patient continued to have been hospitalized for at least 31 days due to a specific disease, 100-2 million won can be additionally paid for the purpose of health recovery funds, etc.

C. Determination

(1) General theory

Unlike general cases of ○○ Hospital’s medical treatment system, once the defendant, who had been at the above hospital, was aware of the patient’s symptoms and, in the process of finding out the patient’s symptoms before and after being charged with each other, recommended the patient to be hospitalized, and when the defendant was discharged, the defendant was determined not to be the principal doctor, but the patient’s authority to examine the patient’s disease with which the patient can claim insurance money at the request of the patient, and the defendant appears to have prepared a diagnosis or a written confirmation of hospitalization. The defendant recommended the hospitalization of the patient whose symptoms are not serious, rather than the pain treatment, and recommended to re-hospitalize the patient to be hospitalized. Such long-term hospitalization is likely to have an interest between the patient and the patient who did not incur a burden on the hospital expenses, and the defendant appears to have been aware of the fact that the defendant did not have been able to request hospitalization or that there was no other circumstance that the patient’s symptoms were presented as a result of the examination to increase the patient’s maximum number.

(2) Whether the facts charged are specified

The facts charged must be specified within the scope that does not impede the defendant's exercise of his/her right to defense. Even if the date, time, place, method, etc. of a crime are not specified in the indictment, it does not go against the purport of the law that specifies the facts charged as above, and in light of the nature of the crime charged, if the general indication of the facts charged is unavoidable in light of the nature of the crime charged, the indictment cannot be deemed unlawful even if the contents of the indictment are not specified. In this case, the list of crimes in attached Form 2 specifies both the date and date of requesting insurance money, which is the date and date of claiming insurance money, the insurance company that is the other party, and the types of insurance products purchased through deception, and the necessity of hospitalization, which is the core contents, and it can be found that there is no obstacle to the defendant's exercise of his/her right to defense. Accordingly, the above assertion is without merit.

(3) Whether the results of medical analysis are reliable

The evidence of the necessity of hospitalization of the patients at issue in this case is the content of deliberation by the Central Review and Assessment Committee of the Health Insurance Review and Assessment Service, the result of the medical analysis (Investigation Record 1123-5899). The above medical analysis result, like the defendant's assertion, is somewhat ambiguous. However, the above mediation committee is the organization which requested deliberation when it is difficult to recognize the necessity of hospitalization. The above mediation committee is the organization which requested deliberation when it is difficult for the Health Insurance and Assessment Service to request deliberation. The above mediation committee is composed of university professors' doctors recommended by each specialized department within the Korean Medical Association and full-time doctors within the Review and Assessment Service (Investigation Record 756 pages). The person who judged the necessity of hospitalization in relation to the above criminal facts 1 and 2 of the original judgment is also the above mediation committee composed of professional doctors (Investigation Report as of June 13, 2006, investigation record9381). Therefore, even if the result of the above medical analysis was analyzed at a private institution entrusted by the Health Insurance Association, the defendant's assertion is without merit.

(4) Whether the cost of medical care benefits and the cost of medical care benefits not recovered from the National Health Insurance Corporation, which are recognized as the necessity of hospitalization in the amount of fraud should be

In the case of the exercise of rights by means of deception, if the act belonging to the exercise of rights and the deception belonging to the said means are comprehensively observed, and such deception cannot be acceptable as a means of exercise of rights by social norms, the act of exercise of rights constitutes fraud (see Supreme Court Decisions 2003Do4914, Dec. 26, 2003; 2002Do6410, Jun. 23, 2003, etc.).

According to the records, there are parts that the Central Review and Assessment Coordination Committee determined that each of the instant patients needs to be hospitalized for three to seven days. On April 27, 2005, the National Health Insurance Corporation (the National Health Insurance Corporation) rendered a notice of recovery only for the sum of KRW 38,696,960 out of the total amount of health care benefit costs related to the instant patients who requested reexamination by the Defendant on April 27, 2005, and accordingly, the Defendant’s claim for reimbursement of the health care benefit costs during the hospitalization period recognized as the necessity of hospitalization or for the part for which the National Health Insurance Corporation did not receive a notice of recovery of the health care benefit costs paid to the Defendant is justifiable.

However, the Defendant’s act of claiming excessive expenses for medical care benefits to the National Insurance Management Corporation by recommending the patients who have less need to be hospitalized without properly performing medical treatment in accordance with the patient’s health condition, and by issuing a written hospitalization certificate to the patients, and aiding and abetting the act of acquiring insurance money by means of aiding and abetting and abetting the Defendant’s act of acquiring insurance money constitutes a case where it is not acceptable as a means of exercising the right by social norms in light of the social status of the Defendant, the patient and the general public’s trust toward the specialized medical personnel, the course, mode, and consequence of the instant crime. Therefore, even if the Defendant’s claim for medical care benefits includes some legitimate rights, the act of exercising the above right also constitutes

2. Judgment on the part concerning the facts constituting the crime of the court below

According to the evidence duly adopted and examined by the court below and the statements of non-indicted 3 and non-indicted 4 of the witness of the trial court, when a traffic accident patient, etc. released the vehicle, the medical records were returned to the person in charge of the request for insurance after obtaining approval from the defendant through the chief, the director, and the chief. The employee in charge of the claim for automobile insurance expenses return to the person in charge of the request for medical records and the vehicle insurance. The employee in charge of the claim for automobile insurance expenses reported to the doctor's negligence in the medical records and the various inspection sites, and entered them in the bit program. However, according to the above recognition that the defendant ordered the original director and the employee to use the daily amount of the automobile insurance to pay KRW 100,000,000 for the amount higher than the ordinary unit price, and as a result, the above officer and the employee of the above hospital set the unit price code by determining the amount higher than the ordinary unit price, and as a result, it is difficult to see that the defendant did not have any specific intent or any false statement about the patient's claims.

Therefore, the defendant's assertion on the facts constituting the crime of the court below is without merit.

Therefore, No. 2, No. 45 is 376,642 won (2,495,254 won x 8 ± 53, 509 won (801,688 won 】 8 ± 53), 75,630 won (5 ± 805 ± 8 ± 533), 48 is 121,09 (801,68 x 888 won ± 53), 49 are 335,242 (2,980 ± 53) ? 50, 507 - 6368, 49 of the Criminal Procedure Act - 49 of the judgment below which found the defendant not guilty, since it constitutes 35,242 won (2,980 ± 543), and 617,3580 won (the total amount of 409,000 ± 6381,64165 won) -646

Judges in writing (Presiding Judge)