부당이득금반환
1. The plaintiff's appeal is dismissed.
2. The costs of appeal shall be borne by the Plaintiff.
The purport of the claim and the appeal.
1. The plaintiff's assertion
A. The Plaintiff is an insurer who has concluded each indemnity medical insurance contract with C and 44 insured workers, and the Defendant is a doctor who operates a medical clinic in D.
The Defendant, against the above insured, performed a non-refluent non-fluent pain Signals Act (Scram Bay) and received a total of KRW 19,100,000 for medical expenses, and the Plaintiff paid insurance money equivalent to the above medical expenses to the above insured.
B. Non-explosive and non-explosive pain signalling method constitutes a legal improvement benefit only when it is used within the permitted scope of “the reduction of the pain of chronic pains, cancer pains, and dyslexic pains which are not managed due to the existing pain treatment.” The non-explosive and non-explosive pain signalling method executed by the Defendant to the insured who are difficult to be regarded as patients with chronic pains, cancer pains, and dyslexic pains, constitutes a voluntary non-explosive treatment, and the procedure under the National Health Insurance Act cannot be paid as a non-explosive treatment in violation of the National Health Insurance Act and subordinate statutes. Thus, the Defendant is obligated to refund the above medical expenses to the insured who received non-explosive and non-explosive pains signalling Act as an unfair benefit.
Meanwhile, according to each indemnity medical insurance contract that the Plaintiff entered into with the insured, since the medical expenses for voluntary non-payment are not subject to insurance money, the insured is obligated to return the amount of the above insurance money paid to the Plaintiff as unfair profit.
(c)
Therefore, the defendant is obligated to pay 19,100,000 won and delayed damages to the plaintiff who subrogated the insured.
2. Whether the lawsuit of this case is lawful
A. The Plaintiff’s exercise of the right to return unjust enrichment against the Defendant on behalf of the insured as the right to avoid preservation of the claim for return of unjust enrichment against the insured, and ① the Plaintiff’s insured.