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(영문) 서울고등법원 2016. 9. 27. 선고 2016누39223 판결
[요양급여불승인처분취소][미간행]
Plaintiff and appellant

Plaintiff (Attorney Kim Jin-young, Counsel for the plaintiff-appellant)

Defendant, Appellant

Korea Labor Welfare Corporation

Conclusion of Pleadings

August 30, 2016

The first instance judgment

Seoul Administrative Court Decision 2015Gudan58341 decided February 26, 2016

Text

1. The plaintiff's appeal is dismissed.

2. The costs of appeal shall be borne by the Plaintiff.

Purport of claim and appeal

The judgment of the first instance is revoked. The defendant revoked the disposition not to grant medical care to the plaintiff on April 15, 2015.

Reasons

1. Details of the disposition;

A. From November 28, 2014, the Plaintiff served as a junitor in a non-party 1 corporation (hereinafter “non-party 1 corporation”) and applied for medical care benefits to the Defendant on January 14, 2015, on the ground that the Plaintiff, along with the employees of the non-party 1, went to the △△△△△△△△ Hospital, fall down from the stairs of the building of the ran tavern (hereinafter “instant accident”) and was diagnosed as “cerebrovascular surgery, thalopa, thalopa, thalopa, and thalopia (hereinafter “the instant accident”).

B. On April 15, 2015, the Defendant rendered a disposition not to grant medical care to the Plaintiff on the ground that “The instant accident that occurred during the course of the Plaintiff’s meeting to which Nonparty 2, who is not the business owner, was autonomously conducted for the purpose of sending out the meeting under the supervision of Nonparty 2, rather than the head of the department who is not the business owner.” The instant accident that occurred in the course of the first class of meeting to a two-lane dan cannot be seen as being controlled or managed by the business owner, and it is difficult for the business owner to view it as an “accident during the event” in charge of the business owner or participating in the direction of the business owner.

[Ground of recognition] Facts without dispute, Gap evidence Nos. 1, 3, 4, 11, and the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The plaintiff's assertion

Since the revolving that the Plaintiff participated on the day of the instant accident was running from the first meal and the second class danran bar under the supervision of Nonparty 2, who was delegated by the business owner to hold a revolving hall and use the corporate card, and all of its expenses were paid by the company, it is reasonable to deem that the revolving ceremony was an event necessary for the labor management of the company, and that the instant injury and disease occurred during that process constitutes an occupational accident, and thus, the instant disposition made by the Defendant on a different premise is unlawful.

B. Determination

1) Relevant legal principles

Where a worker suffers from an accident while participating in an event or a meeting that is not ordinarily obligated to engage in labor contract as an occupational accident, the overall process of the event or meeting must be in the state of being controlled or managed by the employer in light of the circumstances such as the organizer, purpose, content, number of participants, methods of operation, burden of expenses, etc. of the event or meeting, and the overall process of the event or meeting must be in the state of being controlled or managed by the employer. In addition, the worker must not deviate from the net course of the event or meeting (see Supreme Court Decision 2007Du6717, Nov. 15, 2007). In a case where a worker drinks in excess of his share of alcohol due to the main cause and is caused by the injury, disease, or disability, and where proximate causal relation is acknowledged between the above accident and the accident, it can be deemed that it constitutes an occupational accident as provided for in the Industrial Accident Compensation Insurance Act, unless the causal relation between the accident and the worker's physical and mental disorder is established, and whether the worker is forced to undergo an abnormal or other accident.

(ii) the facts of recognition

A) The 10 employees of the non-party company worked for a team consisting of 5 teams. In the case of the ○○ ○○ apartment site where the team to which the Plaintiff belongs was employed, 2 employees, including the non-party 2, the non-party 4, and the plaintiff, were dead on December 2014 at the time of the instant accident, and 3 employees, including the non-party 2, the non-party 4, and the plaintiff, were on the said site.

B) On December 31, 2014, Nonparty 2, Nonparty 4, and the Plaintiff completed work at the above site located at ○○, Namnam on December 31, 2014, and got drinking along with the drinking house located in the ( Address omitted) North-gu, Gwangju (hereinafter “first meal”) with the drinking house (hereinafter “the first drinking house”). Nonparty 2 did not drink, and Nonparty 4 did not drink a drinking house, and the Plaintiff and Nonparty 4 d drank a approximately two-half of the illness of the drinking house (the Plaintiff’s ordinary drinking house is a small three-way disease). However, Nonparty 2 proposed that two-one-one of the two-halfs of the Plaintiff who died while driving the drinking house at Dondong-gu, △△△△△△△△△△△△△△△△△. Then, Plaintiff 3 moved the vehicle driven by Nonparty 2 to his own boarding school, and she went to the Jeju △△△△△△△△△△△.

C) While the Plaintiff’s first-class entertainment orders the beer and the rest of the beer and the rest of the beer and the rest of Nonparty 2 and Nonparty 4, the Plaintiff went out of the above ran tavern to make a telephone. The Plaintiff was found to have lost consciousness in front of the stairs of the first-class entertainment building.

D) The head of Nonparty 2 paid the expenses of Nonparty 3’s corporate card that was received from Nonparty 3 with the birth of Nonparty 3’s representative. The head of Nonparty 2 paid the expenses of the above site by using the above corporate card. The meal expenses and the drinking value of the above shot bar was also paid by the above corporate card.

E) Nonparty 3 submitted to the Defendant an additional confirmation on January 26, 2015, stating that “The Vice-Chairperson of Nonparty 2, the day of the instant accident, was the end of the year on December 31, 2014, and the Hannnnn Han Hah Hah Hah Hah.” On the other hand, Nonparty 2 submitted to the Defendant a written confirmation on January 26, 2015, stating that “The head of Nonparty 2 was a letter of meeting once a month and did not make a prior report to Nonparty 3 once a month, but did not pay corporate expenses, making a subsequent report.” In the first instance court, Nonparty 3 not only submitted a written confirmation on January 26, 2015, but also did not receive an order from Nonparty 3 to make a reply on December 31, 2014, and notified the Plaintiff and Nonparty 3-41 of the instant accident.”

[Ground of recognition] Facts without dispute, entry of Gap evidence 3, 7, 8, 9 (including paper numbers), non-party 2's testimony of the first instance court witness and the purport of the whole pleadings

3) Determination

The following circumstances revealed by the evidence and the facts of the above recognition. ① The plaintiff is difficult to conclude that the plaintiff was forced to attend the first round of the meeting, despite the non-party 2's absence of drinking at the time of the first round of the meeting, and the non-party 3 was forced to attend the meeting on his own will; ② The second round of the meeting was not planned in advance, but was decided at the non-party 2's proposal at the time of the first round of the meeting, and the attendance was not forced. ③ The plaintiff's statement of the non-party 3 and the non-party 2 on December 31, 2014 regarding the circumstance during which the plaintiff's first round of the meeting was legitimate, and it is difficult to conclude that the non-party 2 was forced to attend the meeting on his own because the non-party 3 was forced to attend the meeting on his own because of the fact that the non-party 2's statement of the additional statement prepared by the non-party 3 on his own food and drinking expenses, and there is no other evidence to deem that the plaintiff 2 and the non-party 4.

3 Conclusion

Therefore, the plaintiff's claim of this case is dismissed as it is without merit, and the judgment of the court of first instance is just, and the plaintiff's appeal is dismissed as it is without merit, and it is so decided as per Disposition.

Judges Landscaping (Presiding Judge)

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