2014No2631 (a) Fraud

(b) Fraud prevention;

(c) Violation of the Medical Service Act;

D. Violation of the Labor Standards Act

(e) Violation of the Guarantee of Workers' Retirement Benefits Act;

1. A. (b) The head of the Office of Secretary of A and A;

Residence

Reference domicile

2. (a)(b)(c)(d)(b), B, and a doctor;

Residence

Reference domicile

3. (a) (b) The Director-General of C and hospital;

Residence

Reference domicile

Both parties

nan

Attorney Lee In-bok (Presiding Justice)

Attorney Lee Jong-soo (Korean National Assembly for Defendant B)

Law Firm, Attorney Park Jae-soo (Attorney Park Jae-soo)

Changwon District Court Decision 2014Da1270, 1879 Decided November 4, 2014

February 26, 2015

The part of the judgment of the court below against the Defendants is reversed.

Defendant A shall be punished by imprisonment with prison labor for two years, by imprisonment for one year and six months, and by imprisonment for ten months.

However, with respect to Defendant C, the execution of the above sentence shall be suspended for two years from the date this judgment became final and conclusive.

1. Summary of grounds for appeal;

A. Defendants

The defendants asserts that the punishment sentenced by the court below (one and half years of imprisonment, one year and one year of imprisonment, and two years of suspended execution in October) is too unreasonable.

(b) Prosecutors;

The prosecutor asserts that the above sentence imposed by the court below is too uneasible and unfair.

2. Ex officio determination

Of the facts charged at the trial of the party, the prosecutor submitted to the Corporation records that are fabricated as if 94 false patients, such as D, as stated in the annexed Table 2 (1) of the Crimes List, had been normally treated, and obtained them by obtaining payment of 10,821,430 won in total as medical care benefits from the victim. "B" submitted to the Corporation records that are fabricated as if 95 false patients, such as D, as stated in the annexed Table 2 of the Crimes List (1), had been normally treated as necessary medical care benefits, and submitted to the Corporation the records that 11,390,460 won were collected from the victim as medical care benefits, and then 10,000 won were collected from the Corporation and 10,000 won were added to the annexed Table 2 of the Crimes List (1-1) and 10,000 won were to be received from each insurance company, and 20,000 won were to be received from the victim, and 10,000 won were to be received from each insurance company.

3. Conclusion

The judgment of the court below is reversed under Article 364 (2) of the Criminal Procedure Act without examining the defendants and the prosecutor's assertion of unfair sentencing, and the part of the judgment of the court below against the defendants is reversed, and it is again decided as follows.

[Judgment to the Defendants]

Criminal facts and summary of evidence

The summary of this court's criminal facts and their evidence is as follows: ① 10,821, 430 won in total for the victim's medical care benefits; ② 10,000 won in the annexed Table 10,000 won in the annexed Table 2; ② 10,000 won in the annexed Table 10,000 won in the annexed Table 2; ② 10,000 won in the annexed Table 10,000 won in the annexed Table 2; and 20,000 won in the annexed Table 10,000 won in the annexed Table 2; and 30,000 won in the annexed Table 10,000 won in the annexed Table 2; ② 10,000 won in the annexed Table 10,000 won in the annexed Table 2; and 30,000 won in the annexed Table 10,000 won in the annexed Table 2

Application of Statutes

1. Article applicable to criminal facts;

(a) Defendant A: Articles 347(1) and 30(a) of the Criminal Act; Articles 347(1), 32(1), and 30(a) of the Criminal Act; Articles 88 and 22(3) of the Medical Service Act; Article 30 of the Criminal Act (a point of preparation of false medical records, etc.)

B. Defendant B: Articles 347(1) and 30(a) of the Criminal Act; Articles 347(1), 32(1), and 30(a) of the Criminal Act; Articles 88 and 22(3) of the Medical Service Act; Article 30 of the Criminal Act (Preparation of False Medical Records, etc.); Articles 109(1) and 36(1) of the Labor Standards Act; Articles 44 subparag. 1 and 9 of the Guarantee of Workers’ Retirement Benefits Act (the point of unpaid retirement benefits)

(c) Defendant C: Articles 347(1) and 30(a) of the Criminal Act; Articles 347(1), 32(1), and 30(a) of the Criminal Act; Articles 88 and 22(3) of the Medical Service Act; Article 30 of the Criminal Act (including preparation of false medical records, etc.)

2. Competition;

Defendant B: Articles 40 and 50 of the Criminal Act (Joint Violation of the respective Labor Standards Act and Violation of the Guarantee of Workers' Retirement Benefits Act)

3. Selection of punishment;

Each Imprisonment Selection

4. Aid and mitigation;

Articles 32(2) and 55(1)3 of each Criminal Act (with respect to each crime of aiding and abetting fraud)

5. Aggravation for concurrent crimes; and

Articles 37 (former part), 38 (1) 2, and 50 of the Criminal Act

6. Suspension of execution;

Defendant C: Article 62(1) of the Criminal Act (The following extenuating circumstances among the reasons for sentencing)

The defendants of the reasons for sentencing are those engaged in the medical service and receive a total of KRW 110 million from the Victim's Health Insurance Management Corporation as medical care benefits by attracting patients who do not require hospitalization over several years in an illegal way, making a false medical examination and taking them into account the following: (a) aiding and abetting the victim's insurance companies from taking money total of KRW 240 million; (b) the amount of damage is large; (c) insurance fraud obtaining illegal profits by abusing the national health insurance system and insurance contract, such as the crime of this case, harming the purpose of the national health insurance system and insurance contract, and harms the foundation of the insurance system, such as impairing the reasonable diversification of risks; (d) providing them with introduction expenses per patient; and (e) actively explaining the methods of receiving a large amount of insurance money to false patients; and (e) actively explaining the methods of avoiding investigation; and (e) providing them with the roles of the criminal act of each of this case, including the law and the circumstances before and after the crime of this case, the sentence of defendant A and the head of the department of the department.

However, the defendants recognized their mistakes and reflects, the victim's national health insurance management corporation was repaid most of the money, and approximately KRW 120 million was deposited for the victim's insurance company, the part of the money obtained by deception related to the fraud was recovered, there was no record of punishment, and the defendant Eul did not have any record of punishment other than one fine due to the crime of this type, and the defendant C did not have a relatively significant degree of participation in each of the crimes of this case in accordance with the orders of the defendant A and B. In addition, the defendants' age, character and behavior, environment, motive and background of the crime, means and method of the crime, the circumstances after the crime, and the health condition of the defendant yellowjin et al. were all the conditions for the punishment specified in the arguments and the records of this case shall be considered as favorable circumstances in consideration of the defendants' age, character and behavior, and the environment of the crime of this case.

Judges Lee Jae-sung

Judges Lee Dong-ho

Judges Kim Jong-soo