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(영문) 서울행정법원 2017.02.10 2016구단59402
요양불승인처분취소
Text

1. The Defendant’s disposition of non-approval of medical care benefits rendered against the Plaintiff on July 8, 2016 is revoked.

2. The costs of the lawsuit are assessed against the defendant.

Reasons

1. Details of the disposition;

A. On July 11, 2015, when the Plaintiff was working as a branch office B of Algerts Life Insurance Co., Ltd. (hereinafter “Non-Party Company”), on July 11, 2015, the Plaintiff claimed medical care benefits under the Industrial Accident Compensation Insurance Act (hereinafter “the instant accident”) to the Defendant under the diagnosis of the “absure of chilling the rear of the vehicle parked on the side (hereinafter “the instant accident”) while driving on the Saemangeum Road along the bicycle from the slope to the west-do slope.

B. Accordingly, on July 8, 2016, the Defendant deemed that the instant accident does not constitute an occupational accident, and rendered a disposition not to approve the said application (hereinafter the instant disposition).

[Ground of recognition] Facts without dispute, Gap 1, Eul 1, the purport of the whole pleadings

2. Whether the disposition is lawful;

A. The plaintiff's assertion that the plaintiff participated in the third class competition on Saturdays in order to secure customers as the head of the non-party company's branch office, and suffered the accident of this case. Thus, the disease of this case constitutes occupational accident.

Therefore, the defendant's disposition of this case on a different premise is unlawful.

(b) as shown in the attached Form of the relevant statutes.

C. The Plaintiff’s work content - The Plaintiff reported to the Defendant as a person in special type of employment under the Industrial Accident Compensation Insurance Act.

- The plaintiff did not set working hours as the head of the branch office of the non-party company, and the wages are determined according to the recruitment and maintenance of new insurance contracts, and the non-party company has urged the plaintiff as the head of the branch office to contact various customers during holidays to develop a new market.

- The Plaintiff had been working as a class 3 club member prior to the instant accident. On July 11, 2015, the Plaintiff visited Gunsan to participate in the 3rd class Coin in the iron 3 club, which was well-known as a type of iron 3.

- The plaintiff himself/herself on July 11, 2015 for the attraction of customers.

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