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1. The Defendant’s disposition of restitution notice of KRW 44,253,120 against the Plaintiff on May 10, 2016 is revoked.
2...
Reasons
1. Details of the disposition;
A. On August 27, 2015, the Plaintiff sustained injury by causing an accident of shocking the Defendant’s front portion of the C Truck, which is a safe vehicle for road construction guidance, that was stopped at a one-lane from the west Eup to the east along the first line, among the two-lanes near the west-gun, the west-gun, the west-gun, the area of which was driven by the B truck, around 20:25, and was provided with insurance benefits from the Defendant upon receiving the treatment.
B. On May 10, 2016, the Defendant: (a) determined that there was a ground for restricting insurance benefits pursuant to Article 53(1)1 of the National Health Insurance Act; and (b) issued a notice of restitution of KRW 44,253,120, which the Defendant provided to the Plaintiff on May 10, 2016 pursuant to Article 57(1) of the same Act, on the ground that the Plaintiff suffered injury caused a traffic accident by gross negligence driving more than 80km/h on the road with a limited speed of 80km/h (hereinafter “instant disposition”).
C. The Plaintiff dissatisfied with the instant disposition and filed an objection against the Defendant on July 21, 2016, but was dismissed on October 27, 2016, and the Plaintiff filed the instant lawsuit on January 25, 2017.
【Ground of recognition】 The fact that there has been no dispute, entry in the evidence Nos. 1, 2, and 4, and the purport of the whole pleading
2. Whether the instant disposition is lawful
A. The grounds for restrictions on the Plaintiff’s assertion of insurance benefits ought to be strictly construed. As such, “where there is a criminal act caused by intention or gross negligence” under Article 53(1)1 of the National Health Insurance Act should be construed as either solely based on one’s criminal act due to intention or gross negligence or where the occurrence of an insurance accident is the principal cause.
However, the accident of this case is proper in violation of the plaintiff's negligence and road construction site agent's traffic management guidelines.