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(영문) 서울행정법원 2018.06.22 2018구단53521
요양승인취소처분 및 부당이득금반환처분취소
Text

1. The Defendant’s disposition of collecting unjust enrichment against the Plaintiff on June 14, 2017 is revoked.

2. The plaintiff's remainder.

Reasons

1. Details of the disposition;

A. On May 27, 2015, the Plaintiff contracted for the construction of a wooden building located in Gyeonggi-gun B (hereinafter “instant construction”) from the Dlim Site Korea Co., Ltd., and performed the construction work.

B. C took part in hand while putting waste timber materials at the construction site of this case on July 31, 2015.

(hereinafter referred to as “instant disaster”). C.

C filed an application with the Defendant for medical care benefits by asserting that “A while working as a daily worker at the construction site of this case as a worker,” the Defendant, on September 9, 2015, issued a disposition to grant medical care approval on the premise that C is the Plaintiff’s employee, and paid C the aggregate of KRW 19,380,810,000 for medical care benefits, temporary disability benefits, and lump sum disability benefits.

Since then, as a result of re-audit of the instant accident, the Defendant determined that C received insurance benefits by fraudulent or other unlawful means, such as submitting a false labor contract and a statement of payment of labor expenses, even though C is not a worker employed on a daily basis. On June 14, 2017, the Defendant revoked the above medical care approval disposition, and notified the Plaintiff of the decision to collect KRW 38,761,620, an amount equal to the total amount of the insurance benefits already paid, as unjust enrichment (hereinafter “instant disposition”).

E. The Plaintiff filed a petition for review against the instant disposition, but was dismissed on December 28, 2017.

[Ground of recognition] Facts without dispute, Gap evidence 1, 2, 4, Eul evidence 10, the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The Plaintiff’s assertion 1) C had been affected by the instant disaster while performing the business of treating waste timber materials as a daily worker at the construction site of this case. As such, C cannot be deemed to have filed a false report on whether or not the Plaintiff was an employee. Even if there was an objective false report, the Plaintiff’s subjective perception of receiving insurance benefits by fraud or other improper means.

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