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(영문) 서울행정법원 2019.01.31 2018구단71956
미지급보험급여부지급처분취소
Text

1. The Defendant’s disposition to pay unpaid insurance benefits payable to the Plaintiff on July 31, 2018 is revoked.

2. The costs of lawsuit shall be.

Reasons

1. Details of the disposition;

A. The Plaintiff’s husband’s husband B (hereinafter “the deceased”) works as a mining source in C, etc.

After retirement on December 10, 2003, the worker was diagnosed with pneumoconiosis, and on December 15, 2003, from December 15, 2003 to December 20, 2003, the worker was determined as Grade 13 of the pneumoconiosis disability grade by the Defendant on January 20, 204 after receiving the result of the close diagnosis conducted by the Industrial Accident Medical Center D Hospital (hereinafter “D Hospital”).

B. On May 19, 2004, the Deceased died on March 8, 2014 while receiving a decision of approval for medical care from the Defendant after combining active tuberculosis, etc. with pneumoconiosis symptoms.

C. The Plaintiff filed a claim against the Defendant for unpaid insurance benefits (Disability Benefits) in consideration of the result of the precise diagnosis of pneumoconiosis in 2004 and the cardiopulmonary function thereafter. However, on December 7, 2015, the Defendant rendered a claim against the Plaintiff for unpaid insurance benefits (hereinafter “previous disposition”) on the ground that the Plaintiff was dead during the medical care, and thus, the cause for disability benefits was not “where the injury or disease was cured and has a physical disability, etc.” (hereinafter “previous disposition”).

The plaintiff is dissatisfied with the previous disposition and filed a request for examination and reexamination with the defendant, but all of which were dismissed, and again filed an administrative litigation against the previous disposition. The defendant revoked the previous disposition in accordance with the decision of the appellate court's recommendation for mediation of the above administrative litigation, and then paid a disability pension to the worker receiving medical care in accordance with the mediation recommendation and revised business process guidelines, and does not constitute a ground for expiration of the extinctive prescription. The plaintiff is confirmed to fall under class 13 of the disability grade at the time of medical care. The plaintiff is confirmed to fall under class 13 of the disability grade at the time of medical care. The plaintiff is confirmed to have received the lump sum payment of disability falling under class 13 of the disability grade on December 10, 203, and the difference payable does not occur.

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