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(영문) 전주지방법원 2018.07.11 2017구단220
요양급여승인취소처분 취소
Text

1. The “the first revocation of the approval of medical care benefits” and the “the amount of insurance benefits” that the Defendant rendered to the Plaintiff on February 11, 2016.

Reasons

1. 당사자 사이에 다툼이 없는 기초사실(☞ 이 사건 쟁송의 배경)

A. On August 26, 2015, the Plaintiff was receiving medical care benefits and temporary layoff benefits from the Defendant on September 11, 2015, by submitting to the Defendant an application for the payment of the amount of the medical care suspension benefits on September 11, 2015, when the Plaintiff was able to receive the medical care benefits and temporary layoff benefits from the Defendant, as well as on September 11, 2015, which is adequate and fall in the “C field” as the wind, which was crashed by the limited liability company B (hereinafter “B”).

B. After that, on December 21, 2015, the Plaintiff submitted a written claim for the difference of average wages and temporary layoff benefits to the Defendant, and the Defendant rendered a decision to revoke the approval of first medical care benefits for the Plaintiff on February 11, 2016, as well as jointly and severally with the Plaintiff’s representative, to determine the amount of KRW 36,369,920, which is the double amount of the insurance benefits already received, even though the Plaintiff was not a worker B at the time of the instant accident, in the course of handling the duties following the application.

C. As a result, on December 2, 2016, the Industrial Accident Compensation Insurance Reexamination Committee rejected the Plaintiff’s request for reexamination on the part on the revocation of the Plaintiff’s initial approval of medical care benefits. On February 11, 2016, the Defendant rendered a ruling to collect only the amount of insurance benefits already paid to the Plaintiff as unjust enrichment (hereinafter referred to as “instant disposition”), by partially revoking (a) the part on “decision to collect unjust enrichment” against the Plaintiff on February 11, 2016.

2. Determination on the legitimacy of the instant disposition

A. The Defendant initially determined the Plaintiff as a worker B, and paid the Plaintiff’s medical care suspension benefits, but was not a worker, part of the instant accident site.

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