1. The Defendant’s disposition of restitution of KRW 11,908,310 against the Plaintiff on August 9, 2018 is revoked.

2...

1. Details of the disposition;

A. On November 26, 2017, at around 05:00, the Plaintiff suffered from the injury, such as other two inner damage, etc. (hereinafter “the injury in this case”), where the head part of D was put in front of the “C Union fish control point” located in Kimhae-si, Kim (hereinafter “C Union fish control point”), and where the head part of D was put in front of the “D”) one time, and immediately after the Plaintiff was put in front of the D’s head part of D and E with each other, the Plaintiff suffered from the injury of D’s head one time from E, and the head was put in back on the floor, and there was no other two inner parts in need of approximately eight weeks of treatment (hereinafter “instant injury”).

B. At the time, the Plaintiff maintained the eligibility of the self-employed insured under the National Basic Living Security Act (the Plaintiff is currently a beneficiary of medical benefits under the National Basic Living Security Act), and received insurance benefits from the Defendant in receiving medical treatment for the instant injury.

C. On August 9, 2018, the Defendant: (a) determined that the Plaintiff’s injury was caused by a bilateral assault accident that occurred in the course of exercising mutual violence by the Plaintiff, D, and E, and thus constitutes a ground for restriction on benefits under Article 53(1)1 of the National Health Insurance Act; and (b) determined that the Plaintiff collected KRW 11,908,310 as unjust enrichment pursuant to the aforementioned provision and Article 57 of the National Health Insurance Act, and notified the Plaintiff thereof.

(hereinafter “instant disposition”) D.

The Plaintiff filed an objection to the instant disposition with the Health Insurance Objection Committee. However, the Health Insurance Objection Committee dismissed the Plaintiff’s objection on January 18, 2019 on the ground that “an accident caused by double assault constitutes a cause for restricting benefits under Article 53(1) of the National Health Insurance Act, regardless of the severity of damage or agreement, etc., and whether to compensate for and punish the injury.”

[Reasons for Recognition] Facts without dispute, Gap evidence 1, 2, Eul evidence 1 and 8 (including branch numbers; hereinafter the same shall apply), the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. Article 53 of the National Health Insurance Act provides a summary of the Plaintiff’s assertion.