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(영문) 인천지방법원 2014.10.29 2013가단229841
부당이득금
Text

1. The Defendant’s KRW 13,450,210 for the Plaintiff and KRW 5% per annum from May 16, 2013 to October 8, 2013, respectively.

Reasons

1. Basic facts

A. A, while working as an employee of “B,” caused an industrial accident that occurred within the workplace on March 14, 2010, resulting in the outbreak of cerebral cerebral Bribery.

(hereinafter “instant accident”). (b)

A due to the instant accident, a medical care institution, such as C Hospital, D Hospital, etc., was provided medical treatment from March 14, 2010 to December 1, 2010.

C. The Plaintiff, as an insurer of the health insurance, paid 43,578,410 won of the Corporation’s charges, excluding the statutory principal charges of KRW 9,092,60,010 paid by A, out of the total medical expenses incurred from the above medical treatment of the insured, as the health insurance policyholder, to the health care institution.

On the other hand, A applied for bereaved family benefits for the instant accident to the Defendant, but the Defendant did not approve A’s above medical care benefit application on October 1, 2010.

Accordingly, A filed a lawsuit against the defendant to revoke the revocation of the revocation of the approval for the medical care as Seoul Administrative Court 201Gudan990, and on October 26, 2011, upon receiving the above court's dismissal decision, A appealed as Seoul High Court 201Nu40150 and was sentenced to the above court on December 12, 2012 to revoke the above disposition for the revocation of the approval for the medical care payment on October 1, 2010, and the above judgment became final and conclusive on May 9, 2013.

Accordingly, on May 15, 2013, the Defendant approved the instant accident as an industrial accident under the Industrial Accident Compensation Insurance Act (hereinafter “Industrial Accident Insurance Act”).

E. On August 7, 2013, the Plaintiff filed a claim for the settlement of the cost of medical care benefits with respect to A’s medical expenses due to the instant accident. The Defendant rejected payment on the ground that: (a) the Plaintiff paid only the amount incurred within three years retroactively from August 7, 2013, the filing date of the claim; and (b) KRW 13,450,210 corresponding to the medical treatment portion from April 23, 2010 to August 6, 2010, which was incurred after January 27, 2010, the Industrial Accident Insurance Act was amended by Act No. 9988, and the three-year extinctive prescription has lapsed.

Accordingly, the Plaintiff brought the instant lawsuit on October 2, 2013.

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