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(영문) 서울중앙지방법원 2014.02.05 2013가단99674
손해배상(기)
Text

1. The Defendant shall pay to the Plaintiff KRW 41,316,902 as well as 20% per annum from April 25, 2013 to the day of full payment.

Reasons

1. The following facts may be acknowledged if there is no dispute between the parties, or if the purport of the entire pleadings is added to each entry in Gap evidence Nos. 1 to 11 (including paper numbers).

The Plaintiff, as a non-life insurance company, concluded each insurance contract with 29 persons, such as B, etc. listed in the attached table of damages (hereinafter “B, etc.”) to pay 80% or 100% of medical expenses when the insured was hospitalized in a hospital, clinic, etc. due to disease during the insurance period.

B. The Defendant is a person who directly takes charge of the overall operation of the hospital, such as treatment, surgery, and issuance of a certificate of release from admission and a written diagnosis to the head of the Dong-gu Seoul Special Metropolitan City, Ansan-si, and directly takes charge of the overall operation of the hospital, or instructs and supervises the employees.

C. The Defendant had been conducting the surgery at the above Council members with Mamomomomo mom, which is the training type removal method of the relevant room, and the method of the surgery does not require continuous observation and treatment of medical professionals after the surgery. As such, the Defendant has also taken measures to ensure the patient’s stability in the hospitalization room or recovery room without any separate treatment, such as medication after the surgery.

According to the "Detailed matters concerning the criteria and methods for the application of medical care benefits" publicly notified by the Ministry of Health and Welfare, the standard for calculating daily admission fees means a case where the maximum time is at least six hours in the "inpatient".

E. The Defendant issued a false certificate of discharge from entry to the Plaintiff on the ground of a false certificate of discharge from entry into a hospital that B et al. received hospital after the surgery at a 3-hour hospital on the same day, but the Defendant: (a) the Plaintiff received a false certificate of discharge from the Plaintiff on the ground that B et al. received a hospital after the surgery; and (b) the Plaintiff claimed insurance money on the ground that B et al. received the false certificate of discharge from the Plaintiff on December 9, 2009; and (c) the Defendant received KRW 1,51,123 from the Plaintiff.

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