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(영문) 인천지방법원 2014.11.21 2014노1622
사기
Text

The defendant's appeal is dismissed.

Reasons

1. Summary of grounds for appeal;

A. There is no fact that the defendant acquired insurance money by deceit as stated in the judgment below.

B. The lower court’s sentence of unreasonable sentencing (7 million won of fine) is too unreasonable.

2. Determination:

A. As to the assertion of mistake of facts, in a case where continuous observation by a medical personnel is necessary with respect to side effects or incidental effects of a patient's disease, where the patient's resistance ability is very low or administered, and the management of the patient's pains and foods needs to be continuously conducted, and thus, the patient's pains and treatment need to be continuously conducted, and where the patient's condition is in a situation where the patient's condition is unable to cope with the patient's disease or where the patient's risk of infection exists, etc., and where the patient stays in the hospital and receives treatment while staying in the hospital for more than 6 hours, according to all the provisions of the "detaileds on the criteria and method for the application of medical care benefits" as the Ministry of Health and Welfare's notice, the patient's act of receiving treatment under the observation and management of the medical personnel while staying in the hospital for more than 6 hours. Thus, it constitutes a case where the patient's sojourn in the hospital, the patient's symptoms, diagnosis and treatment of the patient, and the patient's behavior constitutes an insurance company's act of fraud.

Even if this is the case, it is long-term hospitalization with the intention to acquire a large amount of insurance money than the actual insurance money.

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