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(영문) 울산지방법원 2018.07.05 2018노245
사기
Text

The prosecutor's appeal is dismissed.

Reasons

1. In order to determine whether a patient was hospitalized (misunderstanding of the facts and misapprehension of the legal principle), the determination should be based only on the time of stay in the formal hospitalization, and the determination should be based on the symptoms, diagnosis and treatment of the patient, the details and circumstances of treatment, and the patient’

However, the Defendant was hospitalized in the D convalescent Hospital (hereinafter “instant hospital”) during the period of hospitalization and received medical treatment.

As a result of the fact-finding on the hospital, most of the hospitals provided that there was no record of medical treatment at most of the hospitals, and it was more reasonable for the hospital that the Defendant received medical treatment to treat the hospital at the Ulsan located in the place of residence than the instant hospital, and the Defendant’s frequent outing and outsideing of the hospital was able to have been able to undergo continuous observation or supervision by the medical professionals.

In addition, it is not reasonable to reject the probative value of the results of medical analysis conducted by the Health Insurance Review Evaluation Institute and E Medical Analysis Institute.

Nevertheless, the court below found the defendant not guilty. Thus, the court below erred by misapprehending the facts and misapprehending the legal principles.

2. Judgment on the grounds for appeal

A. The gist of the facts charged lies in: (a) the Defendant, based on the fact that the D convalescent Hospital located in Busan-gun C, was hospitalized in patients with minor injuries or diseases that need not be hospitalized; or (b) was hospitalized for a long time beyond the necessary period of hospitalization; and (c) was able to claim insurance proceeds without receiving normal hospitalized treatment by neglecting illegally going out and going out of the country.

From February 18, 2015 to March 19, 2015, the Defendant was hospitalized in the D convalescent hospital in detail for 30 days, in which he/she was hospitalized in the D convalescent hospital. However, the Defendant did not need hospital treatment due to lack of pain or inconvenience.

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