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(영문) 울산지방법원 2018.02.20 2016고정800
사기
Text

The defendant shall be innocent.

Reasons

1. The summary of the facts charged in the instant case is that the Defendant, in Busan-gun C, committed the act of receiving insurance proceeds by taking advantage of the following: (a) the Defendant: (b) hospitalized the patients with minor injuries or diseases that need not be hospitalized; (c) was hospitalized for a long time after the patient was actually required for hospitalized treatment; and (d) was hospitalized for a long time when the patient was placed outside of the country and was able to claim insurance proceeds even without receiving normal hospitalized treatment by neglecting outside of the country.

From February 18, 2015 to March 19, 2015, the Defendant was hospitalized at the instant hospital as a finite of a 30-day basin, in which detail was unclear, from February 18, 2015, and from March 19, 2015, the Defendant received from the instant hospital, but did not need hospital treatment due to lack of pain or inconvenience. The Defendant received a certificate of discharge and a receipt of discharge as if he had undergone hospital treatment within the said period even if he had not undergone hospital treatment due to frequent out-of-door and out-of-door gambling, and acquired the insurance proceeds from Samsung Life by obtaining a certificate of discharge and a receipt of discharge as if he had undergone normal hospitalized treatment, and by taking delivery of KRW 17,575,519 in total, as indicated in the list of crimes in the attached Table.

2. Determination:

A. “Hospitalization” refers to where continuous observation by a medical personnel is necessary with respect to side effects or incidental effects of a patient’s disease which are very low resistance or are administered, where management of nutritional conditions and food and drinks is needed, and it is necessary to continuously take care of drugs, so that the patient’s pain may cause more inconvenience to medical treatment, or where the patient’s condition is unable to cope with the patient’s disease or where the patient’s risk of infection exists, etc., while staying in the hospital, the patient’s medical personnel’s observation and management is conducted while staying in the hospital for more than 6 hours pursuant to all the relevant provisions, including “detaileds on the criteria and methods for the application of the medical care benefits,” which are published by the Ministry of Health and Welfare.

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