1. The Defendant’s KRW 55,419,668 as well as the Plaintiff’s annual rate from December 4, 2012 to November 27, 2014, and the following.

Basic Facts

The Plaintiff is an educational foundation that operates Yangyang University Hospital, which is a medical care institution under Article 40(1)1 of the former National Health Insurance Act (amended by Act No. 9386, Jan. 30, 2009; Act No. 9690, Jan. 21, 2009; Act No. 11141, Dec. 31, 201; hereinafter “former Health Insurance Act”) and Article 42(1)1 of the current National Health Insurance Act (hereinafter “Health Insurance Act”).

The defendant is an insurer of the health insurance established under Chapter III of the Health Insurance Act, and the Health Insurance Review and Assessment Service (hereinafter referred to as the "Review and Assessment Service") is a corporation established under Article 55 of the former Health Insurance Act and Article 62 of the Health Insurance Act in order to examine health care benefit and evaluate

Under the Health Insurance Act, the subject of the health insurance program consists of the defendant (management of insurance benefits, payment of insurance benefit costs, imposition and collection of dues), health care institutions, which are medical suppliers (medical institutions established under the Medical Service Act and medical care institutions separated from pharmacies established under the Pharmaceutical Affairs Act, and medical care institutions which are designated under the Health Insurance Act) and three-dimensional relationships between the insured (beneficiary).

The procedures for paying medical care benefit costs under the Health Insurance Act shall be as follows:

(1) An account holder shall, after receiving medical care from a medical care institution, request the Review and Assessment Service to review medical care benefit costs.

② The Review and Assessment Service shall examine whether the claimed details meet the standards of “Rules on the Standards for Medical Care Benefits under National Health Insurance” enacted pursuant to Article 39(2) and (3) of the former Health Insurance Act and Article 41(2) and (3) of the Health Insurance Act and “detailed matters on the standards for and methods of medical care” publicly notified by the Minister of Health and Welfare (hereinafter collectively referred to as “standards for Medical Care Benefits”).