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(영문) 광주지방법원 2013.04.24 2012노2234
사기
Text

All appeals by the Defendants and the Prosecutor are dismissed.

Reasons

1. Summary of grounds for appeal;

A. Defendants 1) misunderstanding of facts or misunderstanding of legal principles as to the Defendants’ fraud portion (A) ① The Defendants did not issue a false written confirmation of hospitalization inasmuch as the patients received substantive hospitalized treatment.

② Defendants did not intend to acquire insurance proceeds in collusion with patients.

③ The Defendants, even if involved in insurance fraud.

Even aiding and abetting is nothing more than aiding and abetting.

2) Defendant B’s violation of the Medical Service Act: (a) there is no error of fact-finding that the Defendant issued a written confirmation of medical treatment; and (b) the adjuster seizes the written confirmation of medical treatment.

B) No misapprehension of the legal principle is subject to regulation of the Medical Service Act, and even if the defendant prepared and issued a written confirmation of medical treatment under the name of the defendant A, it is not a violation of the Medical Service Act. 3) Each sentence of the lower court’s judgment on unreasonable sentencing (fine 10 million won) is too unreasonable.

B. The above punishment of the lower court against the Defendants by the prosecutor is too unhued and unreasonable.

2. Judgment on the misunderstanding of facts or misapprehension of legal principles by the Defendants

A. As to the Defendants’ assertion that the “inpatient” constitutes “inpatient” as to the Defendants’ fraud, where continuous observation by a medical personnel is necessary with respect to side effects or incidental effects of drugs which are very low or invested in the patient’s disease, the term “inpatient” means a case where the management of drugs and drinking foods is necessary, and where the patient’s pain treatment is continuously required, and the patient’s pain treatment is in a situation where the patient’s condition is unable to cope with the pain or where the patient’s risk of infection exists, etc., and where the patient stays in the hospital and takes medical treatment is under the observation and management of the medical personnel when the patient stays in the hospital for at least six hours pursuant to all the provisions, such as “detaileds on the criteria and methods for applying medical care benefits” publicly notified by the Ministry of Health and Welfare.

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