1. The plaintiff's claim is dismissed.

2. The costs of lawsuit shall be borne by the Plaintiff.

Details of the disposition

The Plaintiff operates the Nuridong Center (hereinafter referred to as the “instant institution”) that provides visiting care and bathing services in accordance with the Yellow-gu Busan Special Metropolitan City Order 9,701 (Mocheon-dong). The instant institution was designated as a long-term care institution on April 20, 2015 pursuant to Article 31 of the Long-Term Care Insurance Act and Article 23(3) of the Enforcement Rule of the same Act.

From Jun. 12, 2017 to Apr. 15, 2017, the Busan District Office conducted a field investigation on all the items of long-term care benefits of the instant institution from Nov. 2, 2015 to Apr. 2017. As a result, the Busan District Office determined that the Plaintiff unduly claimed KRW 177,930 for visiting care, including ① service days and frequency increase, ② KRW 877,930, ② KRW 1,508,280, ③ even if the Plaintiff did not provide services during the period of non-life liability insurance, ③ KRW 334,360, ④ violation of the criteria for additional placement of human resources, ④ KRW 18,140,30, ⑤ other visiting bathing, and KRW 173,560, respectively.

Among the unfair claims for visiting medical care made by the Plaintiff, the details on the violation of reduction in the period of subscription to liability insurance and the violation of additional placement standards for human resources are as follows.

A violation of the term of non-life liability insurance policy was not covered by each liability insurance policy from September 19, 2016 to November 1, 2016; C from December 7, 2016 to December 14, 2016; D from December 7, 2016 to January 5, 2017; E from August 26, 2016 to September 3, 2016; and F from June 3, 2016 to July 28, 2017 to June 16, 2016 to July 3, 2016; and from November 28, 2016 to December 31, 2017 to December 31, 2017; and from September 26, 2016 to July 3, 2016 to 30, 2017; and