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(영문) 서울고등법원 2016.11.04 2016누47767
반송처분 등 취소
Text

The plaintiff's appeal is dismissed.

Expenses for appeal shall be borne by the plaintiff.

Purport of claim and appeal

The judgment of the first instance.

Reasons

1. The summary of the case and the facts premised on the case

A. The summary of the case is that the Plaintiff filed a request for review of medical care benefit costs to the insured by the National Health Insurance Act (hereinafter “Insurance Corporation”) and filed a request for review to provide the Defendant with the medical care benefits covered by the comprehensive water system while claiming review of the medical care benefit costs, and accordingly, received a disposition to collect unjust enrichment (transfer) based on Article 57 of the National Health Insurance Act on the ground that all of the medical care benefits received from the National Health Insurance Corporation (hereinafter “Insurance Corporation”) according to the review results constituted the medical care benefits received by fraudulent or other unjust means, and accordingly, filed a request for review of the medical care benefits benefits corresponding to the Defendant on the ground that the amount of the medical care benefits benefits paid by the Plaintiff should be paid to the insured by the method of medical care act provided by the Plaintiff among the medical care benefits benefits returned to the Insurance Corporation. Thus, the Defendant filed a request for review of whether the request for review satisfies the criteria for review of the medical care benefits benefits and notified the Insurance Corporation and the medical care institutions of the details thereof without the request for review of the Plaintiff’

The judgment of the first instance rejected the plaintiff's claim on the ground that the plaintiff's claim is unlawful, since the return of the plaintiff's request for review of medical care benefit costs and the notification of insolvency are not a disposition subject to appeal litigation.

[Attachment 2] The relevant statutes are as shown in [Attachment 2]

B. Presumed factual basis 【Evidence 【A’ 1-6, A7-1-28, A8, A9-1-6, A10-1-37, A11, 12, 13, 14, B-1, and the purport of the entire pleadings (i.e., correction of Sungnam-si).

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