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(영문) 부산지방법원 2016.05.12 2015구합22289
장기요양급여비용환수처분 취소청구의 소
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. Details of the disposition;

A. The Plaintiff operates a long-term care communal home for older persons, which is a long-term care institution for older persons, which provides home-like residential conditions, meals, medical care, and daily convenience to older persons and facilities that provide long-term care for older persons, such as home, etc. under the Act on Long-Term Care Insurance for Older Persons (hereinafter “Act”) in Busan Dong-gu, Busan.

The defendant is a non-profit special public corporation that manages and operates the long-term care insurance business under the control of the Minister of Health and Welfare pursuant to Article 7 of the Act.

B. The Plaintiff subscribed to liability insurance in preparation for injury, etc. to beneficiaries who may arise in the course of providing visit care and bathing benefits operated by C (hereinafter “house visit benefits”). However, the Plaintiff did not subscribe to liability insurance in preparation for injury, etc. to beneficiaries who could arise in the course of providing weekly and night protection benefits provided by C from December 2, 2011 to November 2014.

C. The head of Dong-gu Busan Metropolitan City Office (hereinafter “Dongdong-gu Office”) and the Defendant conducted a field survey on C from January 12, 2015 to January 15, 2015, and confirmed that the Plaintiff claimed the full amount of long-term care benefits even though he/she claimed for the total amount of the long-term care benefits, by reducing the cost of the insurance coverage period for liability insurance (from December 12, 2011 to November 201, 201).

Accordingly, on May 11, 2015, the Defendant rendered a disposition to recover the cost of long-term care benefits claimed by the Plaintiff in excess of the amount of depreciation (hereinafter “instant disposition”).

[Ground of recognition] Facts without dispute, Gap evidence Nos. 1 through 5 (including, if any, the number; hereinafter the same shall apply), Eul evidence No. 4, the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The plaintiff's assertion 1.

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