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(영문) 대구지방법원 2018.05.25 2017노2194
사기
Text

1. All appeals by the Defendants are dismissed.

2. The applicant for compensation shall dismiss an application for compensation;

Reasons

1. The summary of the grounds for appeal is that the Defendants, as the Defendants were hospitalized with legitimate hospitalization according to the medical judgment of the competent doctor, there is no fact that they acquired insurance money by false hospitalization.

Nevertheless, the judgment of the court below which found the Defendants guilty is erroneous as a matter of fact.

2. Determination

A. In a case where continuous observation by a medical staff is necessary with respect to side effects or incidental effects of a drug with very low resistance to, or is likely to, a patient’s disease, the relevant legal doctrine refers to the patient’s treatment under the observation and management of a medical staff when he/she resides in a hospital for at least six hours in accordance with the following provisions: (a) in a case where the treatment is needed due to the need for continuous management of nutritional conditions and food in-take; (b) in a case where the patient’s pains are in a situation where the patient’s condition is unable to cope with the patient’s condition or where the patient’s risk of infection exists; and (c) in a case where the patient stays in a hospital for at least six hours; and (d) the patient suffers from the treatment under the care and management of the medical staff by comprehensively considering the symptoms and symptoms of his/her stay in the hospital, the patient’s diagnosis and treatment details, the patient’s actions, etc., as well as in a case where the patient’s substance of treatment falls under the hospital treatment rather than the hospital treatment.

The act of claiming insurance money by asserting that the insurance company satisfies the hospitalization period stipulated in the terms and conditions of the insurance contract without notifying the case of a long-term hospitalization more than necessary for the erroneous payment, constitutes deception in fraud (see, e.g., Supreme Court Decision 2007Do2941, Jun. 15, 2007). Moreover, even if there are any grounds for receiving insurance money, it can be actually paid by means of deception.

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