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(영문) 대법원 2019.05.30 2017두70359
산재요양급여비용환수처분 취소 등
Text

The appeal is dismissed.

The costs of appeal are assessed against the defendant.

Reasons

The grounds of appeal are examined.

1.(a)

The Industrial Accident Compensation Insurance Act was enacted for the purpose of compensating workers for occupational accidents promptly and fairly, establishing and operating insurance facilities necessary to promote the rehabilitation of workers suffering from occupational accidents and their return to society, and contributing to the protection of workers by carrying out projects to prevent accidents and promote the welfare of workers (Article 1); Article 40(1)); Article 40(1) of the Medical Service Act; Article 43(3) of the Industrial Accident Compensation Insurance Act provides that medical institutions, including medical institutions, designated by the Service, shall be in charge of medical care for workers suffering from occupational accidents (Article 43(1)3); Article 45(1) of the Medical Service Act provides that the Defendant shall pay the medical expenses to the medical institutions that received medical expenses in the form of “any false or other unjust means” (Article 45(1)); Article 45(2) of the Act provides that the Defendant shall collect double the medical expenses.

(Article 84(3)1 of the Medical Service Act was enacted for the purpose of protecting and improving the health of the people by providing for matters necessary for national medical fees so that all citizens can benefit from high-quality medical treatment (Article 1), and stipulates that only a medical institution may be established (Article 33(2)1), such as a doctor, dentist, oriental medical doctor, or midwife (hereinafter “medical person”). Meanwhile, medical personnel are prohibited from establishing and operating two or more medical institutions (the main sentence of Article 33(8)), and medical personnel are restricted from prohibiting the establishment and operation of medical institutions under the name of another medical person (Article 33(8)).

(Article 4(2) and the main sentence of Article 33(8) together with that of each of the instant Medical Service Act (hereinafter “each of the instant provisions”).

As such, the Industrial Accident Compensation Insurance Act provides for the insurance operation for workers' compensation for occupational accidents.

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