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(영문) 대구지방법원의성지원 2020.07.07 2019가합10131
손해배상(기)
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. The gist of the Plaintiff’s assertion was that the Plaintiff, a company running a general non-life insurance business, concluded respectively with policy holders of C, etc., and the insured, who received hospitalization or outpatient treatment due to disease or injury, and entered into an indemnity medical insurance contract that compensates for lost medical expenses and daily allowances for hospitalized illness, such as the cost of hospitalization and outpatient treatment actually borne by them.

However, the insured under the above contract (hereinafter “insureds of this case”) did not require hospital treatment, such as frequent outing and staying outside during the period of hospitalization at a D hospital operated by the Defendant, but, as if they were normally hospitalized in the above hospital, he received false medical records from the physician affiliated with the Defendant, and claimed insurance money based on such records, and received insurance money from the Plaintiff as illegal for reasons of loss and medical expenses, etc.

Although the Defendant’s intent to be employed by the Defendant prepared a record of duty consistent with the facts, as if the instant insured had been hospitalized due to frequent out-of-the-door and out-of-door gambling, he/she conspired or she aided and abetted such unlawful act with the instant insured by preparing a false confirmation of entry and discharge.

Therefore, the Defendant is liable for joint tort liability with the insured in accordance with Articles 756 and 760 of the Civil Act. As such, the Plaintiff, as the instant lawsuit, seek against the Defendant for the payment of KRW 210,000,000, which is a part of the damages equivalent to the actual medical insurance money paid by the Plaintiff to the insured in accordance with the false medical record from August 2015 to February 2019, as well as damages for delay.

2. The evidence presented by the Plaintiff alone prepared false medical records, such as false certificates of hospitalization and discharge, against the insured of this case, for which the Defendant’s affiliated physician did not need hospitalized treatment, as alleged by the Plaintiff.

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