[1] A person who is obligated to collect unjust enrichment and a joint and several payment obligor under Article 52 of the National Health Insurance Act

[2] The case holding that even if a doctor took an excessive place outside of Korea, the disposition on the recovery of medical care benefit costs is null and void as it is not a person liable for the collection of unjust enrichment under Article 52 of the National Health Insurance Act or a person jointly and severally liable for payment

[1] Article 52 (1) and (2) of the National Health Insurance Act / [2] Article 52 (1) and (2) of the National Health Insurance Act

Plaintiff (Attorney Jeon Soo-hee et al., Counsel for the plaintiff-appellant)

National Health Insurance Corporation (Attorney Kim Han-soo, Counsel for defendant-appellant)

Health Review Service

Seoul High Court Decision 2005Nu16880 delivered on March 29, 2006

The appeal is dismissed. The costs of appeal are assessed against the defendant.

The grounds of appeal are examined (to the extent of supplement in case of supplemental appellate briefs not timely filed).

In order for a defective administrative disposition to be null and void as a matter of course, it must be objectively obvious that the defect has violated an important part of the law and objectively, and in determining whether the defect is significant and obvious, the purpose, meaning, function, etc. of the law should be examined from a teleological perspective, and at the same time, reasonable consideration should be made on the specificity of the specific case itself (see, e.g., Supreme Court en banc Decision 94Nu4615, Jul. 11, 1995; Supreme Court Decision 95Da46722, May 9, 197; Supreme Court Decision 2002Da68485, Oct. 15, 2004).

Meanwhile, a person liable to collect unjust enrichment under Article 52 (1) of the National Health Insurance Act shall be the "person who has received the insurance benefits" or "medical care institution that has received the insurance benefits costs" by deceit or other unjust methods: Provided, That in cases where the defendant collects all or part of the amount equivalent to the benefits or the insurance benefits costs from a person who has received the insurance benefits by deceit or other unjust methods or a medical care institution that has received the insurance benefits costs in accordance with Article 52 (1) of the same Act, if the employer or the policyholder makes a false report or certification, or the insurance benefits have been provided by a false diagnosis of the medical care institution, he/she may be jointly and severally liable to pay the relevant employer, the insured or the medical care institution with the person who has

However, in the case of this case, even if the plaintiff increased the defendant's expense expenditure by excessive treatment, the plaintiff himself did not receive insurance benefit costs, and it is difficult to view that the medical care institution that received insurance benefit costs such as pharmacies's pharmacy with respect to excessive treatment does not directly receive insurance benefit costs by deceit or other improper means, and it is difficult to view that the person who received the insurance benefit bears the duty of collecting unjust enrichment under Article 52 (1) of the above Act for the same reason. It is difficult to view that the plaintiff's excessive treatment of the insurance benefit was conducted with false diagnosis, and therefore it is difficult to view that the defendant is jointly and severally liable with the person who received the insurance benefit pursuant to Article 52 (2) of the above Act, and that the defendant is not liable for collecting the above insurance benefit from the plaintiff's medical care benefit in light of the fact that the plaintiff's excessive treatment of the insurance benefit in this case is obviously and clearly different from the above provision of the insurance benefit in this case.

The judgment of the court below to the same purport is just and acceptable, and there is no error in the misapprehension of legal principles as alleged in the grounds of appeal.

Therefore, the appeal is dismissed, and the costs of appeal are assessed against the losing party. It is so decided as per Disposition by the assent of all participating Justices on the bench.

Justices Kim Nung-hwan (Presiding Justice)