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The defendant's appeal is dismissed.
Reasons
1. The summary of the grounds for appeal (misunderstanding of facts) of this case, there was a need for hospitalization in light of the diagnosis and the details of surgery against the defendant, and the defendant was not hospitalized in the hospital of this case as being actually hospitalized and received treatment, but was not falsely hospitalized, and at the time there was no intention to defraud the defendant.
However, the court below erred by misapprehending the facts and adversely affecting the conclusion of the judgment.
2. Judgment on the grounds for appeal by the defendant
A. The relevant legal doctrine 1) In a case where continuous observation by a medical personnel is required in relation to the side effects or incidental effects of the patient's low resistance ability or the drugs that are administered by him/her, where the management of nutritional conditions and food intake needs to be continuously conducted, and where the patient's pains are causing inconvenience to medical treatment, the patient is under the patient's stay in the hospital and undergo medical treatment, such as where the patient's condition is in a state of being unable to cope with the pain or where the patient's risk of infection exists.
Whether hospitalization is necessary ought to be determined by comprehensively taking account of the patient’s symptoms, the details and circumstances of the diagnosis and treatment, the patient’s behavior, etc. (see, e.g., Supreme Court Decisions 2004Do6557, Jan. 12, 2006; 2007Do2941, Jun. 15, 2007; 2014Do5903, Mar. 15, 2017). Meanwhile, the patient was in the form of receiving treatment by allocating a fixed sick room after undergoing continuous hospitalization and then staying in the hospital for at least six hours.
Even if the time of actual treatment is limited to part, and the patient remains in the hospital without any observation or supervision of the medical personnel during the remaining hours, and if the content or purpose of the treatment received by the patient can sufficiently be achieved due to the outpatient treatment, it shall be deemed as not the hospital treatment but the hospital treatment.
2) The reasons for the payment of insurance proceeds.