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(영문) 서울남부지방법원 2017.05.12 2016노1022
사기
Text

The defendant's appeal is dismissed.

Reasons

1. The summary of the grounds for appeal (misunderstanding of the facts) as to whether the Defendant’s situation is sufficient to provide hospital treatment solely with the outpatient treatment is not determined by a doctor, and the Defendant does not actually determine whether the Defendant has received hospital treatment and claimed insurance proceeds for the part that received hospital treatment according to the doctor’s instructions. As such, it does not constitute deceiving an insurance company and by deceiving the insurance company.

2. Determination

A. “Hospitalization” means a patient’s constant observation and treatment while staying in a hospital for more than 6 hours pursuant to the following provisions: (a) in a case where continuous observation of medical personnel is necessary with respect to side effects or incidental effects of drugs low or administered; (b) nutrition conditions and food needs to be continuously administered; and (c) in a case where the patient’s pains and treatment are in a situation where the patient’s condition is unable to cope with pain or where the patient’s risk of infection exists; and (d) the patient suffers treatment while staying in the hospital; and (e) the patient’s observation and management cannot be determined based on the period of stay in the hospital; and (e) the patient’s symptoms, diagnosis and treatment process; and (e) the patient’s behavior should be determined based on the patient’s symptoms and treatment; and (e) the patient’s treatment need to be duly conducted without considering the evidence duly admitted by the court below, other than the examination and examination of the patient’s symptoms and the patient’s actions (see Supreme Court Decision 208Do4665, May 28, 2009).

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