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(영문) 서울행정법원 2019.11.14 2019구단10217
산업재해보상보험 요양급여신청불승인처분취소
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. Details of the disposition;

A. On January 1, 2018, the Plaintiff entered a company B (hereinafter “instant company”) and worked on January 1, 2018, and filed an application for medical care benefits with the Defendant on June 22, 2018, by asserting that the hospital was diagnosed “the instant accident” in the hospital located in the south cycle in C to walk around the crosswalk (hereinafter “instant accident”) in order to work at work at around 08:15 on January 23, 2018.

B. On July 26, 2018, the Defendant issued a disposition of medical care benefit payment (hereinafter “instant disposition”) to the Plaintiff on the ground that “(i) the Plaintiff’s work beyond the fence is not based on a reasonable method that is generally accepted by social norms, but exceeds the fence to the facility security protection area, constitutes an illegal act and constitutes a deviation from or suspension of the moving route during the work; and (ii) the instant injury is not recognized as a proximate causal relation with the instant accident.”

C. The Plaintiff filed a request for examination against the Defendant on December 6, 2018, but the request for examination was dismissed, and the request for reexamination was again filed with the Industrial Accident Compensation Insurance Reexamination Committee on May 23, 2019, but the request for reexamination was dismissed.

[Ground of recognition] Facts without dispute, entry of Gap evidence 1 to 4, purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The Plaintiff’s assertion: (a) on July 6, 2018 and July 10, 2018, the Plaintiff submitted medical records and video data from E Hospital and D Hospital to the Defendant; and (b) on June 29, 2018, the instant disposition stated that the Defendant’s advisory advice was given on June 29, 2018; (c) the false content is written in the instant disposition; and (d) even if the said advisory advice was given on June 29, 2018, it was conducted without examining the data submitted by the Plaintiff on July 6, 2018 and July 10, 2018.

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